Republic Party Talking Points (A)
The Better Care Reconciliation Act is only one step in a three step process to replace the Affordable Care Act and lower healthcare costs. Step two includes administrative actions, by the Department of Health and Human Services Secretary, that will make regulatory reforms to the health insurance market. Step three includes additional healthcare legislation that cannot be done through the reconciliation process.
FACTS ABOUT THE REVISED BETTER CARE RECONCILIATION ACT:
Lowers health insurance premiums by 30% by 2020, compared to Affordable Care Act projections.
Requires continued coverage for people with preexisting conditions.
Allows dependents to stay on their parents health policies until age 26.
Dedicates $132 billion, over 8 years, to encourage states to assist low-income individuals to purchase health insurance.
Impacts Members of Congress healthcare just like all Americans.
Allows insurers to offer cheaper plans with less coverage options.
Does not make any changes from current law to annual lifetime coverage limits.
Does not cut Medicaid. Funding for Medicaid would continue to grow, yet not at the steep, beyond-inflation growth that is projected over the next 10 years. In fact, under the BCRA, spending on Medicaid in 2026 will increase to $466 billion, a 26 percent increase from now.
Provides state Governors with more flexibility in how their Medicaid system provides healthcare to those who are eligible.
Provides assistance for low-income Americans by offering health insurance subsidy assistance for Americans in the 0% to 350% federal poverty level range. This would also benefit the approximately 82,000 Oklahomans in the “coverage gap.” This tax subsidy will expand healthcare access and choice for low-income Americans, because they can transition from Medicaid to private insurance, with the help of tax subsides.
Eliminates the individual and employer mandates penalties.
Makes no changes to Medicare (which is the primary source of health coverage for Americans 65 and older).
Protects against an “age tax” by limiting what older, middle-income Americans pay toward the purchase of health insurance, to ensure they have access to a plan that fits within their financial means.
Helps rural hopsitals by restoring Affordable Care Act cuts to Medicaid Disproportionate Share Hospitals (DSH), which helps non-expansion states pay hospitals an enhanced Medicaid payment to care for its safety net population.
Allows people to use their pre-tax Health Savings Accounts (HSAs) to pay for their health insurance premiums.
Creates a Medicaid special exemption for disabled children from the per capita caps, which guarantees children with medically complex disabilities will continue to be covered through Medicaid.
Will not include any changes from current law to the net investment income tax, the additional Medicare Health Insurance (HI) Tax, or the remuneration tax on executive compensation for certain health insurance executives.
Democratic Party response (B)
Washington—Senator Dianne Feinstein (D-Calif.) today released the following statement in reaction to the Senate Republican health care bill:
“Senate Republicans spent the past two weeks putting lipstick on a pig. In all the ways that matter, the health care bill unveiled today is the same atrocious bill they couldn’t pass two weeks ago.
“The bill would still take coverage from tens of millions. It would still gut Medicaid. It would still increase premiums, particularly for older Americans. It would still undermine protections for pre-existing conditions.
“Once again, this bill was written behind closed doors. There will be no hearings. There will be no markups. There will be no opportunity for senators to amend the bill or understand the views of the millions who would be affected by it.
“Democrats will do all we can to ensure the American people understand that this bad bill is no better than the previous bad bills.”
Just as with earlier versions, the latest iteration of the Senate’s Affordable Care Act repeal bill would devastate insurance coverage, gut the Medicaid program, and dramatically increase deductibles and out of pocket costs.
The newest repeal bill:
leaves in place enormous cuts to Medicaid and ends the Medicaid expansion;
ensures that millions of low-income workers will lose health coverage and that those left on Medicaid will be enrolled in a hollowed out program with funding reduced by 35% over time;
continues to allow states to eliminate the essential health benefits and minimum coverage requirements that are core protections for people with pre-existing conditions and goes a lot further in this damaging direction, imposing a new structure—thought up by Senator Ted Cruz—that further erodes pre-existing conditions protections;
continues to cut financial assistance for private coverage and eliminates all assistance with out-of-pocket costs like deductibles;
increases deductibles for working lower- and middle-income families across all ages by an average of close to $5,000;
still increases premiums for older people by hundreds to thousands of dollars on top of these new higher deductibles;
still institutes an age tax on premiums, allowing insurers to charge older people five times the premium of younger people;
still provides billions of dollars in tax cuts to the wealthy and corporations.
So what has changed?
Fewer protections for pre-ex
Shifts Medicaid funds into poorly defined block grants
A small substance abuse grant fund as a token offset to much larger Medicaid cuts
Lessens tax cuts but still benefits corporations and the wealthy
These changes largely make the profound problems in previous versions of the Senate bill worse. They will formally divide the market for individual health insurance into plans for people with pre-existing conditions and for healthier people. They offset huge cuts to Medicaid and the regulated individual health insurance market with small expansions in Medicaid block grants and substance use grants and a stabilization fund that goes direct to insurance companies.
(A) Senator Lankford Statement on Revised Senate Healthcare Bill, https://www.lankford.senate.gov/news/press-releases/senator-lankford-statement-on-revised-senate-healthcare-bill
(B) Feinstein Statement on Senate Health Care Bill, https://www.feinstein.senate.gov/public/index.cfm/press-releases?ID=E83D14CD-9BA0-4B97-B0F0-9C5EAE30F1C2
(C) Latest Version of Senate Health Care Bill Fundamentally the Same as Previous Versions, http://familiesusa.org/blog/2017/07/latest-version-senate-health-care-bill-fundamentally-same-previous-versions