The official numbers are out from the Congressional Budget Office, and the U.S. Senate’s “healthcare” bill is just as bad as the one approved by the House. The Senate bill made only minor changes to the House-passed American Health Care Act, and the CBO score reflected that: 22 million fewer people would have health coverage in 2026 compared to current law, including 15 million who would lose Medicaid coverage. The Center on Budget and Policy Priorities’ Edwin Park explains what it all means:
This means that, by 2026, the historic coverage gains achieved under the ACA would be eliminated and the resulting uninsured rate among the non-elderly would be the same as the 2010 level. According to CBO, like with the House bill, the increase in the number of uninsured would be disproportionately larger among people aged 55-64 with income less than 200 percent of the federal poverty line.
The CBO also had bad news regarding the quality and affordability of coverage that would be offered on the marketplaces. For the New York Times, Margot Sanger-Katz reports:
[The CBO report] said the legislation would increase deductibles, make insurance more skimpy and destabilize the markets. Average premiums would go down largely because the insurance they would pay for would become thinner and less valuable. Older people more likely to need insurance would be priced out of the market.
The report turned the heads of many senators, including four who have said that they’re not willing to vote in favor of moving forward on the bill in its current form. Louisiana Sens. Bill Cassidy and John Kennedy remain publicly undecided.
Medicaid is not the problem
Complaints about the Affordable Care Act typically center on premiums and deductibles being too high and insurers pulling out of state insurance marketplaces. One thing that has not been a major source of complaints regarding the ACA: Medicaid. The Advocate’s Stephanie Grace wonders, then, why is the Senate bill making such dramatic changes to a program that effectively and efficiently serves the most vulnerable in our society?
Is that what anyone out there thought they were voting for? How exactly would this help families struggling with high premiums and deductibles? And do most people really want to tear a huge hole in the country’s safety net, one that probably helps someone that everybody knows, in order to make the rich richer?
The Senate bill would cut and cap Medicaid allotments for every state. But Louisiana would be singled out for punishment for having an efficient Medicaid program and relatively low per-enrollee spending compared to other states. Gov. John Bel Edwards voiced that concern, among others, in a letter to Sens. Cassidy and Kennedy:
Our Medicaid program runs with the ninth lowest administrative overhead of any state in the country, and was recently commended by the Trump Administration for virtually eliminating fraud, waste, and abuse. For these financially prudent efforts, the BCRA punishes Louisiana with less money for running a leaner program. States with significant wasteful spending will have that waste built into their caps in perpetuity, while lean states like Louisiana are penalized with lower caps.
In a letter to The Advocate, Sr. Helen Prejean reminds us that ensuring access to healthcare, especially for the poor, should be a chief objective for pro-life advocates in Congress:
Those with the most at stake are our nation’s most vulnerable people — people in poverty, the elderly and people with disabilities — many of whom rely on Medicaid. Medicaid covers more than 37 million children in low-income families and pays for almost half of all births. The Senate bill has even deeper cuts to this pro-life, life-saving program than the House bill, undercutting our moral obligation to support the common good. Sen. Bill Cassidy should know the benefits of health care coverage for individuals, as well as our society. As a doctor in Baton Rouge, he provided low-income and uninsured individuals with health care. I applaud him for all he has done, but I am concerned that by supporting this bill he will diminish his record of caring for Louisiana’s most vulnerable.
Adding to the cliff
Plans to overhaul the state’s tax code didn’t go far this session, but a handful of tax measures did make it to the governor’s desk. Unfortunately, the majority of them make the looming fiscal cliff worse, by creating new tax breaks or extending existing ones. While most were fairly minor in scope, one in particular could cost the state millions. Julia O’Donoghue with The Times Picayune/Nola.com reports:
The state’s inventory tax credit has been extended to large equipment that companies rent out for construction, mining, forestry and other purposes. Legislative analysts were unable to say how much money this might cost the state, but mentioned that it could be “substantial,” totaling in the millions of dollars. The new law is retroactive to the beginning of 2016.
The lock-out period
The original version of the Senate healthcare bill did not include a provision to require, encourage, or incentivize people to buy coverage. Instead, it eliminated the current “individual mandate” that people buy insurance or face penalties, causing some to predict that insurance markets would become even more unstable if the Senate bill becomes law. In an effort to solve that problem, the Senate bill now calls for a six-month waiting period for any person who goes uninsured for more than two months in a given year. Thomas Kaplan and Robert Pear with The New York Times report that this new penalty could cost some people their lives:
For someone with cancer or a severe illness, a six-month waiting period could be a death sentence. “Being denied critical and potentially lifesaving health care for six months is not a fair punishment for someone who is a few hundred dollars short on insurance payments because they lost their job and finances are unexpectedly tight,” said Sen. Chuck Schumer of New York, the Democratic leader. In yet another rebuke from outside Congress, the AMA, the nation’s largest physicians organization, declared Monday, “Medicine has long operated under the precept of primum non nocere, or ‘first, do no harm.’
Number of the Day
$6,500 – Projected annual cost for a benchmark “silver” plan for a 64-year old earning $24,600 per year under the Better Care Reconciliation Act, compared to $1,700 a year under current law. (Source: Congressional Budget Office)