YOU WON’T BELIEVE WHAT THE PROPOSED REPUBLICAN HEALTH CARE BILL DOES. IZIAH EXPLAINS.
WHAT IS IT? The Graham-Cassidy Amendment to the American Health Care Act of 2017 (HR-1628)
WHO SPONSORED IT?
Amendment Sponsors: Sen. Lindsey Graham (R-SC), Sen. Bill Cassidy (R-LA), Sen. Dean Heller (R-NV) and Sen. Ron Johnson (R-WI)
Bill Sponsor: Sen. Diane Black (R-TN)
Released: Wednesday, September 20, 2017
WHAT DOES IT DO?
The Graham-Cassidy Amendment is most likely the GOP’s last chance to pass the American Health Care Act. That’s the bill that the Senate tried to pass earlier in the summer and again in July, only to come up one vote short.
SO WHAT?
This bill makes major changes to American health care as we know it. Here is what’s inside the Amendment:
CUTS:
The Amendment cuts many of the main parts of the Affordable Care Act , which is also known as ‘Obamacare.’ The most crucial cute are:
The Individual and Employer Mandate
Healthcare Subsidies to offset the costs premium and co-pays
The Medicaid Expansion
Tax Credits for middle and low income earners
EXPLAIN PLEASE!
COMPANIES WOULD NO LONGER HAVE TO INSURE EMPLOYEES WHO ARE NOW INSURED:
Citizens and large companies — LARGER that 50 employees — would no longer be fined for not having or providing health care coverage.
Insurance costs would INCREASE for those previously covered under the Medicaid expansion, who received tax credits or benefited from subsidies.
CHANGES:
The biggest changes the Amendment makes to Obamacare is to state funding, and to what can be considered a “health care” plan.
It drastically changes the way the Federal Government gives money to states.
Currently, the amount sent to states for healthcare is based on the states’ need — taking into account the incomes of citizens and the level of poverty in the state.
BUT
The Graham-Cassidy Amendment changes this system — to a “block grant” system.
AGAIN, WHAT THE HECK DOES THAT MEAN?
As we saw, the Amendment cuts many of the programs used to address the needs of states. The ‘block grant’ system substitutes that with a fixed amount of money to states.
ISN’T THAT OKAY?
Well, according to analysis by the DC-based health-policy consulting firm Avalere Health, the ‘block grant’ funding in this bill, will cut state budgets by $215 BILLION between 2020 and 2026. Big states would see the most change.
But whether or not a state accepted the Medicaid expansion under Obamacare determines whether the effect is negative or positive:
-Californians will LOSE $786 billion
-New Yorkers will LOSE $456 billion
-Texans will GAIN $356 billion
Other states to lose billions in funding include Pennsylvania, Ohio, Colorado, and Michigan.
(Source: Avalere Health Study: Graham-Cassidy-Heller-Johnson Bill Would Reduce Federal Funding to States by $215 Billion)
By “block granting” funds off, the bill also allows states to figure out how to spend the money and to redefine what they allow to be considered “health care”. States can waive essential components of healthcare that Obamacare had made mandatory for all health insurance plans.
So state will be able to waive (get rid of, not insist on) coverage of:
Outpatient care — the kind you get without being admitted to a hospital
Trips to the emergency room
Treatment in the hospital for inpatient care
Care for moms before and after a baby is born
Mental health and substance use disorder services: These services include behavioral health treatment, counseling, and psychotherapy
They can not cover your prescription drugs
Services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
Your lab tests
Preventive services including counseling, screenings, and care for managing a chronic disease.
Pediatric services: This includes dental care and vision care for kids.
TELL ME MORE IN LANGUAGE I CAN UNDERSTAND PLEASE, IZIAH:
With block grants and waivers for essential services, states could still work to make sure citizens received a high standard of care. But with the massive cuts in what states have to work with, many see this as unlikely. Many citizens are most wary of the freedom the Amendment gives states in no longer requiring insurers to cover essential services.
This could mean that insurers no longer have to cover preexisting conditions, which include: acid reflux, acromegaly, AIDS/HIV, Cancer, Alcohol abuse, high blood pressure and bariatric surgery, to name a few conditions that many Americans suffer from.
Health plans could also be priced based off of your age. This means that older citizens could be charged more because of their age (a component of past AHCA Amendments).
The reason some fear that giving states the right to dictate whether plans are based of age or have to or don’t have to include essentials like covering pre-existing conditions, is because doing so gives health insurance providers the opportunity to raise rates and limit coverage.
The Congressional Budget Office has yet to score this amendment. Which means we don’t know exactly what the costs will be to Americans.
For the bill to pass, it will need just one more Republican Senator’s vote than it received in July. Senator Rand Paul (R-KY) has already tweeted, “Graham/Cassidy keeps Obamacare and tells the states to run it. No thanks.”
Senator McCain just announced that he could not support this bill.
The most important political actors are the other Republican Senators, like Sen. Paul (R-KY), who voted against the prior version: Sen. John McCain (R-AZ), Sen. Lisa Murkowski (R-AL), and Sen. Suzanne Collins (R-ME).
Do you love this bill? Do you have it? Do you think employers should be able to drop folks from insurance coverage? Do you think people should keep their coverage if their are employed with benefits? Do you think folks over 55 should pay more just because the are over 55 — or not? How do you feel about insurers having the right to refuse coverage due to preexisting conditions such as cancer?
Use the BILLCAM to tweet the bill’s sponsor Sen Diane Black, R-TN, and your representative. DO THIS BY WEDNESDAY WHEN THEY ARE DUE TO VOTE!! Have your say.
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