Our senators must vote no on Senate's Trumpcare bill

Vincent Carr
July 16, 2017

"I look forward to reviewing the revised Senate health care legislation and forthcoming CBO report to determine the impact on West Virginians, but continue to have serious concerns about the Medicaid provisions", Sen. We need to attract more than 600,000 additional home care workers by 2024. But Republicans are offering $70 billion in subsidies for lower income people.

And there are potential unintended consequences for people with employer-provided insurance, now about 170 million Americans.

The bill includes a version of an amendment proposed by Texas Sen. Pat Toomey, R-Pa., and which was unveiled June 22.

GOP is the latest healthcare bill and Democrats are trying to make changes but this new Senate bill left Medicaid untouched. As many as 20 million Americans get coverage this way, about half through subsidized markets like HealthCare.gov, created under former President Barack Obama.

States that offer state-funded adoption assistance payments for children with special needs may also make them eligible for Medicaid. They said it would "undermine protections for those with pre-existing medical conditions", increase premiums and lead many to lose coverage. It also provides almost $45 billion from 2018 through 2026 to help states battle opioid addiction. But it's not clear how those backstops would work, and the federal funding eventually would end.

The provision would let insurers sell low-priced policies with skimpy coverage, as long as they also sold policies that met a stringent list of services required under the ACA, like mental health counseling and prescription drugs. She predicted skyrocketing costs for taxpayers also, stuck with the bill for sicker patients.

In an unusual joint effort, the nation's two major insurer lobbying groups wrote to Senate Majority Leader Mitch McConnell and Democratic Leader Charles Schumer to say they "strongly oppose" the provision.

The revised bill would allow consumers to use health savings accounts (HSAs) to pay for their premiums. Under current law, they can only be used to cover out-of-pocket costs, such as deductibles and copayments.

Many vets instead rely on Medicaid for their health insurance.

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The president remains focused on getting a deal on health care that's better for the American people, a senior administration adviser told CNN on Friday.

"Allowing individuals to purchase insurance with pre-tax dollars eliminates one of the advantages to employer-provided insurance", said Elizabeth Carpenter of the Avalere Health consulting firm.

Yet leading mental health groups say they see no reason to celebrate. States would have to find space within a fixed, insufficient amount of money for everyone helped by Medicaid.

The Senate's proposal to repeal the Affordable Care Act (ACA) and to sharply cut Medicaid payments to states through so-called per capita caps can sound very abstract to social workers and policymakers coping with the day-to-day tragedies and crises of child welfare. Perhaps more significantly, it would limit future federal funding for the overall program. What the ACA did was to create the Medicaid expansion program.

In changes aimed at appeasing concerns from Capito and others, the new bill added $45 billion to states to fund opioid treatment.

The Cruz amendment "is simply unworkable in any form and would undermine protections for those with pre-existing medical conditions, increase premiums and lead to widespread terminations of coverage for people now enrolled in the individual market", wrote the CEOs of America's Health Insurance Plans and the BlueCross BlueShield Association.

Republican governors don't like the Medicaid cuts, and some have been vocal.

Increasing the pressure: GOP leaders have restarted the clock by publicly stating that they'd like a vote (or at least to take the procedural steps toward a vote) next week. "I keep going back to the fact that they are living a better quality of life".

Other reports by BadHub

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