President Donald Trump promised to “make health insurance available to everyone” and to “expand choice, increase access, lower costs and, at the same time, provide better health care.” The new House bill, the American Health Care Act (AHCA), violates these promises – and would result in millions of people losing coverage and higher premiums and out-of-pocket costs for many who remain insured. It would not only effectively end the Affordable Care Act’s Medicaid expansion but go further by capping Medicaid and shifting costs to states, hurting local economies and putting quality coverage for seniors, people with disabilities and families with kids at risk. The House committee markup will begin without analysis from the Congressional Budget Office. Vox’s Ezra Klein takes a stab at what an eventual CBO score would look like:
My guess is it will say this: The GOP plan will lead to significant declines in coverage ([Brookings Institution health policy expert] Loren Adler estimates an eye-popping 15 to 20 million people will lose insurance) as well as accelerating the exhaustion of the Medicare trust fund due to the tax cuts. After years of Republicans complaining that co-pays and deductibles were too high in Obamacare, co-pays and deductibles will be significantly higher under their replacement. The plan will significantly reduce taxes on the rich.
Andy Slavitt, the former administrator of Medicare and Medicaid, writes about the impact of the Medicaid cuts in The Washington Post:
More draconian is a permanent capping of the Medicaid program. In my time overseeing the government agency that runs the program, we dealt with many unexpected shocks — Zika, high-cost drugs and the national opioid epidemic, to name a few. Under the changes sought by Republicans, states would no longer have the resources to manage these crises, with devastating results for our communities. Medicaid pays for nearly half the births and half the long-term care in this country, to say nothing of the millions of Americans with disabilities who rely on it. If the federal government retreats on its commitment to Medicaid, the repercussions will be felt quickly – by our neighbors and by our care providers and hospitals.
Other useful analyses include Vox explainers on: the AHCA’s elimination of the Public Health Prevention Fund, the AHCA’s impact on efforts to fight the opioid epidemic, the American Hospital Association’s disapproval of the bill and the AHCA as tax cut for the wealthy. Jeanne Lambrew and Ellen Montz of The Century Foundation provide commentary on implications for the individual health market.
Under the House bill, premium tax credits would not vary with income. This is a change estimated by a former Republican presidential candidate advisor to “price many poor and vulnerable people out of the health insurance market.”
Closer to home, Gov. John Bel Edwards told The Advocate’s Elizabeth Crisp that the bill fails “a critical test” by undoing the expansion of Medicaid that has seen more than 405,000 low-income Louisianans gain coverage since July.
Board of Elementary and Secondary Education meets
The state Board of Elementary and Secondary Education (BESE) met Tuesday and adopted a funding formula for public schools that does not include an adjustment for increased costs due to inflation. BESE’s proposal is in line with what Gov. John Bel Edwards presented in his executive budget. The Associated Press has more:
The Board of Elementary and Secondary Education on Tuesday backed a recommendation for a $3.7 billion financing formula for the 2017-18 school year that would freeze the amount of money doled out per student. The proposal would include $18 million in new money for higher-need students and dual enrollment programs that help students earn credit toward advanced degrees. The formula’s price tag also would rise by another $18 million, to account for increased student enrollment.
The Brookings Institution’s Mark Dynarski recently wrote about the importance of long-term adequate school financing:
Two recent studies concluded that changes in spending induced by state education finance reforms improved outcomes such as test scores, high school graduation, and earnings. On the surface, reforming a state’s education finance system sends more money to low-income schools, which is what (short-term) SIG (School Improvement Grants) did without success. But finance reforms are long-lasting, and low-income districts and schools can invest in improvements knowing that their funding is higher for the foreseeable future.
BESE also reviewed a report to the House and Senate education committees on public school fees assessed on lockers, parking spaces, school IDs, physical education uniforms, technology and more. Corey Mitchell writes for Education Week that the fees add up quickly for families struggling to make ends meet.
The online survey of Louisiana school districts and charter schools, in which 99 percent of local education agencies responded, found that all schools charged students for something, with the costs ranging from $95 for school supplies to $10 for locker fees. Some districts charge fees for parking, registration, and student identification cards…”The assessment of fees to students attending public schools should be addressed with extreme caution in order to provide all students with equitable access to a quality education, particularly in a state whose student body is 71.3 percent economically disadvantaged,” the report concludes.
Number of the Day
$370 billion – Amount of Medicaid costs shifted to states over the next ten years if House GOP health plan enacted. Note: this is an update to yesterday’s Number of the Day based on additional analysis of House bill. (Source: Center on Budget and Policy Priorities)