A Dozen Reasons Not to Love the Better Care Reconciliation Act of 2017

Here is a link to the Congressional Budget Office Score on the latest Senate proposed Better Reconciliation Act of 2017.

https://www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/52941-hr1628bcra.pdf

If you don’t have time to read all 22 pages, here are some highlights (This is simply copied and pasted. My own editorial comments are in bold type.):

1) Compared with the June 26 cost estimate for a previous version of the legislation, this cost estimate shows savings [to the federal deficit] over the next 10 years that are larger—as well as estimated effects on health insurance coverage and on premiums for health insurance that are similar.

2) enacting this legislation would reduce federal deficits by $420 billion over the 2017–2026 period. This is about $100 Billion more than the previous version. Good news for the deficit.

(Bad news for the disabled [like my son, Matt], the elderly in nursing homes, and children born into or living in poverty through no fault of their own who will be subsidizing this deficit reduction plan by the cuts to their Medicaid health care and services.  Very brave of the Republican Senate to do that. Very brave.)

3) The largest savings would come from a reduction in total federal spending for Medicaid resulting both from provisions affecting health insurance coverage and from other provisions. By 2026, spending for that program would be reduced by 26 percent.

4) In 2026, for people who are made newly eligible under the ACA (certain adults under the age of 65 whose income is less than or equal to 138 percent of the federal poverty level [FPL]), Medicaid spending would be reduced by 87 percent, from $134 billion to $17 billion

5) This one is my personal evaluation, and I am sourcing a bar chart in the report.  The June 26 version shows a cut of $772 Billion in Medicaid.  The July 20 version shows a $756 cut in Medicaid.  PLEASE, FOR THE LOVE OF GOD, DO NOT LISTEN TO SENATOR LAMAR ALEXANDER WHEN HE WILL MOST LIKELY SUGGEST THESE NUMBERS MEAN “THE NEW PROPOSAL INCREASES MEDICAID SPENDING BY $16 BILLION”)

6) The increase in the number of uninsured people relative to the number under current law would reach 19 million in 2020 and 22 million in 2026

7) Under this legislation, in 2018, average premiums for benchmark plans for single policyholders would be about 20 percent higher than under current law,

8) under this legislation, 64- year-olds could be charged five times as much as 21-year-olds, CBO and JCT expect, compared with three times as much under current law—resulting in higher premiums for most older people.

9) For many lower-income people, the net premiums paid in the nongroup market under this legislation would be lower than those under current law if they purchased benchmark plans, but the plans would require them to pay a greater share of their health care costs.

“We will lower your premiums” the Republican Senators told us.  What they didn’t tell us: “The deductibles and copays will be much higher for all of you.”

10) For older people not eligible for premium tax credits, net premiums (after taking into account the tax savings from paying premiums from a health savings account) could be more than five times larger than those for younger people in many states, rather than only three times larger under current law.

11) Under this legislation, for a single policyholder purchasing an illustrative benchmark plan (with an actuarial value of 58 percent) in 2026, the deductible for medical and drug expenses combined would be roughly $13,000, the agencies estimate.

12) Because a deductible of $13,000 would be a large share of their income, many people with low income would not purchase any plan even if it had very low premiums.

If you are an “older American” – say, just a few years shy of being eligible for Medicare; if you are a family member of a person with Developmental Disabilities; if you are poor or working poor, or if you are a Christian, and simply aware of Jesus’ cry for the poor and a Christian’s call to be for the same thing Jesus is for, then you might want to call your United States Senator and let them know you oppose this legislation.  Offer a word of encouragement to them. One hundred bright Americans elected to deliberate and write legislation that builds up our great nation should really be able to come up with something better than this. (202) 224-3121

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