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Stephanie Pellitt

Policy and Advocacy Associate

CBO Projects Huge Coverage Losses as Congress Continues Work on Heath Reform

May 25, 2017 | ACA | Medicaid | Comments
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The American Health Care Act (AHCA) will result in dramatic reductions to Medicaid coverage and cuts to spending, according the Congressional Budget Office’s (CBO) updated analysis released this week. Over the next ten years, the AHCA is projected to roll back Medicaid coverage for 14 million low-income Americans and cut $834 billion dollars from the program, shifting the burden of health care costs to states. Also, this week, the Senate discussed possible paths forward for health care reform as House members worked to advance a package of smaller measures aimed at the individual insurance market.

CBO Score on AHCA

The Congressional Budget Office’s updated score released Wednesday noted a few changes compared to their initial analysis completed in March. Specifically, the latest projections estimate total coverage losses at 23 million individuals with a cost savings of $119 billion, compared to original CBO estimates of 24 million individuals losing coverage with $337 billion in cost savings. The new report predicts that over the next ten years, 14 million people would lose Medicaid coverage under the AHCA – this is more than the number who gained Medicaid coverage under the Affordable Care Act. If the AHCA passes, 14 million people who rely on Medicaid will not get the care they need, including millions for whom Medicaid is their key source of substance use disorder and/or mental health treatment.

As the result of an amendment to AHCA that would allow states to waive required essential health benefits, out-of-pocket spending for mental health and addiction services for individuals with nongroup health plans “could increase by thousands of dollars in a given year.” Additionally, the CBO report projects an overall cost savings of $119 billion, nearly all of which is achieved by slashing Medicaid funding and severely reducing its enrollment. Read more about National Council’s position on the House-passed version of the American Health Care Act here.

Senate Deliberations Continue

This week, the 13-member Senate leadership working group continued deliberations on health care legislation to earn the support of 50 Senators. Concerns regarding reduced Medicaid spending and the potential elimination of Medicaid expansion have been amplified since the bill moved to the Senate, with multiple Senators expressing fear that their own constituencies would lose coverage under AHCA.

“Anytime you’re cutting Medicaid, you’re obviously endangering a lot people in my state,” said Sen. Shelley Moore Capito (R-WV) describing to Politico the dramatic benefits West Virginia has seen since adopting Medicaid expansion. Senators Portman (R-OH) and Toomey (R-PA) have been tasked with bringing together the moderate and conservative perspectives on Medicaid within majority caucus in the Senate (read more here).

Health Care in House

The House Ways and Means Committee advanced three health care bills earlier this week as part the larger Republican plan to repeal and replace the Affordable Care Act (ACA). The bills, which represent the “third bucket” of the GOP health care plan, were approved mostly among party lines. The bills’ provisions would only be effective if the AHCA is passed and signed into law. In short, the measures would:

  • Allow veterans to retain eligibility for ACA subsidies if the American Health Care Act becomes law.
  • Allow AHCA tax credits to be applied to Consolidated Omnibus Budget Reconciliation Act (COBRA) health plans.
  • Require individuals to verify their income eligibility and citizenship or legal immigration status with the Social Security Administration before accessing AHCA’s premium tax credits.

Take Action

As the health care debate continues, the National Council asks all advocates to reach out to their Members of Congress, particularly Senate offices. The passage of health reform in the Senate is far from certain and your advocacy makes a huge difference in preventing potentially devastating cuts to Medicaid and behavioral health care. Congress is currently on recess, making this is a great time to reach your Representatives and Senators at home and share your views on health care reform. Book a meeting at your local district offices or send in a personalized letter. Need help? Click here for guidance and resources on booking legislative meetings.