Senate Healthcare Bill Cuts Medicaid, Insurance Subsidies and Taxes
Update: 6/28 Senate majority leader Mitch McConnell announced the vote will be delayed until after the July 4 holiday. LBBC will continue to update you with major changes to the bill. If you have concerns about this bill, you should continue to call or write your senators as discussions continue and they decide how to vote.
6/27 The Congressional Budget Office released a report on June 26 that estimated the Senate’s Better Care Reconciliation Act will cause 22 million people to lose health coverage by 2026. The bill will cause average premiums to fall 20 percent by then, but these savings come from older people being priced out of coverage and plans that cover less of your medical costs. It says there will be 15 million fewer people enrolled in Medicaid in 10 years and the program would continue to lose funding each year even after the window of this report.
Also on June 26, a section was added to the bill that changes the rules on how long you have to wait before getting insurance coverage if you sign up for a plan after being uninsured for some time. Read below for more information.
Republicans in the Senate released a health care bill on June 22 that they plan to vote on before the end of the month. The process started in the House of Representatives, which passed the American Health Care Act in May. Rather than pass that bill, Senate Republicans said they would write a new one that would change many of the unpopular aspects of the House bill, but their proposal, the Better Care Reconciliation Act is still modeled on it and cuts funding in many of the same places.
The Better Care Reconciliation Act limits how many people get health coverage from the government and how much assistance the government will offer to people who make less than $50,000 (or $100,000 for a family of four). This will cause many people to lose health coverage, and also shift more costs onto people who need coverage but have an income that makes it hard to afford. Many news organizations have resources about how this bill will change the health industry, including NPR and the New York Times.
The Senate plans to move quickly to vote on this bill, so now is the time to call your senator with your experiences under the Patient Protection and Affordable Care Act and express your concerns about the bill.
Medicaid. Starting in 2021 the Senate bill will cut the federal contribution to the people who get coverage through the Medicaid expansion and limit how much it will pay for Medicaid overall. Though your state can choose to continue offering Medicaid and accept the extra costs, the funding cuts will mean many states will limit who can get Medicaid and people with low incomes will lose coverage.
Subsidies. Government subsidies to help pay for private insurance will work like they do in the ACA but be less generous. Currently, these funds are given based on income and the cost of insurance in your area. This will still be how they are decided, but the levels will change so more of the burden shifts to you.
Taxes. The Senate bill repeals several current taxes put in place by the ACA including taxes on investments, people making over $200,000, medical devices and indoor tanning services.
Age Rating. As you get older, you are more likely to need health care, so insurance companies charge you more — whether you actually need more care or not. The ACA limited insurance companies to charging older people no more than 3 times what they charge younger people for the same plan. The Senate bill will raise that so insurers can charge older people up to 5 times as much for the same plan.
Planned Parenthood. The Senate bill will not allow people to use Medicaid for health services at Planned Parenthood clinics. If you are on Medicaid you can currently get certain health services at Planned Parenthood, but the Senate bill says you must pay out of pocket or find another provider.
Mandates. You will no longer be charged a fine if you do not have health insurance, as you would be under the ACA. Also, larger employers (50 or more people) will not have to provide an insurance option for employees.
Waiting periods. A section was added to the Better Care Reconciliation Act on June 26. The bill now states that people who go without insurance for more than 2 months will face a waiting period when they do sign up for insurance. This means if you are uninsured for more than 2 months and then you sign up for insurance, your new plan will not start covering your medical care for at least 6 months. It could be even longer. You will not be charged premiums during this time.
Regulations. The Senate bill makes it easier for states to waive certain health coverage rules from the ACA. At the moment, states have to prove their law would provide at least the same level of coverage as the ACA. The Senate bill requires only that a state plan does not have any additional cost to the federal government. Rules that could be waived under the Senate bill include
- Essential Health Benefits. The ACA said a health insurance plan, to really be considered health insurance, must include some coverage for 10 “essential health benefits.” These included prescription medicines, mental health, emergency services and maternity care.
- Lifetime and Annual Limits. The law that says insurance companies cannot put a limit on how much they will pay in health costs either per year or over your lifetime.
Pre-Existing Conditions. The Senate bill keeps the rule that insurance companies cannot deny you coverage or charge you more because you already have a disease or a condition that affects your health. While they must give you a plan, some worry that allowing states to waive the essential health benefits can lead to insurance plans that simply leave out expensive health costs.
Young Adults. Adult children can stay on a parent’s insurance plan until they turn 26 years old.