Yesterday, the new draft to repeal the Affordable Care Act by Speaker Paul Ryan, Majority Leader Kevin McCarthy, and the GOP Leadership of the U.S. House of Representatives was released, showing it goes a lot further to undermine the health care for Californians than simply undoing the coverage for most of the five million Californians who get direct help from the Affordable Care Act.
The House leadership’s proposal would undermine the way millions of Californians get coverage, public and private. The plan goes beyond repealing the Affordable Care Act and the loss of coverage for millions Californians by also capping Medi-Cal, which covers a third of our state. While they promised not to pull the rug out from under anyone, this plan would cut at least $8 billion from Medi-Cal by 2020, and another $10-20 billion more in the future, imperiling the coverage of the over 14 million Californians who depend on the program.
For those who buy coverage as an individual, this proposal would reduce the tax credits that low- and moderate-income people get to afford coverage—and no longer based than on income or the cost of the premiums. Hundreds of thousands of Californians of the 1.2 million who get affordability assistance now through Covered California would likely fall off of coverage, but the rest of us would be left in a smaller and sicker insurance pool–spiking premiums significantly and leading to additional uninsured Californians.
Overall, the replacement plan cuts and caps coverage and affordability assistance for low- and moderate-income working Americans, just to give a massive tax giveaway to the wealthiest and the health industry. (They make a special point to give a tax break to health insurance executives, whose deductions were capped at $500K under the ACA—all while cutting aid to low- and moderate-income families who make far less.)
This isn’t repeal and replace, but repeal and destroy coverage for millions of Californians. The only good news is that this is such a poorly written draft—one that doesn’t resolve many tough political or policy issues—that you wonder whether it will pass.
Partially because the consequences are so grave, Congress is rushing to committee votes on these bills this week without the normal independent analysis of coverage and financial impacts. When they promised to repeal the ACA they in the same breath pledged to replace it, with something better, yet they are not waiting for the analysis that will certainly indicate that this covers less and costs more.
On Wednesday, key House Committees will mark up and vote on the bill. California members will be on the hot seat, especially including GOP Rep. Mimi Walters in House Energy and Commerce Committee, and GOP Rep. Devin Nunes in House Ways and Means Committee. But to be clear: No member of the California Congressional delegation, of either party, should vote for such a proposal that would do such disproportionate harm to their own constituents and to our state’s health system on which we all rely. No member of Congress should be voting for this without the analysis of its impact, the regular independent analysis of the Congressional Budget Office, the “CBO score.”
They are racing to a House floor vote on March 23rd, the anniversary of the passage of the ACA seven years ago—but after seven years, they are not necessarily closer to consensus needed to ultimately pass this bill. Several right-wing members of the House have already come out against it for providing too much and not just repealing it all straightaway. Four Senators sent a letter yesterday indicating they would not support a proposal that undoes the Medicaid expansion—and there are over 100 Representatives from states that did the Medicaid expansion, including the 14 from California.
The more we can—in the next week or two–get more of our California Congressmembers to wait until they get the information about the actual impacts, if not to recognize the life-and-death consequences, the real world cuts on the health system in their own districts, and the huge political backlash they will face for allowing these impacts to occur—the more likely we can get a much better result than the health care Armageddon outlined in this plan. We have two weeks.