– By Lise Millay Stevens
The non-partisan Congressional Budget Office released its assessment of the Better Care Reconciliation Act, the Senate health care bill aimed at repealing and replacing the Obama administration’s Affordable Care Act. The numbers are devastating; within nine years, 50 million Americans would lose their health insurance if the bill becomes the law of the land.
The CBO report states, “The Senate bill would increase the number of people who are uninsured by 22 million in 2026 relative to the number under current law, slightly fewer than the increase in the number of uninsured estimated for the House-passed legislation. By 2026, an estimated 49 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.”
What is clear is that if the bill is passed, nothing will be “better” except the bank balances of the wealthiest Americans. The Senate version eliminates the taxes on the rich, insurance companies and others that have helped to fund the ACA’s Medicaid expansion, which allowed millions of the most vulnerable people to gain access to health care. Under the BCRA, federal Medicaid spending would be slashed by $772 billion over the next 10 years and a net total of 26 percent by 2026. Currently, Medicaid covers the health care costs of 20 percent of all Americans, 39 percent of children, 49 percent of births and 64 percent of nursing home residents.
A ‘Take No Prisoners’ Bill
The cuts will make health care unaffordable for low-income individuals and families, and millions will be forced to drop their coverage. Medicaid enrollment—which currently covers 70 million U.S. men, women and children—would fall by approximately 16 percent among people age 65 years and younger. The elimination of the Medicaid expansion will cut funding for states, which in turn will be forced to reduce eligibility for coverage, cut benefits for people who are insured, and lower payment to providers, who may in turn refuse to treat patients on Medicaid.
The BCRA would have a disastrous effect on broad swaths of the population. The bill allows states to waive current ACA regulations the currently prevent insurance companies from shifting many costs for care onto their subscribers. If the bill passes, deductibles will increase and insurers will be allowed to provide plans that cover fewer health expenses and have much higher premiums, with no limits on consumers’ out-of-pocket expenses. The monumental financial burden will cause millions of consumers to drop their coverage.
The legislation would decimate the health care of wide swaths of the U.S. population. Cuts in subsidies for the elderly would reduce the number eligible for assistance. People in their early 60s would have to pay 16 percent of their incomes for coverage, and fewer middle-class people would qualify for the premium subsidies they currently receive under the ACA. People with pre-existing conditions such as diabetes, substance use and mental health issues would lose coverage; the bill allows states to opt out of covering the 10 essential health benefits currently required by the ACA.
Republicans May Save the Day
Although the CBO report data can be viewed as a damning repudiation of the Republican’s health care agenda, a few legislators who are willing to break with the party are poised to save America from this punishing bill. GOP senators Susan Collins (Maine), Dean Heller (Nev.) and Rand Paul (Ky.) have vowed to block the bill’s passage, and several supporters have wavered in the wake of the CBO report. With unilateral opposition to passage by Senate Democrats, the bill will fail if more than two Republicans defect. Complicating matters for the GOP is the looming summer recess, which begins next week and could see legislators returning home to a tide of furious constituents if they support the measure.
States such as West Virginia and Ohio, for example, voted for President Trump but are at the apex of the opioid epidemic. Approximately 35 percent to 50 percent of Americans who receive treatment for substance use and behavioral health issues do so under Medicaid’s auspices. It is hard to see how senators from these states and others similarly devastated by the opioid epidemic can emerge unscathed if they vote ‘yes’ on the BCRA. And given the number and scope of Americans whose health will be in serious jeopardy if the bill passes, it is hard to believe than anyone who votes ‘yes’ on BCRA won’t get a ‘no’ vote when their congressional seat is up for grabs.
About Sovereign Health
Sovereign Health’s mission is to provide a broad spectrum of high-quality behavioral health treatment services for adults and adolescents, including support services for family members. One factor that differentiates Sovereign from other treatment providers has been the company’s ability to offer separate mental health and addiction or dual diagnosis treatment programs at its facilities. Sovereign’s facilities are licensed and have been awarded Gold Seal accreditation by The Joint Commission, the highest level of accreditation available in the behavioral health field. For more information, visit www.sovhealth.com.