CBO Confirms Devastating Impact of Senate Health Bill.

A new independent analysis released today confirms that the Senate Republican health care proposal, called the “Better Care Reconciliation Act” or BCRA, will result in millions more uninsured, or paying much more for far less coverage. Some highlights about this devastating bill slated for Senate (and maybe House) votes this week:

  • Congressional Budget Office Estimates 22 Million MORE Uninsured Nationally; Likely 4-5 Million in California
  • Senate Bill Cuts Medicaid by 26% or $772 Billion–But Actually Has Steeper Cuts in Out Years, Likely More than $25B/Year to Medi-Cal
  • Cuts to Subsidies Would Raise Premiums and Cost Sharing, Shifting Many in Covered California and Medi-Cal to $6,000 Deductible Plans

The non-partisan and independent Congressional Budget Office’s (CBO) found that BCRA will result in 15 million Americans losing coverage in 2018, 19 million by 2020, and 22 million by 2026. The proposal will also cut overall Medicaid funding by $772 billion (a 26% reduction) over the next decade by eliminating the Medicaid expansion and capping the Medicaid program and ending the matching guarantee that has been in place for over 50 years.

The new independent analysis confirms the catastrophic impacts of Congressional proposals to cap and cut Medicaid and the ACA. With this analysis of these awful impacts, it’s shocking that this bill was ever even proposed, much less slated to be voted and passed into law in just a week. The bill’s severe cuts to Medicaid and affordability assistance for private coverage would mean 22 million more uninsured Americans, but also cuts to the hospitals, providers, and health system on which we all rely. In our state, the Senate bill’s passage means at least 4-5 million uninsured Californians becoming uninsured, living sicker, dying younger, and being one emergency away from financial ruin.

As bad as this analysis is, the CBO score underplays the impact of the Medicaid cuts, which are backloaded in the final years of the ten-year window, and are even worse in future years. The California Department of Health Care Services suggested the House bill would lead to $24 billion/year in cuts to Medi-Cal which is equivalent to what the state budget spends on all of higher education and all of corrections, combined. The Senate version is likely even worse.

The CBO confirms that many in Covered California will pay far more for far less coverage, shifting many more low- and moderate-income families into plans with over $6,000 deductibles that they can’t afford. The analysis shows low-income residents of any age making $26,500 would pay hundreds if not thousands of dollars more in premiums. Older residents making $56,800 go from paying $4,400 for a higher deductible plan to paying $16,000 with even higher cost-sharing.

This report is just the tip of the iceberg in terms of detailing the interlocking and unintended consequences that will never be known and properly analyzed, given that this bill has never had a single hearing and yet it may be law within the week. What we know now should be enough to stop this slide into destruction of our care and coverage. Unless some Republican legislators put good policy over party, we are a vote away this week from health care Armageddon.