Senate leaders released a “new” version of their bill to replace the Affordable Care Act that fixes none of the original Senate bill’s core problems and makes some of them even worse.
Through its cuts in funding, the Senate bill would effectively end Kentucky’s highly-successful Medicaid expansion, resulting in lost coverage for 473,000 Kentuckians. The bill goes beyond that to permanently harm the traditional Medicaid program by instituting caps that will squeeze funding over time. Those caps will jeopardize coverage for another nearly 1 million Kentuckians, including people with disabilities, seniors and children. An analysis of the initial Senate bill found that the cuts would reduce federal Medicaid funding in Kentucky by more than half.
The Senate bill would raise premiums and deductibles for millions of Americans who buy coverage in the individual marketplace by reducing tax credits and eliminating cost-sharing assistance, especially harming older people. It also would gut consumer protections, leaving people with pre-existing conditions without access to needed health care. The so-called “Cruz Amendment” would effectively segregate people with pre-existing conditions into plans with other people needing expensive care, leading to rising costs and destabilized markets.
While a Congressional Budget Office score is not yet available for the revised bill, its cuts to Medicaid and marketplace financial assistance will result in many millions of Americans losing coverage. And the bill makes these cuts in order to give $400 billion in tax cuts to the wealthy, drug companies, insurers and other corporations.
The much-touted new funding Senate leaders put in the bill doesn’t solve these problems. They point to additional “stability” funds for states. But the funds are woefully inadequate, poorly designed and will do little to improve health insurance for low-income people who will lose Medicaid coverage or those whose subsidies used to buy marketplace insurance are being cut.
Proponents are also touting additional funding for opioid treatment. But the bill provides far less than experts estimate we need. And, more importantly, it would be greatly outweighed by the bill’s deep Medicaid cuts and other fundamental changes to the ACA that would cost millions of people their health care coverage, leaving many opioid sufferers without access to much-needed treatment. As reported this week in The Atlantic, some of the hardest-hit places in the country by the opioid crisis are also places where Medicaid plays a big role in insurance coverage — and Medicaid, as noted here, is slashed under the Senate bill.
Now Senate leaders are trying to rush this bill through next week without the time needed for the public to understand how it will affect them and their communities. Sen. Mitch McConnell indicated recently that if the bill failed, he would shift to a bipartisan approach to fixing the Affordable Care Act including action to stabilize the marketplaces. For Kentucky’s sake, let’s hope that’s where this is headed.