GOP joins health care fray

GOP joins health care fray

It took seven years, but House Republicans finally released their alternative to the landmark Affordable Care Act.

It took seven years, but House Republicans finally released their alternative to the landmark Affordable Care Act. The replacement plan – dubbed the American Health Care Act (AHCA) – aims to shift resources from Americans who are poor and sick to those who are comparably better off. As Alan Fram and Ricardo Alonso-Zaldivar of the AP detail, the new plan would be costlier for low-income individuals, while covering less people and providing a massive tax cut to the wealthiest Americans.

It would replace income-based subsidies the law provides to help millions of Americans pay premiums with age-based tax credits that may be skimpier for people with low incomes. Those payments would phase out for higher-earning people. In perhaps their riskiest political gamble, the plan is expected to cover fewer than the 20 million people insured under Obama’s overhaul, including many residents of states carried by President Donald Trump in November’s election.

A few other significant items worth noting:

  • The House GOP plan would effectively eliminate the Medicaid expansion that brought health coverage to 405,000 Louisianans. Four Republican Senators wrote a letter in strong opposition to the elimination of the Medicaid expansion included in the House plan.
  • It would fundamentally transform the character of the Medicaid program by imposing a per-capita funding cap that would cut $370 billion in federal funding to states over the next decade. The change would likely mean deep cuts to eligibility, benefits and provider payments, with those cuts growing more severe each year.
  • Tax credits to help people afford insurance in the individual market would be be less generous– in most cases- for those with the least. This not only makes coverage less accessible but also threatens to destabilize the individual market as healthy people drop out because they can’t afford coverage.

Writing for The Upshot blog, The New York Times’ Margot Sanger-Katz explains the Medicaid changes:

Instead of paying a set percentage of medical bills, the new system would instead hand states a flat payment for each person who is signed up. And the amount states would get for the people signed up under the Obamacare expansion would be substantially reduced, by more than a third in some states, except in the case of people who stay continuously enrolled in Medicaid, a somewhat rare circumstance in a program in which people tend to cycle in and out of eligibility as their incomes change. States will retain the option of eliminating coverage for the Obamacare expansion population, and many may do so if their federal funding is cut and they can’t make up the difference.

LBP’s initial reaction to the plan is here, with more detailed analysis to follow.


Medicaid myths

The Medicaid program provides many proven benefits: Better mental health outcomes, less financial strain, better reported health and increased health care access. Yet some lawmakers believe that Medicaid discourages people from seeking jobs, despite the fact that 87 percent of beneficiaries are working, in school, looking for work or in ill-health. Writing for the Health Affairs blog, Leighton Ku and Erin Brantley attempt to correct some Medicaid myths as Congress considers significant cuts to the program:

Low-wage workers are often not offered health insurance at work or are offered plans that are too expensive or too skimpy. Most of the low-wage jobs that Medicaid recipients could obtain do not provide health insurance. Only 28 percent of employees of private firms with low average wages (e.g., retail, food service, agriculture) get health insurance through their jobs. Almost half of employees (42 percent) of these firms are not even eligible for job-based health insurance, according to the 2014 Medical Expenditure Panel Survey.


Benefits of trade with Cuba

With Louisiana’s economy still in recovery mode, capitalizing on the loosening of trade restrictions with Cuba could be a much-needed shot in the arm. As Louisiana’s Commissioner of Agriculture and Forestry, Mike Strain, explains our state has much to gain from exporting its goods to Cuba. The Advocate’s Rebekah Allen has more:

Strain spoke Monday to the Press Club of Baton Rouge about the economic potential of loosening trade restrictions with Cuba. He noted that from 2006 to 2015, Louisiana has led the nation in trade with Cuba, exporting $1.4 billion worth of goods, despite a decades-long U.S. economic embargo that severely restricts exports to Cuba.


Housing assistance may be on federal chopping block

Federal housing vouchers can help citizens put a roof above their families and promote social mobility. However, because of cuts expected when the White House releases its federal budget proposal, these opportunities may soon be out of reach. James Oliphant has the story for Reuters:

But the housing assistance provided by the U.S. Department of Housing and Urban Development, or HUD, could fall victim to fiscal policies under consideration by the White House and Congress, which include a massive tax cut and increased military spending, according to a dozen congressional aides who spoke to Reuters. While the White House has not been specific about its plans for HUD – the budget process remains in flux – it has called for a $54 billion cut in non-military discretionary domestic programs in the next fiscal year, which likely will dramatically impact safety-net programs that are not entitlements such as Medicare and Social Security, budget experts said.


Number of the Day

$370 billion – Amount of Medicaid costs shifted to states over the next ten years if House GOP health plan enacted. (Source: Center on Budget and Policy Priorities)