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Non-Partisan Analysis of 22 Million More Uninsured Deals Blow to Senate Health Bill

| June 27, 2017

mitch mcconnell

Thank you and goodnight. (Mark Taylor).

Senate Republicans’ legislation to overhaul the Affordable Care Act would leave an additional 22 million people without health care coverage over the next decade and cut the federal deficit by $321 billion, according to a Congressional Budget Office analysisreleased late Monday.


By 2026, an estimated 49 million people would be uninsured, compared with about 28 million who would lack coverage under current law.

The Senate’s bill — the Better Health Care Act, which GOP leaders hope to put to a vote later this week — comes nearly two months after the House passed its plan to overhaul the Affordable Care Act. That measure would cut about $834 billion from Medicaid and leave an additional 23 million people without coverage in 2026, according to CBO. It would reduce the federal deficit by $119 billion.

Earlier in the day, before the nonpartisan budget office’s score was released, Senate Majority Leader Mitch McConnell (R-Ky.) described the GOP plan as preserving “access to care for patients with preexisting conditions.” He also said it would “strengthen Medicaid,” give “Americans more power to control and reduce their medical costs and out-of-pocket expenses” and give “states significant new tools to drive down premiums.”

Yet it was unclear if Republicans, who have a razor-thin Senate majority, could garner the 50 votes necessary for the measure to pass. The budget office’s findings added to this uncertainly.

Sen. Susan Collins (R-Maine), a moderate who has been on the fence about the bill, tweeted late this afternoon that she could not support the current bill based on the CBO score. “I want to work with my GOP and Democratic colleagues to fix the flaws in ACA. CBO analysis shows Senate bill won’t do it. I will vote no” on bringing the bill to the Senate floor, she announced.

Senate Democrats were also swift to react.

“The CBO report should be the end of the road for Trumpcare,” tweeted Senate Minority Leader Chuck Schumer (D-N.Y.). And, in a statement, Sen. Ron Wyden (D-Ore.) said it was “abundantly clear [Republicans] are going in the wrong direction.”

Sen. Bernie Sanders (I-Vt.) pointed to the analysis and said the GOP plan was “a cynical and immoral proposal.”

Detailing The Medicaid Numbers

Under the GOP measure, federal spending on Medicaid would drop by 26 percent over current spending projections, or $772 billion, over the next decade, according to the analysis.

The drop in spending would occur mainly because the Senate plan phases out federal funds for states to expand Medicaid and it puts annual caps on federal Medicaid dollars to states. Currently, federal Medicaid matching payments to states are open-ended.

By 2026, the budget office predicted, 15 million fewer people would be enrolled in Medicaid than projected under the ACA. Currently, more than 74 million low-income and disabled people are Medicaid beneficiaries.

How Medicaid beneficiaries are affected by these caps depends on how states respond to them, the CBO notes.

“With less federal reimbursement for Medicaid, states would need to decide whether to commit more of their own resources to finance the program at current-law levels or to reduce spending by cutting payments to health care providers and health plans, eliminating optional services, restricting eligibility for enrollment through work requirements and other changes,” according to the analysis.

The Medicaid funding provisions are a key reason several influential health groups say they cannot support the bill.

“Access to care for some of the most vulnerable members of our society — including those who require treatment for opioid-use disorder — would be endangered by the Senate proposal’s arbitrary, unsustainable, and shortsighted formula for funding Medicaid,” David Barbe, president of the American Medical Association, said in a statement posted on the organization’s website.

And even before the CBO report was issued, the National Association of Medicaid Directors was on record with its concerns. “The Senate bill does formalize several critical administrative and regulatory improvements, such as giving Medicaid Directors a seat at the table in the development of regulations that impact how the program is run, and the pathway to permanency for certain waiver programs,” the group said. “However, no amount of administrative or regulatory flexibility can compensate for the federal spending reductions that would occur as a result of this bill.”

Other organizations, such as Families USA and the American Public Health Association, said the CBO’s findings show the Senate proposal did “devastating harm” and would “seriously jeopardize the health of America.”

Cost And Coverage

The budget scorekeepers also concluded that, for the individual insurance market, premium costs would go down under the Senate plan, but so would the amount of coverage provided.

Because these plans “would pay for a smaller average share of benefits under this legislation, most people purchasing it would have higher out-of-pocket spending on health care than under current law,” CBO said.

In 2017, an estimated 12 million people bought health coverage through the ACA’s marketplaces. Most bought silver-level plans, which covered 70 percent of health care costs.

Under the Senate’s plan, the average premiums for an individual in 2020 would be about 30 percent lower. But these policies would cover about 58 percent of costs on average.

According to the CBO, “a combination of factors would lead to that decrease – most important, the smaller share of benefits paid for by the benchmark plans and federal funds provided to directly reduce premiums.”

The CBO also analyzed the Senate bill provision that would allow states to use waivers to modify the health law’s essential health benefits that include items like prescription drugs, maternity coverage, mental health and substance abuse. In states where such waivers were granted, consumers could experience substantial cost increases for supplemental premiums or out-of-pocket spending, or choose to forgo services. Nearly half the population, the CBO estimates, would reside in states that seek these waivers.

In addition, the ACA’s ban on lifetime and annual limits on covered benefits would no longer apply to health benefits not defined as essential in a state.

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13 Responses for “Non-Partisan Analysis of 22 Million More Uninsured Deals Blow to Senate Health Bill”

  1. beachcomberT says:

    We can keep rearranging the deck chairs, depending on which party is in power, but long term, the private insurance market isn’t going to be able to provide “affordable” healthcare. Government-based single payer will eventually come about, but even that will have a tough time so long as the US clings to its empire and a bloated military.

  2. Veteran says:

    What they don’t say is the additional uninsured are 18-30 year olds that don’t want insurance because it’s not mandatory under the new law.

  3. Marilyn Wilkinson says:

    Why can’t we have a process for this? Why doesn’t Dept HHS do something like this?? Quote from article: In Japan — where doctors, politicians and economists get together to decide what medical encounters are currently worth — the price of a novel technology must go down as it ages. That means that in Japan, Charlap’s exact echocardiogram at the time he had the tests went for under $100.

    http://www.cnn.com/2017/06/26/opinions/us-health-care-prices-rosenthal-opinion/index.html

  4. Sherry says:

    The reason NO ONE is saying that the “additional uninsured are 18-30 year olds” is because IT IS NOT TRUE!

    The CBO assessed those that would be CUT from Medicaid . . . those who do not want insurance aren’t on Medicaid! Rural hospitals would be forced to close their doors because a high percentage of their patients are on “Medicaid”. If Medicaid is destroyed, millions of citizens would be left with ZERO health care!

    In addition. . . having healthcare rules differ from state to state is ludicrous! People MUST be FREE to move from one region of our country to another to find the best jobs and places for their families! Handcuffing them to their “state” healthcare, and limiting their freedom, is UNAMERICAN!

    Meanwhile, the horrific Senate bill gives “MASSIVE TAX CUTS” to the wealthy billionaires in our country!

    Here is what Physicians say about the Republican plans:

    The National Physicians Alliance opposes the draft Republican House bill revealed last night. We believe the drastic cuts it proposes to Medicaid, coupled with the substantial reductions in subsidies that helped millions afford healthcare would be extremely detrimental to our patients.

    Moreover, the bill would, in effect, shift huge costs onto working families, force many to pay more for worse coverage and push millions of American off of health coverage entirely. All the while, the proposed legislation hands millionaires, billionaires and health insurance CEOs a massive new tax break.

    The National Physicians Alliance supports efforts to improve healthcare in America. However, we believe the misguided priorities in this bill would move us in the wrong direction.

  5. capt says:

    It will never pass.

  6. Robjr says:

    And guess what side of the fence good ole Marco Rubio sits. Although reports say he is undecided the translation is that he is in McConnell’s pocket.

    Fools get exactly what they voted for.

  7. A tiny manatee says:

    Please pass this law so it lays waste to the over-65 trump crowd

  8. Ws says:

    Ho hum another daily story about the health care bill. Get a grip people. What does it take for people to understand that Obamacare is dying and going away permanently? I cannot believe there are still people out there who just don’t get it. Crazy!

  9. Anonoymous says:

    Medicaid is not Health Care it is “Welfare.”

  10. Anonymous says:

    I don’t like either plan, Affordable Health Care Act or the new Republican plan{Whatever it is called}. Whatever they pass will probably not last for very long before it must be replaced with a single payer plan. I hate big government, but in this case, Congress and the President need to put on their big boy and girl panties and put all legal American citizens into one group and pay for it with a Tax on every citizen, corporation, and product that generates revenue. Also, convert every dollar from Medicare and Medicaid in to helping in funding this colossal cradle to grave healthcare plan. Every American citizen would be covered for any ailment no matter if it were preexisting or not. Every legal citizen and those people who are here legally could use the health system. Those here illegally would get only emergency life sustaining care. This massive plan would probably cost 20-30 percent of GNP, but Everyone would be covered. If the American people want this system and are willing pay for it, then let Congress and the President call a special national election to decide this matter once and for all.

  11. beachcomberT says:

    Agree with Anonymous but how much longer do we have to wait for the slow crawl toward single-payer? Expect the giant insurers to fight tooth and nail against it, but then switch and become the government’s contractors for single-payer, just as is happening with Managed Medicaid. They will still find a way to enrich themselves. Not all national healthcare systems are alike. If we had far-sighted politicians, they would be studying the systems of Canada, UK, Germany, France etc to see which system would work the best in America. But what politician besides Bernie is actually doing this? Watch how the 2018 campaign shapes up. Let’s see how many congressional candidates and early presidential hopefuls have the guts to endorse the single payer concept. Sticking with the Obamacare status quo is not a solution. It will self-destruct in many states within 2-3 years. It already is leaving 28 million uninsured so why are people thinking it is so wonderful?

  12. Anonymous says:

    The professional politicians are all to spineless {unless the opinion polls favor an issue} to vote on what is needed. That is why the health care issue should be put to a Vote before the American people directly. This is going to cost as much or more than National Defense before it is over with. The American people are going to pay this bill, so let them decide this issue.

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