Noam N. Levey – September 20th, 2017
This piece originally appeared in the LA Times
The latest Republican bid to roll back the Affordable Care Act would likely leave millions of currently insured Americans without health coverage in the coming decades, and strip benefits and protections from millions more, a growing number of independent studies suggest.
Healthcare safety nets in dozens of states stand to lose more than $200 billion by 2026 and hundreds of billions of dollars more in the years that follow, the analyses indicate.
And while the magnitude of the coverage losses is difficult to quantify because the new GOP proposal — written by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) — leaves crucial details to be determined, studies of similar proposals suggest tens of millions of Americans would see major changes to their health coverage.
“The vast majority of states lose money, and some lose truly jaw-dropping amounts,” said Jocelyn Guyer, managing director of Manatt Health, a consulting firm that has analyzed the Graham-Cassidy proposal.
“That suggests coverage losses that are likely somewhere between significant and vast,” she said.
Analyses by other experts — including consultant Avalere Health, the nonprofit Kaiser Family Foundation and the Center on Budget and Policy Priorities, a left-leaning think tank — reach similar conclusions, suggesting the bill would likely erode the historic insurance gains recorded in recent years.
Since 2014, when the current health law was fully enacted, more than 20 million previously uninsured Americans have gained coverage, driving the rate of uninsured to the lowest levels ever recorded.
Fitch Ratings added its own caution, warning in a report that states would face significant “budgetary challenges” under the GOP proposal, which, in turn, could put pressure on state support for schools, cities and colleges and universities.
States like California that have moved aggressively to expand coverage through the 2010 law by expanding Medicaid eligibility and investing in a robust insurance marketplace stand to lose the most under Graham-Cassidy, Avalere and others suggest.
GOP leaders have issued repeated assurances in recent days that the Graham-Cassidy bill would not erode protections extended by the 2010 law, often called Obamacare.
“More people will have coverage, and we protect those with preexisting conditions,” Cassidy said Wednesday in an interview with CNN.
But as they rush to vote, Republican lawmakers are not waiting for an independent analysis by the Congressional Budget Office, or CBO, which lawmakers customarily rely on to asses the impact of large, complex bills. A spokeswoman for Senate Majority Leader Mitch McConnell (R-Ky.) told Politico on Wednesday that McConnell is planning a vote next week.
President Trump added his encouragement from New York, where he is attending the United Nations General Assembly.
“They’re going to do a great job,” the president told reporters, noting many GOP lawmakers had been embarrassed by their inability to pass a repeal bill. “If this happens, it will be a great thing for the country.”
CBO analyses of previous GOP repeal plans have estimated coverage losses of 20 million or more.