Congress Still Struggling to Craft Palatable Healthcare Bill

May 26th, 2017

The Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) released the latest cost estimates on the newest version of the House’s American Health Care Act (AHCA) — and the results still are not very rosy.

After the first version of the bill was widely panned by just about everything with a pulse, the House Republicans went to work on the latest version. The CBO’s findings were similar to the previous bill, including the following:

• The number of uninsured Americans would increase 14 million by 2018, eventually swelling to 23 million by 2026, bringing the total amount of uninsured under age 65 to 51 million. Under the Affordable Care Act, 28 million would lack insurance by 2026.
• Premiums for single policyholders would increase by about 20% in 2018, and 5% in 2019.
• The number of Medicaid patients would drop by 14 million by 2026. Medicaid spending would drop by $834 billion over 10 years.
• Eliminating the individual mandate, replacing it with a 30% surcharge for those who have gone without insurance coverage for more than 63 days in the year.
• States can opt to waive the essential health benefits and community rating requirements. CBO and JCT project that states seeking the full waivers will create market instability, which could result in unaffordable premiums for sicker patients. However, states that do waive community rating would receive $8 billion to offset premium increases.
• The federal deficit would decrease by a net of $119 billion from 2017-2026 — about $100 billion less than the bill’s previous iteration.
• The number of people with employer-sponsored health plans will increase by 4 million by 2026.

Reaction to the report was swift, with about as much acceptance as the first time around.

“This bill would force states to choose between denying care to people who need it and vastly expanding their budgets,” according to a statement from Association for Community Affiliated Plans CEO Margaret Murray. “It phases out the federal match for the Medicaid expansion and deliberately adds red tape and layers of bureaucracy for people who seek access to Medicaid coverage, which leads to enrollment churn in the program.… We hope the deliberations in the Senate represent a fresh start, and look forward to engaging in more productive bipartisan conversations to enhance quality, preserve access, and control costs.”

“This week’s estimates from the nonpartisan Congressional Budget Office show that last-minute changes to the AHCA made by the House offered no real improvements,” said American Medical Association President Andrew W. Gurman, MD, in a statement. “Millions of Americans will become uninsured — with low-income families on Medicaid being hit the hardest. We urge the Senate to ensure that any changes made to current law do not cause Americans to lose access to affordable, meaningful health insurance coverage.”

As Congress adjourns for its weeklong Memorial Day recess, the fate of both the Affordable Care Act and the American Health Care Act remain as uncertain as before. The Senate will take up the monumental task of revising the AHCA in a way that, even if it doesn’t please everyone, will offend the fewest people.