Republican leaders in the U.S. Senate today unveiled their much anticipated bill to revamp the Affordable Care Act (ACA), which included many of the elements contained in the health bill passed last month by the House of Representatives.
The new legislation would eliminate many of the taxes enacted under the ACA to fund the expansion of health insurance coverage. Also, the bill would roll back current mandates on individuals to secure insurance coverage and on some businesses to provide insurance coverage for employees.
These moves clearly would increase the number of people without insurance and, in turn, raise the cost of insurance for everyone else.
The bill would remove government subsidies to help purchase insurance for some people by lowering the income threshold to qualify for that benefit from 400 percent of the federal poverty level to 350 percent. Subsidies to insurance companies that reduce out-of-pocket costs for low-income beneficiaries who purchase coverage on through the government-sponsored insurance exchanges would also be eliminated by 2020.
As a result, insurance deductibles for millions of Americans will rise. Experience has shown us that those added costs to patients frequently get passed on to hospitals as bad debt or charity care for unpaid hospital bills.
Under other provisions of the Senate bill, federal funding for the expansion of state Medicaid programs (called MediCal here in California) will drop from 90 percent to 57 percent over the next seven years, adding a huge financial burden on states that have expanded Medicaid coverage under the ACA. To make up the difference, states will be forced to either increase their own taxes to fill in the funding gap, reduce the number of people eligible for Medicaid coverage, reduce Medicaid reimbursements to hospitals and other health care providers, or adopt a combination of all of these options.
While the ACA certainly has its flaws and shortfalls, there is no question that this new proposal is a worse alternative.
If this bill is passed by Congress and signed into law by the president, we will see a rise in the number of uninsured Americans either by choice or due to the reductions of direct subsidies to individuals and reimbursements to states. Just here in California, millions of people could lose their coverage.
Federal taxes might be lowered for some, but we’re likely to see taxes rise in states that choose to maintain insurance coverage at current levels.
Of course, the future remains uncertain. We don’t yet know if Republican leaders in the Senate can muster enough votes from their members to overcome the solid voting opposition that is guaranteed to come from Senate Democrats. Pressure from all sides of the debate will enormous over the coming days if the Senate leaders stick to their schedule of holding a final vote on the measure next week.
Partisan attempts to pass national health care policy will always fail in the end because it will never be supported by the opposing party. American health care should not get caught up in a ping-pong match between political parties.
I once again ask that the leadership of Congress from both parties come together to forge true bipartisan supported health care legislation for the good of our entire country.