The Senate Republican healthcare bill, called the Better Care Reconciliation Act, would dramatically transform the nation’s healthcare system, and not for the better. The 142 page bill creates a new system of tax credits to help people purchase health insurance but makes gigantic cuts to Medicaid, ends the requirement that most Americans have health insurance, and allows states to drop many of the benefits they are currently required to cover, like maternity care, emergency services, and mental health treatment.
As we previously mentioned, the Senate bill is very much like the House bill, with the same basic structure. It lowers the income limit for people to receive subsidies to get health insurance to 350% of the poverty line or $42,000 a year. It allows insurers to charge older people five times as much as younger people; the current limit is three times. And over a period of three years, it phases out the money the federal government has given to the states to expand eligibility for Medicaid. Finally, this bill puts Medicaid on a tight budget. Instead of open-ended payments, the federal government would give states a maximum payment for every person enrolled in the program. And these allotments would be increased very slowly, much more slowly than the average increase in medical costs.
The Senate bill also repeals most of the tax increases that the Affordable Care Act used to finance its reforms, essentially giving the wealthiest Americans and health care companies a big tax cut. High income Americans will get substantial tax cuts on their payroll and investment income. Subsidies to help low-income Americans who buy their insurance will decline and low-income Americans will also lose federal help in paying deductibles and co-pays. Middle-income Americans will have to pay a larger amount of money to get health insurance that covers a smaller share of their health care.
The bill’s benefits would go to rich Americans who already have the best health care and its losses will fall on low-income Americans who rely on government support to get adequate health care. And it will not fix the problems of high premiums, high deductibles, or a lack of effective competition. In fact, this bill will likely make them worse.
Medicaid provides health insurance to 74 million Americans, most of whom are disabled or in poverty. This includes 40% of all children and almost two-thirds of seniors in nursing homes. Reductions in funding will result in more people losing health coverage.
The Congressional Budget Office has not released its analysis of this bill; it is expected to do so next week. But it has released an analysis of the House health care bill, which is quite similar. Their paper projected that if that bill passes, by 2026 23 million more Americans will lack health insurance. So if the Senate Republicans’ health care bill is passed, millions of Americans will lose their health coverage, and be substantially less healthy as a results. Some of them will even die: having health insurance leads to improved health and reduced mortality. People who have access to health care see improvements in both their mental and physical health. This bill will take that away for a great many people.
Unsurprisingly, health care groups, consumer advocates, and governors of many states have come out in opposition to the bill. In a statement, former President Obama denounced the bill as “not a health care bill, but a massive transfer of wealth from middle-class and poor families to the richest people in America.” Several Republican Senators are unsure whether they will vote for it.
It is vital that consumers, healthcare providers, and all Americans reach out to their Senators and urge them to vote against this bill. Should it pass, we will all feel the consequences.