Red alert: Delay on healthcare is time to redouble efforts

Monday, the Congressional Budget Office (CBO) released its score on the U.S. Senate healthcare bill, the Better Care Reconciliation Act or BCRA. According to the report from the nonpartisan CBO, nothing in the bill makes care better and it is largely a continuation of the flaws in the House-passed healthcare bill.

Over the last two days, a vote by the Senate on their healthcare bill went from imminent to delayed at least a week. But we still need to keep fighting and make sure everyone knows how bad the BCRA is.

The CBO report shows that under the Senate healthcare plan:

  • 15 million people would become uninsured in 2018, with a total of 22 million people by 2026.
  • Federal funding to states for Medicaid would decline by $772 billion, forcing states to increase provider rates or reduce care. These cuts would also force states to look at funding priorities whether it be infrastructure, education or healthcare.
  • States’ Medicaid expansion programs would be phased out. In Michigan, that would mean the over 670,000 Michiganians who receive care through the Healthy Michigan Plan would lose health coverage.
  • Individuals may lose coverage to critical health services including treatment for substance use disorders and maternity care.
  • Average healthcare premiums would go up 20% in 2018.
  • Individuals who are low income will pay more for less comprehensive coverage.
  • Four million people with employer-sponsored coverage would lose insurance.
  • Nearly all of the coverage gains experienced under the ACA would be eliminated by 2026 and the uninsured rate among the non-elderly would rise almost to its 2010 level, before the ACA took effect. (Under the ACA, the uninsured fell to a historic low of nine percent.)

I’ll admit, I have been having a hard time over the past couple of months thinking that legislation that hurts this many people would and could actually pass. I understand that there is a legislative process and following the announcement that the vote will be delayed, I’m sure that over the coming days and weeks we will see changes made to this bill, but changes may still result in large sums of people losing life-saving care.

CBPP BCRA-AHCA Comparsion 575x525

I want to enjoy my Fourth of July and I want you to do the same, but maybe you can also take a few minutes over the next couple of weeks to call Congress at (202) 224-3121 or attend an event or town hall and tell your Representative that you will not accept any healthcare bill that:

  • Reduces healthcare coverage;
  • Ends Medicaid expansion and the Healthy Michigan Plan;
  • Ends the traditional Medicaid program as we know it through per capita caps or block grants; and
  • Makes individual market coverage less affordable.

This delay on a vote is a great sign, but the fight is not over. We must keep up our pressure on our members of Congress. Thankfully, Michigan’s two U.S. Senators Debbie Stabenow and Gary Peters have already come out in strong opposition to the BCRA (but it doesn’t hurt to thank them for their support). The lives, safety net and economic peace of mind of our fellow Michiganians and Americans are at stake.

— Emily Schwarzkopf

CB…oh no?!

Earlier this month, the House Republicans in Congress passed the American Health Care Act (AHCA) without an updated Congressional Budget Office (CBO) score. The CBO is an independent, nonpartisan office that analyzes the cost and impact of proposed federal legislation. Wednesday, in full nerd behavior I anxiously awaited the release of the new report.

While earlier versions of the AHCA revealed that over 24 million people would lose their health coverage, the effect of amendments that allowed for waivers for essential health benefits and pre-existing conditions was not yet known … until now. (Yes, 20 days after the bill was voted on by the House). What we know from the newest CBO score is that not much has changed. According to the report released yesterday:

CBO Uninsured Rate F 448 x 457

  • 23 million more people would be uninsured by 2026;
  • $8 billion dollars allocated for high-risk pools would not be sufficient to cover the large increases in premiums for high-cost enrollees;
  • Medicaid enrollment (including children, people with disabilities and the elderly) would decrease by 14 million people;
  • People needing maternity, substance abuse & mental health care would incur thousands of dollars in extra out-of-pocket costs in states who apply for a waiver.
  • Premiums would go up 20 percent more than current law in 2018.
  • In states that pursue waivers, the report says that average premiums would fall but “less healthy people would face extremely high premiums.”

Last week, our national partners at the Center on Budget and Policy Priorities released two reports on the effects the AHCA has on rural America and home- and community-based services. Both of these reports once again put on display the great harm this legislation would bring.

One of the things that really stood out to me was the huge effect the AHCA would have on our rural Michiganians. In Michigan, 113,800 people in rural communities gained coverage through Michigan’s Healthy Michigan Plan. That’s nearly 20 percent of the total enrollment of the program. Those suffering from opioid addiction (of which rural Michigan has been greatly affected) have been particularly helped by the expansion of Medicaid. The coverage gained allowed these people to access the necessary treatment and education they need to fight this growing epidemic.

Home- and community-based services are optional services that states are not required to provide but many individuals rely on as a way to receive care at home rather than in a nursing home. In 2013, 102,810 Michigan residents relied on these services. Restructuring Medicaid through per capita caps and the ultimate end of Medicaid expansion would result in a significant cost shift to states, so much that states could choose to no longer provide these important services to seniors and people and kids with disabilities.

There is no doubt that the Affordable Care Act needs to be improved and as the U.S. Senate moves forward in its process, we can hope that they look at this data to develop legislation that rejects caps on the Medicaid program, continues successful Medicaid expansion programs—including Michigan’s Healthy Michigan program, and increases the number of insured individuals.

We know you are being pulled in a lot of directions right now, but we still have a lot of work to do on the healthcare front and we need you to keep fighting. We have a helpful website set up with our coalition partners so you can contact your member of Congress, and all these reports to help keep you informed on the devastating impact of the AHCA. And they come in handy when you battle your friends on the intricacies of Medicaid financing … oh wait, I’m the only one that does that?

— Emily Schwarzkopf