Once again, Republicans are pushing for a wickedly cruel bill that would leave an estimated 32 million Americans without health insurance. From the Commonwealth Fund:
The bill repeals the ACA’s marketplace subsidies and Medicaid expansion, which currently cover about 30 million people. The Center on Budget and Policy Priorities (CBPP) estimates Graham-Cassidy would cut $239 billion from current spending levels, and then divide the remaining funding among states according to a complicated block-grant scheme that results in gains for some states at the expense of deep losses in other states. CBPP projects that the states that would lose the most funding are those that expanded Medicaid, including highly populated states like California and New York.
But all of that grant funding vanishes in 2026. CBO estimated the effects of a repeal of the ACA’s subsidies and Medicaid expansion in January. The bottom line: elimination of those provisions in combination with a repeal of the law’s individual mandate could lead to a loss of health insurance coverage for at least 32 million people. Compounding the coverage losses, Leighton Ku and colleagues at George Washington University have estimated that a repeal of the coverage expansions would have severe nationwide economic effects, leading to a loss of 2.6 million jobs.
Millions would lose coverage very quickly:
CBO’s prior analyses of the elimination of the individual mandate found that 15 million to 18 million people would become uninsured in the first full plan year after enactment (in this case 2019), as people dropped their coverage from all sources and insurers left the marketplaces. CBO also projected that premiums in the individual market would climb by 15 percent to 20 percent in the first plan year.
The majority of that increase would come from the repeal of the mandate penalties: insurers would expect that those who remained in the pool would be the least healthy. And as the CBPP has pointed out, uncertainty over how states would use their block-grant funding would likely lead to even greater instability in the individual market.
As Charles Gaba notes, the fallout from Graham-Cassidy could come as early as 2018. From the text of the bill. Graham-Cassidy, Sections 102 and 103:
Section 102: Modification and Repeal of Premium Tax Credits
- Excludes from the definition of QHP a plan that provides coverage for abortions (except if necessary to save the life of the mother or if the pregnancy is the result of rape or incest), beginning tax year 2018.
- Repeals the ACA premium tax credits as of January 1, 2020
Section 103: Modification and Repeal of Small Business Tax Credits
- Starting in 2018, amends IRC Section 45R to indicate that the term “qualified health plan” does not include any health plan that includes coverage for abortions, except abortions necessary to save the life of a mother or abortions for pregnancies that are a result of rape or incest.
- Repeals the small business health insurance tax credit beginning as of January 1, 2020.
Stop what you are doing and take one minute to call. Call your senator at (202) 224-3121 and tell them to vote NO. (After you call, please tell us how it went.)