Talking Points: GOP Efforts to Sabotage ACA, End Medicaid and Privatize Medicare Will Continue, Despite Repeal and Replace Failures So Far

 

Every Trump-Republican Senate bill to repeal and replace the ACA with watered-down, more expensive coverage and severe cuts to Medicaid has failed, including the so-called “skinny repeal” that would have taken healthcare away from 16 million Americans, raised premiums by more than 20%, allowed more insurance companies to discriminate against people with pre-existing conditions and given big tax breaks to corporations.

But despite failure in the Senate, GOP leaders still won’t stop trying to take away our health care to give tax breaks to the rich and corporations. Republicans continue their assault on our healthcare with flagrant efforts to sabotage the Affordable Care Act and with cuts to Medicaid and Medicare in the federal budget resolution that are even deeper than those we saw in their repeal bills.

President Trump and Republicans in Congress are Already Sabotaging Obamacare So They Can Renew Their Push for Repeal

Despite clear indications that the majority of the public supports the ACA, rejects repeal and wants politicians to work together to improve the law, President Trump continues his campaign to destabilize the ACA by refusing to implement basic provisions like the individual mandate and the cost sharing reductions that stabilize insurance markets and make coverage affordable for millions. 

  • Trump has said repeatedly that we should let Obamacare collapse and affirmed again after the most recent repeal vote that he plans to “let Obamacare implode” so that there’s a rationale to replace it in the future.
  • President Trump’s administration, including HHS Secretary Price, who is responsible for implementing the ACA have already started to sabotage the ACA by creating chaos and uncertainty, refusing to enforce key provisions and refusing to make critical cost sharing reduction payments that make coverage more affordable for 6 million people who buy insurance on the exchange.
  • The LA Times and other outlets are already reporting on the impact of Trump’s sabotage: “Insurers and State Officials Say Trump is Undermining Obamacare, Pushing UP Rates” (May 18, 2017). Read more to find out what they are saying!!
  • Trump’s Administration is purposely trying to lower enrollment in the ACA by cancelling public education outreach and advertising that help people looking for insurance understand where they can go to get affordable coverage under the law.

TRUMP-RYAN Budget Resolution Cuts Trillions from Medicaid and Medicare to Give Trillions in Tax Cuts to the Rich and Corporations

Republicans are going to give up on dismantling Medicaid and Medicare either. While Senate GOP leader Mitch McConnell and the Republicans were busy trying to move their deeply unpopular legislation to repeal the ACA and make dramatic changes to Medicaid, House Speaker Paul Ryan has been working on a FY2018 budget resolution that would end Medicaid and Medicare as we know them.

The House budget would cut funding for Medicare by $487 billion over 10 years and cut Medicaid and other health care programs by $1.5 trillion over the same period—in order to give massive tax breaks to the richest households and corporations.

  • The budget resolution calls for immediate adoption of the House passed bill (AHCA) that repeals the ACA, eliminates Medicaid expansion, and weakens coverage while increasing out of pocket costs especially for older people.
  • The budget ends Medicaid as we know it by replacing the traditional Medicaid program that for over 50 years has provided health care for seniors, children, people with disabilities, pregnant women and low income people with a per capita cap or block grant that cuts funding permanently and shifts the burden of coverage to states or to the patients themselves.
  • The budget fundamentally changes Medicare—a program Trump vowed not to touch—o that rather than providing guaranteed benefits for seniors, it offers “premium support” or vouchers to purchase more costly private insurance that may or may not cover all of seniors’ health care needs. Just like they Republican plan to end Medicaid as we know it, they are doing the same to Medicare by privatizing it with a voucher system.
  • Includes trillions in tax breaks for the rich and corporations funded by cuts to healthcare and the social safety net. Nearly all—99%–of these tax breaks will go to the top 1% richest households, which will get an annual tax break of $213,000 a year.

We stopped healthcare cuts to fund tax breaks in the repeal bills that were just defeated, but during the August Recess we must up keep up the pressure on Congress and deliver the same clear message:

Don’t Take Away Our Healthcare to Give Tax Breaks to Millionaires and Corporations!

In September, House Republicans will take up the Budget Resolution and hope to get a floor vote so they can then send the bill to the Senate and Trump’s desk. Once again, we must educate our communities about the devastating impact of these proposals and mobilize grassroots activists and impacted people to stop these attacks on our healthcare.

Talking Points: GOP Continue Efforts to Sabotage and Repeal ACA, End Medicaid and Medicare Even As Senate Bill to Repeal and Replace Dies This Week

The Trump-Republican Senate bill to repeal and replace the ACA with watered-down, more expensive coverage and severe cuts to Medicaid has failed, but GOP leaders still won’t stop trying to take away our healthcare to give tax breaks to the rich and corporations. Right now, the Republican assault on our healthcare continues on three fronts: repeal without replacement in the Senate, ACA sabotage and deep cuts to Medicaid and Medicare in the House budget.

Next week, Senate Leader Mitch McConnell plans a new vote to fully repeal the ACA, this time without proposing replacement plans until two years after the law is repealed. The bill is a version of the 2015 “repeal and delay” reconciliation bill that President Obama vetoed.

What repeal without replace will do – according to the non-partisan Congressional Budget Office

  • Take away health coverage from 32 million Americans. The repeal bill will take health care away from 18 million people, almost all working families, next year alone; 27 million in two years; and 32 million by 2026.
  • Double health insurance premiums. The repeal bill will raise premiums 25% next year, then 50% in two years, doubling them by 2026.
  • Cut healthcare for millions while giving households with incomes over $1 million by over $50,000 per year in tax breaks.

How repeal without replace does this

  • Takes away the tax credits that help working families pay for health insurance.
  • Ends the Medicaid expansion that provides health coverage to 11 million Americans.
  • De-stabilizes the individual insurance market by ending the requirement that everyone have insurance and driving insurance companies out of the market.   By the early 2020s, about half of U.S. population would live in areas with no individual market insurers under this bill.

President Trump and GOP leaders won’t stop with just one more repeal vote. Even though voters and their own caucus have rejected their “repeal and replace” bill–one of the most unpopular bills in history—they continue to attack healthcare in new ways.

President Trump and Republicans in Congress are Already Sabotaging Obamacare

  • Trump has said repeatedly that we should let Obamacare collapse and affirmed again this week that he plans to “let Obamacare fail,” so that there’s a rationale to replace it in the future.
  • President Trump’s administration, including HHS Secretary Price, who is responsible for implementing the ACA have already started to sabotage the ACA by creating chaos and uncertainty, refusing to enforce key provisions and refusing to make critical cost sharing reduction payments that make coverage more affordable for 6 million people who buyinsurance on the exchange.
  • The LA Times and other outlets are already reporting on the impact of Trump’s sabotage: “Insurers and State Officials Say Trump is Undermining Obamacare, Pushing UP Rates” (May 18, 2017). Read more to find out what they are saying!!

As McConnell and the GOP moves forward with their repeal the ACA with no plan for replacement in the Senate , the House Republicans are working a FY2018 budget resolution. Like the House and Senate repeal bills, the GOP’s Budget Resolution Ends Medicaid (& Medicare) as we know it

  • House budget would cut funding for Medicare by $487 billion over 10 years and cut Medicaid and other health care programs by $1.5 trillion over the same period—the cuts to Medicaid are even bigger than those in the House passed repeal bill (AHCA).
  • The budget resolution calls for immediate adoption of the House passed bill (AHCA) that repeals the ACA and ends Medicaid as we know it by replacing the traditional Medicaid program that provides healthcare for 70 million seniors, children, people with disabilities, pregnant women and low income people with a per capita cap or block grant that cuts funding permanently and shift the burden of providing coverage to states or to the patients themselves.
  • The budget fundamentally changes Medicare—a program Trump vowed not to touch–so that rather than providing guaranteed benefits for seniors, it offers “premium support” or vouchers to purchase more costly private insurance that may or may not cover all of seniors’ healthcare needs. Just like the Republican plan to end Medicaid as we know it, privatization through vouchers would transform Medicare and hurt seniors who depend on it.

So far, grassroots energy and activism has stopped the GOP’s efforts to take our healthcare away. By confronting lawmakers at town halls, organizing events, educating our neighbors and taking action to protest health care proposals that would put our lives on the line, we’ve stopped the latest Senate bill from advancing.

But President Trump and the Republicans won’t stop because of one failure. In fact, they are already exploring other avenues to advance their agenda piecemeal and to cut healthcare for America’s families in order to fund huge tax breaks for the rich and corporations. We must continue to tell Republicans on all fronts: Don’t Take Away Our Healthcare!

Talking Points: Don’t Cut Health Care for Families to Give Tax Breaks to Millionaires and Corporations

 

Don’t Cut Health Care for Families to Give Tax Breaks to Millionaires and Corporations

The Senate plans to vote soon on a health care bill that they’ve been crafting behind closed doors. While they’ve been trying to keep it a secret, the word is out – the Senate bill is the same as the awful House bill the public has already rejected. The Senate is just putting lipstick on a pig.

Core Message

The Republican health care bill takes health care away from 23 million Americans, slashes Medicaid, sends premiums through the roof, and puts people with pre-existing conditions back at the mercy of the private insurance companies. It promotes barebones coverage, even weakening protections for people who get health insurance, and defunds Planned Parenthood. All to give more than $600 billion in tax breaks, mostly to the very wealthy and drug and insurance companies.

Key Points

  • The Republican bill takes coverage away from 23 million Americans by drastically cutting tax credits to buy coverage and by making huge cuts in state funding for Medicaid.
  • The Republican bill will slash Medicaid by $834 billion in two ways– taking away Medicaid expansion coverage from millions of people and radically restructuring the federal funding for the basic Medicaid program to starve it over the years, forcing eligibility and benefit cuts. Their gutting of Medicaid threatens the health care of 74 million Americans – from children to seniors – who rely on Medicaid every day and blows huge holes in state budgets.
  • The Republican bill jacks up premiums the most for people over 50 and families with moderate incomes.
  • The Republican bill is an attack on women’s health care, from family planning and preventive services to the half of pregnant women who rely on Medicaid to pay for their children’s births to the millions of older women who rely on Medicaid to pay for their long-term care.
  • Trump and Republicans in Congress are actively sabotaging Obamacare now, to justify their repeal wrecking ball. They are decreasing the number of people who have coverage and refusing to make promised payments to lower out-of-pocket costs, all of which is leading to insurance companies raising premiums even higher and fewer insurance companies offering coverage.
  • The problem the ACA faces is Republican sabotage and repeal – not the markets. A record number of people gained coverage under the ACA, and the biggest insurance companies made robust profits – some tripling their profits from 2011 to 2015.
  • If Trump and Republicans in Congress really wanted to protect our health care, they would stop sabotaging Obamacare and immediately support provisions in the ACA that make private insurance more affordable and offer Medicaid or Medicare alongside private insurance, so everybody has a choice of insurance plans.

Talking Points: On the CBO Scorecard for the Republican Plan to Gut the ACA and Slash Medicaid

 

Trump and the GOP will take health coverage from 23 million Americans

Talking Points on the CBO Scorecard for the Republican Plan to Gut the ACA and Slash Medicaid

One Sentence

According to the official, non-partisan scorekeeper, the Republican American Health Care Act (AHCA) will take health coverage away from 23 million Americans, slash Medicaid by $834 billion and ruin protections for people with pre-existing conditions to give $600 billion in tax breaks, mostly to the wealthy and drug and insurance corporations.

Key Points

According to the CBO, the official, non-partisan scorekeeper:

  • The Republican bill takes coverage away from 23 million Americans by drastically cutting tax credits to buy coverage and by making enormous cuts in state funding for Medicaid.
  • The Republican health care bill slashes Medicaid by $834 billion in two ways – taking away Medicaid expansion coverage from millions of people, and radically restructuring the federal funding for the basic Medicaid program to starve it over the years, forcing eligibility and benefit cuts. Their gutting of Medicaid threatens the health care of 74 million Americans – from children to seniors – who rely on Medicaid every day and blows huge holes in state budgets.
  • The Republican bill is a disaster for people with pre-existing conditions. In states that eliminate protections for people with pre-existing conditions,  “less healthy people would face extremely high premiums” and “it would become more difficult for less healthy people (including people with preexisting medical conditions) in those states to purchase insurance because their premiums would continue to increase rapidly.” Even worse, the CBO says people may not be able to buy any health plans that cover essential health benefits.
  • The Republican bill cuts benefits and hikes out-of-pocket costs. In states that choose to eliminate essential health benefits (as allowed under the AHCA),  people  “would experience substantial increases in out-of- pocket spending on health care or would choose to forgo the services … In particular, out-of-pocket spending on maternity care and mental health and substance abuse services could increase by thousands of dollars in a given year.
  • The Republican bill hikes premiums as you get older. In states that keep the Affordable Care Act’s current consumer protections, the bill’s huge cuts in tax credits to pay for coverage will result in big hikes in premiums for people over 50 and for working families with moderate incomes. A 64 year old will pay $16,100 a year, nine times the $1,750 it costs now!! In every state, premiums will be higher the older you get.
  • The Republican bill gives $664 billion in tax breaks, mostly to the wealthy and drug and insurance corporations. It even has a special tax break for insurance company CEOs.
  • The Republican bill pushes people into high-deductible insurance plans and ends the ACA program that limits out-of-pocket costs to many working families.
  • The Republican plan defunds Planned Parenthood in 2018.

Talking Points: Revised CBO Score – Short Version

 

Today’s updated Congressional Budget Office (CBO) score shows that the GOP repeal bill will destroy America’s health care. The analysis shows that the 23 million will lose coverage, millions of people with pre-existing conditions will be at risk of paying higher premiums or giving up coverage, and Medicaid will be cut by $834 billion, putting healthcare in jeopardy for seniors, children, people with disabilities and families.

  • The Republican AHCA bill waters down coverage and makes coverage for essential health benefits like maternity and newborn care, mental health treatment, prescription drugs among many others optional for insurance companies.
  • The AHCA still defunds Planned Parenthood, the source of healthcare for over 2 million people, many in rural communities where there are no other providers of basic health care.
  • The bill still makes radical changes to Medicaid, starving the program, killing jobs and shifting huge burdens to state budgets that could put many services at risk.
  • At the same time that the bill takes healthcare away and raises costs for millions, it gives over $600 billion tax breaks to the rich, insurance and prescription drug companies.

Today’s CBO score affirms what we already know: the Republican repeal bill doesn’t fix healthcare, it dismantles our health care and makes things worse. That’s why less than half of Americans support the bill.

The Senate should reject this dangerous bill. Instead, Senators should work with Democrats to develop proposals that improve, expand and protect health care. Any Senate bill should ensure that no one loses health care, including people who got coverage from the expansion of Medicaid, and should reject block grants and caps in that make permanent cuts in Medicaid services for children, seniors, people with disabilities and poor adults who have no other source of healthcare.

Talking Points: Tell Congress: Don’t Take Our Health Care

 

Shortest message

The Senate should not vote for any bill that does what the Republican bill in the House does: takes away our health care, cuts Medicaid, raises our premiums and jeopardizes protections for people with pre-existing conditions. All to give massive tax cuts to the very wealthy and drug and insurance corporations.

Core message

The Republican health care bill takes health care away from 24 million Americans, slashes Medicaid, sends premiums through the roof, and puts people with pre-existing conditions back at the mercy of the private insurance companies. It promotes barebones coverage, even weakening protections for people who get health insurance and defunds Planned Parenthood. All to give huge tax breaks to the wealthy and drug and insurance corporations. To get their way, Trump and the Republicans in Congress are now sabotaging care for the millions of Americans who rely on the Affordable Care Act, by hiking premiums and co-payments and chasing insurance companies out of providing coverage.

Key points to make

  • The Republican bill takes coverage away from 24 million Americans – 14 million next year alone – by drastically cutting tax credits to buy coverage and by making enormous cuts in state funding for Medicaid.
  • The Republican bill will slash Medicaid by $880 billion in two ways – taking away Medicaid expansion coverage from millions of people and radically restructuring the federal funding for the basic Medicaid program to starve it over the years, forcing eligibility and benefit cuts. Their gutting of Medicaid threatens the health care of 74 million Americans – from children to seniors – who rely on Medicaid every day and blows huge holes in state budgets.
  • The Republican bill jacks up premiums the most for people over 50 years old and families with moderate incomes.
  • The Republican bill is an attack on women’s health care, from family planning and preventive services to the half of pregnant women who rely on Medicaid to pay for their children’s births to the millions of older women who rely on Medicaid to pay for their long-term care.
  • Trump and Republicans in Congress are actively sabotaging Obamacare now, to justify their repeal wrecking ball. They are decreasing the number of people who have coverage and refusing to make promised payments to lower out-of-pocket costs, all of which is leading to insurance companies raising premiums even higher and fewer insurance companies offering coverage.
    • The problem the ACA faces is Republican sabotage and repeal – not the markets. A record number of people gained coverage under the ACA, and the biggest insurance companies made robust profits – some tripling their profits from 2011 to 2015. 
    • If Trump and Republicans in Congress really wanted to protect our health care, they would stop sabotaging Obamacare and immediately support provisions in the ACA that make private insurance more affordable and offer Medicaid or Medicare alongside private insurance, so everybody has a choice of insurance plans.

Talking Points: Tell Congress: Don’t Take Our Health Care by Wrecking Medicaid

 

Core message

The Republican health care bill takes health care away from 24 million Americans, slashes Medicaid, sends premiums through the roof, and puts people with pre-existing conditions back at the mercy of the private insurance companies. It promotes barebones coverage, weakens protections for people who get health insurance, and defunds Planned Parenthood. All to give huge tax breaks to the wealthy and drug and insurance corporations. To get their way, Trump and the Republicans in Congress are now sabotaging care for the millions of Americans who rely on the Affordable Care Act, by hiking premiums and co-payments and chasing insurance companies out of providing coverage.

Core message on Medicaid

The Republican health care bill slashes Medicaid by $880 billion in two ways – taking away Medicaid expansion coverage from millions of people, and radically restructuring the federal funding for the basic Medicaid program to starve it over the years, forcing eligibility and benefit cuts. Their gutting of Medicaid threatens the health care of 74 million Americans – from children to seniors – who rely on Medicaid every day and blows huge holes in state budgets.

Medicaid Matters

Medicaid provides coverage to 74 million people – one in four Americans, including 30 million children. It pays for half the births in the United States, 75% of all family planning services and 50% of long-term care.

The Republican bill will take Medicaid away from 14 million Americans:
The Republican bill ends the expansion of Medicaid to working families, which has led to millions of Americans getting lifesaving health coverage, having a regular doctor or clinic to go to, cutting their out-of-pocket costs and improving their health.

The Republican bill radically changes Medicaid, with deep cuts that will endanger health care for 74 million Americans.

  • The Republican bill is an attack on women’s health care, from family planning and preventive services to the half of pregnant women who rely on Medicaid to pay for their children’s births to the millions of older women who rely on Medicaid to pay for their long-term care.
  • The Republican bill is an attack on long-term care for seniors and people with disabilities. Medicaid now covers more than 60% of nursing home residents across our nation. And Medicaid allows more than 3.2 million seniors and people with disabilities to live with independence in their own homes.
  • The Republican bill’s radical changes and deep, permanent cuts to Medicaid will wreck state budgets and jeopardize the jobs of millions of health care providers. It will force many hospitals and community health centers to cut back services and others to close.
  • The Republican health care bill radically replaces a 50-year partnership between the federal government and states with an artificial cap that will forces states to either end coverage or eliminate health care services for seniors, people with disabilities, children and working families.
  • The Republican bill’s radical changes in Medicaid funding will cripple states faced with health emergencies like the opioid crisis. When there is a health care emergency, it will be up to the states alone to meet the challenge, without a dime of extra help from the federal government.

Talking Points: Tell Congress and the President: Don’t Take Our Health Care by Sabotaging The Affordable Care Act

 

Core message

The Republican health care bill takes health care away from 24 million Americans, slashes Medicaid, sends premiums through the roof, and puts people with pre-existing conditions back at the mercy of the private insurance companies. It promotes barebones coverage, even weakening protections for people who get health insurance through their employers. All to give huge tax breaks to the wealthy and drug and insurance corporations.

“Insurers and State Officials Say Trump is Undermining Obamacare, Pushing UP Rates” Headline in LA Times, May 18, 2017. Read more to find out what they are saying!!

To get their way, Trump and the Republicans in Congress are sabotaging health care for the millions of Americans who rely on the Affordable Care Act by hiking premiums and co-payments and by pushing insurance companies to abandon the system.

Trump and Republicans are Threatening People’s Health Care Today to Sabotage Obamacare:

  • What they are saying: Republicans in Congress can’t defend their awful health care bill. Instead they just keep claiming, in the words of Speaker Paul Ryan, “Obamacare is collapsing.”
  • What they are doing – Higher premiums; fewer choices of insurers. The Trump administration and Republicans in Congress are actively sabotaging Obamacare now, to justify their repeal wrecking ball. They are decreasing the number of people who have coverage and refusing to make promised payments to lower out-of-pocket costs, all of which is leading to insurance companies raising premiums even higher and fewer insurance companies offering coverage.
    • President Trump, HHS Secretary Price and the Republicans want the ACA to fail—that’s why they are no longer implementing pieces of the law like the individual mandate and are pulling back on the marketing that encourages people to enroll in marketplaces.
    • President Trump has repeatedly threatened to stop making payments to insurers called Cost Sharing Reductions that help lower the cost of premiums so that more people can afford to buy coverage in the marketplace. These payments are designed to keep insurers in the marketplaces and make coverage affordable so that customers can buy it.
    • Republicans want to destroy Obamacare anyway they can by repealing the ACA, creating instability and making out-of-pocket costs for coverage too expensive for too many people to afford. Without customers, insurance companies will be forced out of the market and Obamacare will collapse in some places where there’s only one insurer – leaving people with no coverage. Some insurers are already pulling out.
    • Republican sabotage led by President Trump is driving insurers out of the marketplace, not the ACA. Up until this year, a record number of people gained coverage under the ACA, generating millions of new customers for insurance companies. The biggest insurance companies made robust profits as a result– some tripling their profits from 2011 to 2015.

If President Trump and the Republicans really wanted to protect our health care, they would reduce premiums and expand coverage by giving people more options: support provisions in the ACA that make private insurance more affordable and offer Medicaid or Medicare alongside private insurance so everyone has a choice.

Talking Points on ACA Cost-Sharing Payments

It’s Not Over! Trump can still take health care away
from millions in one easy step

He can be the one to cause Obamacare to “explode” by wrecking consumer protections against high out-of-pocket costs.

If Trump does not defend a lawsuit filed by Republicans in Congress against the Affordable Care Act, insurance premiums will skyrocket and many more health insurance companies will flee, taking health care away from millions of working families.

The Story

The Affordable Care Act pays health insurance companies to keep out-of-pocket costs low for millions of working families. But Republicans in Congress filed a lawsuit to stop the Obama administration from making those payments to insurance companies. The lawsuit is now stuck in court – waiting for the Trump administration to act.

If the Trump administration decides not to fight the lawsuit, those payments will stop and insurance companies will send premiums through the roof and stop selling health insurance all together.

President Trump tweeted “Obamacare will explode.” We need to stop him from pulling the trigger by doing nothing. Instead we need Trump to defend the payments.

Congress must act too!

Congress should approve keeping the payments that lower deductibles and co-payments for working families. At the same time, Members of Congress should urge Trump to defend the payments in court so people can keep their care.

We stopped Congress from repealing and replacing Obamacare because that would take health care away from millions of Americans. We must keep the pressure on Congress to keep consumer protections against high-out-of-pocket costs.

6 million Americans pay lower out-of-pocket costs under the ACA

State #
United States 6,353,551
Alabama 125,424
Alaska 7,500
Arizona 94,463
Arkansas 36,134
California 707,671
Colorado 28,929
Connecticut 52,132
Delaware 11,146
District of Columbia 279
Florida 1,125,850
Georgia 322,348
Hawaii 8,067
Idaho 58,781
Illinois 156,469
Indiana 77,251
Iowa 25,677
Kansas 53,034
Kentucky 32,186
Louisiana 118,597
Maine 42,880
Maryland 72,175
Massachusetts 132,721
Michigan 164,725
Minnesota 12,128
Mississippi 60,354
Missouri 148,033
Montana 23,479
Nebraska 41,950
Nevada 48,736
New Hampshire 17,376
New Jersey 129,277
New Mexico 22,655
New York 40,544
North Carolina 360,045
North Dakota 9,199
Ohio 95,312
Oklahoma 81,053
Oregon 52,960
Pennsylvania 227,304
Rhode Island 21,270
South Carolina 150,030
South Dakota 15,108
Tennessee 138,272
Texas 646,415
Utah 106,589
Vermont 9,751
Virginia 222,233
Washington 66,083
West Virginia 17,414
Wisconsin 123,307
Wyoming 12,235

Talking Points on the Republican Bill to Gut the ACA and Slash Medicaid

One sentence

The Republican bill to gut the Affordable Care Act and slash Medicaid takes health coverage away from millions of Americans – from seniors to children – will force people to pay much, much more for, high-deductible insurance and blows a huge hole in state budgets, while giving massive tax cuts to the very wealthy and drug and insurance corporations. And it defunds Planned Parenthood.

Key Points

  • The Republican bill guts the Affordable Care Act and slashes Medicaid.
  • The Republican bill takes coverage away from millions of Americans by drastically cutting tax credits to buy coverage and by making enormous cuts in state funding for Medicaid.
  • The Republican bill will hike the cost of health insurance for millions of Americans, with the biggest increases for seniors and moderate-income working people.
  • The Republican bill hike premiums by 30% for people with pre-existing conditions if for any reason – such as losing a job – they don’t have coverage for 63 days.
  • The Republican bill pushes people into high-deductible insurance plans and ends the ACA program that limits out-of-pocket costs to many working families.
  • The Republican bill ends Medicaid expansion and slashes state funding for the regular Medicaid program by radically changing the way Medicaid is funded. States will be forced to end coverage and eliminate health care services for seniors, people with disabilities, children and working families.
  • The Republican bill gives huge tax cuts to the wealthiest Americans and to drug, insurance and medical-device companies – it even has a special tax break for health insurance CEOs.
  • The Republican plan defunds Planned Parenthood.

Key Provisions

  • Ends the ACA’s tax credits, which were based on income, starting in 2020 and replaces them with tax credits that only go up with age.
    • Tax credits are reduced to $2,000 for people under 30 to $4,000 for people over 60.
    • Phases out the tax credits for incomes above $75,000.
    • Tax credits are not adjusted by local cost of living.
    • At the same time, allows insurance companies to charge seniors up to 5 times as much as young people – current law is 3 times.
  • Bottom line: most people will get much lower tax credits and so have to pay more themselves for coverage – with moderate-income families, older people, and people who live in high medical cost areas seeing the biggest increases.
  • Immediately eliminates the ACA’s requirement that individuals have insurance coverage and that employers with more than 50 employees pay for coverage.
    • Ending the individual mandate, combined with keeping coverage for pre-existing conditions and lowering tax credits, will start an insurance market death spiral. People who are the sickest will scrape to find a way to buy coverage while others drop out, leading to higher premiums and more people dropping out.
  • Ends Medicaid expansion and cuts coverage for children and adults in Medicaid.
    • Ends Medicaid expansion beginning in 2020, with some transition for people already enrolled.
    • Only requires states to cover children in Medicaid who are under the poverty level, reducing the requirement from 133% of the poverty level.
    • Ends federal funding for adults in Medicaid who are over 133% of poverty.
  • Replaces Medicaid’s funding of actual health spending by capping at a cost per-person, starting in October 2019.
    • Instead of states getting a fixed percentage of payments from the federal government (which varies by state), the federal government would cap the amount that it pays per person at the medical CPI.
    • Capping Medicaid will result in hundreds of billions of dollars in cuts to states.
    • In a public health crisis – the opioid crisis, Zika, etc. – the federal government will not increase funding for state Medicaid programs.
  • Pushes people into high-deductible health plans, through several provisions.
    • Allows insurance companies to sell catastrophic plans, ending the requirement that plans cover a set percentage of medical costs – the ACA’s platinum, gold, silver and bronze plans.
    • Ends the ACA’s plan that limits out of pocket costs for people with moderate incomes.
    • Increases tax benefits of health savings accounts, which are usually high deductible plans that only work if you are rich enough to save money out of your paycheck.
  • Hikes health care costs for people with pre-existing conditions.
    • Insurance companies must charge anyone who has not been insured for 63 days a 30% surcharge on their premiums.
    • Sets up a “Patient and state stability fund,” which can fund state high-risk pools, for people who need costly medical care. The 35-year history of states attempting high-risk pools resulted in high-premiums, high-deductibles and long-waiting lists.
  • Huge tax breaks – $525 billion over 10 years – for the wealthy and for drug, insurance and medical device corporations.
    • Ends the ACA’s taxes on unearned income for people with high incomes. The top 0.1% of households—those with income of at least $3.7 milliona year—would receive a tax cut of about $197,000 in 2017, on average.
    • Ends the ACA’s taxes on insurance, drug and medical device corporations.
    • Even ends an ACA provision that limited insurance companies from writing off high executive salaries.
  • Defunds Planned Parenthood.