Commentary

What you need to know about the new report on Trumpcare

Health policy expert Brendan Riley of the N.C. Justice Center’s Health Advocacy Project released his analysis of the Congressional Budget Office report on Trumpcare last night, Here’s what he found:

Today, the Congressional Budget Office (CBO) released its analysis of the American Health Care Act passed on May 4 by the U.S. House of Representatives by a vote of 217-213. The bill was amended less than 24 hours before the final vote, and the House – including nine Republican lawmakers from North Carolina’s congressional delegation – passed it without having obtained the critical analysis from the CBO about the impacts on health coverage.

The previous iteration of this bill failed to attract sufficient votes from centrists and conservatives alike. Yet the amended bill would devastate older North Carolinians, Tar Heels with lower incomes, and our neighbors living with pre-existing conditions. Overall the CBO finds that the amended Trumpcare bill would:

  • Leave 23 million more Americans uninsured than the Affordable Care Act;
  • Hike premiums, particularly for low-income communities and people over the age of 50;
  • Eliminate affordable coverage options entirely for less healthy consumers and those with pre-existing conditions; and
  • Provide tax breaks to the wealthy, insurers, and drug companies at the expense of the Medicaid program, for which it would cap federal spending and cut by $834 billion.

Today’s CBO analysis confirms what we knew all along: last-minute amendments negotiated in the middle of the night made the American Health Care Act even worse for the American people. These changes would eliminate key protections for consumers, including the ban on pricing discrimination against people with pre-existing conditions and minimum standards of coverage for plans.

Contrary to predictions recently made by Senator Thom Tillis, the CBO estimates that states would take up waivers to eliminate protections for people with pre-existing conditions against pricing discrimination and to allow insurance companies to sell plans that offer bare-bones coverage and minimal protection from major medical risks. In fact, according to the CBO, one-sixth of the U.S. population would see their insurance markets destabilized by the AHCA, and people with pre-existing conditions would be practically priced out of the market entirely. What’s more, 3.4 million North Carolinians with job-based coverage could once again face lifetime limits on coverage. Both this bill and its previous iteration would slash a total of $834 billion from the Medicaid program, kicking 14 million Americans off the coverage upon which they rely. As a result of these cuts, North Carolina would have to absorb $6 billion in cost shifts from the federal government to our state budget over 10 years, putting the benefits and coverage of North Carolina’s children, people with disabilities, and seniors in long-term care at risk.

In short, this bill would increase the number of uninsured in our state, make premiums and out-of-pocket costs like deductibles less affordable, reduce the quality and comprehensiveness of coverage, and deny equitable access to coverage for people with pre-existing conditions.

The Senate must start from scratch with a proposal to improve the health care system in our country. In order to do that, the Senate must ensure any future proposal does not:

  • Increase the uninsured rate
  • End the Medicaid program as we know it through a cap on federal funding to states (such as a per capita cap or a block grant)
  • Repeal the Medicaid expansion

The following members of the North Carolina delegation voted for the AHCA without waiting for today’s CBO report to analyze the impact of the bill:

  • Rep. George Holding (District 2);
  • Rep. Virginia Foxx (District 5);
  • Rep. Mark Walker (District 6);
  • Rep. David Rouzer (District 7);
  • Rep. Richard Hudson (District 8);
  • Rep. Robert Pittenger (District 9);
  • Rep. Patrick McHenry (District 10);
  • Rep. Mark Meadows (District 11); and
  • Rep. Ted Budd (District 13).

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