The CBO score is out: Senator Portman has plenty of information about the Senate’s bill, and it’s time to make a decision. In this article, some of the key CBO findings will be reviewed, but the short story is that this bill, the “Better Care Reconciliation Act,” is not much better than the House bill in terms of how many people will lose coverage (talk about a low bar!), and in some ways it is worse.
Rob Portman should vote NO if he’s really on the side of Ohio’s elderly, chronically ill, children, and working poor.
Bad News: 22 Million Americans Will Lose Coverage
The House’s American Health Care Act would cost 23 Million Americans their insurance. The Senate bill, which was supposed to be less “mean” will cost 22 Million Americans their insurance. As comedian Stephen Colbert quipped, they Republicans only need 21 more drafts to break even!
But the effect on Americans who lose their healthcare is no laughing matter: a disproportionate number of those losing coverage will be older people with lower incomes.
The CBO also projects that many people will choose to drop out of the market because there will no longer be an individual mandate. As mentioned in a previous post, this could have the effect of destabilizing the markets, or at least causing the premiums for those who are left to rise dramatically.
Republicans did introduce a new “incentive” yesterday to keep these people from dropping out: namely that anyone without continuous coverage (63 days or more) will be penalized by being kept out of the market for 6 months. You can imagine many situations, like unexpectedly losing a job, where a person who really needs healthcare could lose coverage through no fault–and no choice–of their own, and then end up on the outside (maybe permanently if they have pre-existing condition). This new idea is just a cruel as the rest of the bill and it won’t mitigate the millions who will lose coverage.
More Bad News: Deep Medicaid Cuts
Among the many health organizations that have come out against the Senate bill is the National Association of Medicaid Directors: they called the cuts proposed in this bill “unworkable.” The group says that without specific guidance from the federal government about how to operate without the federal funds being cut, “It would be a transfer of risk, responsibility, and cost to the states of historic proportions.”
Recently, Republicans and White House officials have been making the rounds on TV saying that these aren’t cuts at all–just a “slower rate of growth for the future.” But take a look at the top line of the CBO’s graph: it could not be more clear that there are deep cuts to Medicaid, and as we’ve discussed, the effects of these cuts will be profound: 15 million fewer people will be enrolled in this program by 2026.
And More Bad News: Most Premiums Will Increase
The CBO reports that premiums will rise in the short term under the Senate bill by an average of 20% for 2018. By 2020, though, it seems that premiums would decrease by 30%, which seems like good news. However, the way this savings is achieved is by changing the rules of the game: instead of mandating a plan that would take care of 70% of people’s predicted costs like in the ACA “silver” plan–the benchmark under the existing law–the Senate plan lowers that bar to plans that take care of only 58% of people’s expected costs. In other words, yes, people may pay 30% less, but they will get less coverage as well.
The Kaiser Family Foundation has calculated apples to apples comparisons between the ACA and the Senate plan, and for insurance plans with the same level of coverage there is actually a 74% average premium hike by 2020, which includes a 94% premium hike for Americans aged 45-54 and a 113% hike for seniors (over 65).
Good News? Budget Savings…
There is $321 Billion in federal budget savings in the Senate bill, compared to only $119 Billion in the House plan, but as mentioned in a previous post, that’s not necessarily a good thing: health care is not about saving the government money, it’s about providing healthcare, and the ACA was deficit neutral because specific taxes were levied (on the wealthiest Americans at a modest rate of 3.8%) to pay for the expanded coverage.
Good News for the Wealthy
Just like with the House bill, the really big winners are the rich, insurance companies, and drug companies. This bill is really a tax cut, not a healthcare bill.
Rob Portman: It’s Time to Decide
Many eyes are on Rob Portman, who is always listed as a moderate who is “concerned” about the bill. Portman’s constituents have been desperate to reach him: driving to DC, and staging die ins at Portman’s Ohio offices in Toledo, Cleveland, Columbus, and Cincinnati.
It should not be a profile in courage to vote NO on a bill that makes our health care problems worse, that does not address a single one of the problems with the ACA that Republicans are so eager to talk about.
Tell Rob Portman to stand with Ohioans and vote NO on this bill. Give up on this cruel plan and work with Democrats to actually fix the issues with the health system: that’s much more important than some campaign promise to repeal the ACA. Americans want health care, not empty rhetoric.
How to get in touch with Rob Portman
Sen. Portman has an office in Toledo, and every Tuesday at noon, constituents visit his staffers there. This is a good way to convey your opinions about these important healthcare topics.
Call or mail
Washington, D.C. Office
448 Russell Senate Office Building
Washington, DC 20510
420 Madison Avenue
Toledo, OH 43604
Toll-Free: 1-800-205-6446 (OHIO)