Healthcare

As Republicans attempt to jam a sneaky health care repeal into law through their partisan tax bill, expert analysis after expert analysis has come to the same conclusion: health care costs will go up massively, particularly for older Americans. This week, independent analyses by AARP and Commonwealth Fund echoed that of the nonpartisan Congressional Budget Office, finding that the sneaky repeal in Senate tax bill will result in higher health care costs, effectively levying an age tax on older Americans, and result in 13 million people losing coverage — all to pay for tax cuts for the wealthiest and corporations.

REPEAL WOULD IMPOSE AN AGE TAX ON OLDER AMERICANS

The Commonwealth Fund: Premiums Would Be $1,875 Higher For 60 Year Olds. “Average premiums in the nongroup market would increase by about 10 percent in most years of the decade (with no changes in the ages of people purchasing insurance accounted for) relative to CBO’s baseline projections.” This amounts to a…$1,269 increase in 2019, rising to $1,875 in 2027 for a 60-year old, effectively an age tax on older adults.

AARP: Repeal Would Impose Age Tax Of Up To $1,500 On Older Adults. According to an analysis by AARP, “Older adults ages 50–64 would be at particularly high risk under the proposal, facing average premium increases of up to $1,500 in 2019 as a result of the bill.”

THE REPUBLICAN TAX CUT FOR THE WEALTHY AND CORPORATIONS WOULD BE PAID FOR BY TENS OF BILLIONS IN MEDICARE CUTS

CBO: Republican Tax Scheme Would Result In $25 Billion In Medicare Cuts. “Without enacting subsequent legislation to either offset that deficit increase, waive the recordation of the bill’s impact on the scorecard, or otherwise mitigate or eliminate the requirements of the PAYGO law, OMB would be required to issue a sequestration order within 15 days of the end of the session of Congress to reduce spending in fiscal year 2018 by the resultant total of $136 billion. However, the PAYGO law limits reductions to Medicare to four percentage points (or roughly $25 billion for that year), leaving about $111 billion to be sequestered from the remaining mandatory accounts.”

13 MILLION PEOPLE WOULD LOSE COVERAGE TO PAY FOR TAX CUTS FOR THE WEALTHY

13 Million People Lose Coverage To Pay For Tax Cuts For The Rich. “Eliminating the health care coverage requirement would also mean that millions more Americans will become uninsured. CBO has estimated that 4 million people under age 65 would no longer have health insurance coverage as early as 2019 if this provision is enacted. By 2027, that number would rise to 13 million people left without coverage.”

To: Interested Parties

From: Brad Woodhouse, Protect Our Care Campaign Director

Date: November 16, 2017

Re: Sneaky Repeal: the GOP’s Latest Secret, Partisan Health Care Repeal

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Republicans in Congress are sneaking health care repeal into their tax bill to pay for another massive tax break for the wealthiest Americans and corporations. What this means is simple: while the wealthy and corporations get a tax cut, middle-class families will get double-digit premium increases and millions of people will lose their coverage. Just last week in elections from Virginia to Maine, the American people rejected their approach to health care. Republicans aren’t listening — and they’ll be held accountable.

Sneaky repeal would be a disaster — it would raise middle-class premiums, make insurance unaffordable for people with pre-existing conditions and rip coverage away from millions of people, just to pay for special tax breaks for millionaires and big corporations. The Congressional Budget Office estimated that 13 million people will lose their health insurance and premiums will rise 10% because of the health repeal provision in the Senate tax plan. What’s the GOP plan for them? What are these millions of people supposed to do about their health care?

Moreover, repealing health care means fewer healthier and younger people buy health insurance, causing a “death spiral” of skyrocketing costs for everyone else — including people with pre-existing conditions. ​Experts predict that insurers will be forced to leave the Marketplace, meaning some consumers may not have any coverage options. So why take away people’s coverage and increase premiums? Because Senate Republicans want to pay for a $94,540 tax cut for multi-millionaires and to permanently cut big corporations’ taxes.

Analysis of the bill shows that families will face premium increase of nearly $2,000. An analysis from the Center for American progress, premium increases for benchmark plan coverage for an unsubsidized middle-class family of four are slated to be $1,990, but would be be even higher in a number of states:

• A family in Alaska would see an increase of $2,900, and 24,000 people would lose coverage
• A family in Maine would see an increase of $2,350, and 50,000 people would lose coverage
• A family in Arizona would see an increase of $2,060, and 282,000 people would lose coverage

As such, the leading experts — patient groups, insurers, doctors and hospitals — all oppose sneaky repeal. Sixteen patient groups have announced their opposition: March of Dimes, the American Heart Association, the Cystic Fibrosis Foundation; the American Cancer Society Cancer Action Network; the Multiple Sclerosis Society; Lutheran Services in America; the American Lung Association; the American Diabetes Association; the National Health Council; the Epilepsy Foundation; the National Organization for Rare Disorders; the American Liver Foundation; Family Voices; Consumers Union; Little Mended Hearts; and Futures Without Violence. These groups wrote that they were “deeply troubled” over the bill, calling it “a step backwards for individuals and families.”

And they weren’t the only ones. Six leading industry groups — America’s Health Insurance Plans. the American Academy of Family Physicians, the American Hospital Association, the American Medical Association, the Blue Cross Blue Shield Association and the Federation of American Hospitals — also announced their opposition, warning of “serious consequences” should the mandate be repealed.

Republicans want to cut taxes for the wealthy and corporations so much they are cutting Medicare and raising taxes on middle class families to do it. In addition to the double-digit premium hikes and 13 million people who would lose their insurance, the CBO found that the GOP tax bill would trigger $25 billion in Medicare cuts. The House Republican tax plan also pays for their tax cuts by eliminating the medical expense deduction, which helps families with high medical costs such as long-term care and chronic diseases. Nearly 9 million people claimed this deduction and nearly 70 percent of those people earned $75,000 or less.

And then there is the scam. Republicans want to give cover to people by promising a vote on the Alexander-Murray stabilization bill, but their actions make Alexander-Murray nothing more than a fig leaf. Attempting to adopt Alexander-Murray — which was crafted through extensive, bipartisan negotiations and with expert input — on the heels of a partisan repeal process represents nothing more than political cover. In fact, House Republicans have expressed opposition to Alexander-Murray so there is no guarantee it will get through Congress, let alone become law. At this point, Alexander-Murray means nothing if health care is repealed — passing it after voting for repeal is like installing guardrails on the highway after your car has gone over the cliff. It’s useless.

And all of this comes on the heels of the American people rejecting the Republican health care agenda. The reason Republicans failed to repeal health care four times already this year was a simple one: because people don’t like it. In fact, GOP health care repeal is the most unpopular legislation in three decades.

Just last week, health care was the dominating issue in elections. In the Virginia governor’s race, health care was the #1 issue, more than double any other issue, and among those voters, Ralph Northam beat Ed Gillespie by 54 points (77–23). Down the ballot, Democratic candidates for the House of Delegates ran on health care and won a historic victory, flipping at least fourteen seats. In New Jersey, 19% of voters ranked health care their top issue, and chose Phil Murphy over Kim Guadagno, who opposed the ACA, by 74 points (86–12). In Maine, voters “easily approved” an expansion of Medicaid by a nearly 60–40 margin.

And this week it was announced that more than 1.5 million people, including more than 345,000 new consumers, have gotten insurance though the first two weeks of open enrollment — a 45% increase from last year.

So why is the GOP pushing this agenda forward? Republicans are sneaking health repeal into their tax bill simply so they can give massive tax cuts to the wealthy and big corporations. Multi-millionaires will get a $100,000 tax cut under this plan while everyday Americans will suffer. But as last spring’s town halls, and summer’s Senate votes, and last week’s elections proved, Americans won’t stand for it.

Republicans were so desperate to give even more tax breaks to their billionaire friends and big corporations that they added a sneaky health care repeal to the plan last night to pay for it.

Turns out, their sneaky repeal is risky and may take their whole tax plan down with the ship.

Uh oh.

The Atlantic: “t could backfire, jeopardizing complicated negotiations over a tax bill and compounding what is already a heavy political lift.”

Bloomberg: “Senate Republicans have tossed a potential bomb in the middle of their tax overhaul bill. […] it complicates the vote calculations in both chambers and hands Democrats a bumper sticker-ready issue they can use to charge up their base.”

The Hill: “A risky play that meets President Trump’s demands but could cost the measure support from centrists.”

Washington Post: “Congressional Republicans are reaching for a booby-trapped bag of cash as they scramble to try to pay for their tax overhaul.”

Roll Call: “A complicated tax overhaul debate got more complicated Tuesday when Senate Republicans injected health care politics into the equation.”

Axios: “It’s a risky maneuver.”

Real Clear Politics: “[Senate Republicans are] adding a controversial debate about health care to their effort to overhaul the tax code before the end of this year.”

NPR: “The decision was a rapid change of direction for Republicans, who previously believed it would be politically dangerous to add any health care measure to the tax legislation.”

Reuters: “U.S. Senate Republicans on Tuesday linked repealing a key component of Obamacare to their ambitious tax-cut plan, raising new political risks and uncertainties for the tax measure that financial markets have been monitoring closely for months.”

New York Times: “Senate Republicans have decided to include the repeal of the Affordable Care Act’s requirement that most people have health insurance into the sprawling tax rewrite, merging the fight over health care with the high-stakes effort to cut taxes.”

Senate Republicans are ignoring bipartisan opposition and trying to repeal health care once again by inserting a provision into the tax bill that repeals the individual mandate. This provision would leave 13 million people without health coverage, raise premiums by double digits and destabilize the insurance markets.

But don’t take our word for it. Key stakeholders warned of these effects right before the Senate voted down the so-called “skinny” repeal bill.

American Cancer Society Cancer Action Society: “Critical Patient Protections In The Current Health Care Law That Ended Discrimination Against People With Pre-existing Conditions, Eliminated Annual And Lifetime Benefit Limits, And Guaranteed Minimum Essential Coverage Will Not Be Sustainable If The Provisions Reported To Be In The “Skinny” Repeal Bill Are Enacted Into Law.” “Critical patient protections in the current health care law that ended discrimination against people with pre-existing conditions, eliminated annual and lifetime benefit limits, and guaranteed minimum essential coverage will not be sustainable if the provisions reported to be in the “skinny” repeal bill are enacted into law. The legislation could cause the individual insurance market to collapse putting millions of American families at financial risk.” [ACS CAN, 7/27/17]

AARP: “The Bill Will Leave Millions Uninsured, Destabilize The Health Insurance Market And Lead to Spikes In The Cost Of Premiums.” “AARP, with its nearly 38 million members, writes to express our opposition to the reported McConnell “skinny” repeal bill. The bill will leave millions uninsured, destabilize the health insurance market and lead to spikes in the cost of premiums. The CBO confirms that the provisions of the reported “skinny” repeal bill will lead to 16 million Americans losing their health coverage, including 4 million Americans who will lose employer-sponsored coverage. The result will be higher health care costs and fewer choices for millions of older Americans. We urge you to reject this flawed bill and this cynical approach. Instead, we urge you to begin work on a bipartisan solution to lower health costs and protect and strengthen the coverage that millions of Americans rely upon.” [AARP, 7/27/17]

America’s Health Insurance Plans: “We Would Oppose An Approach That Eliminates The Individual Coverage Requirement, Does Not Offer Alternative Continuous Coverage Solutions, And Does Not Include Measures To Immediately Stabilize The Individual Market.” “This continued uncertainty — combined with targeted proposals that would eliminate key elements of current law without new stabilizing solutions — will not solve the problems in the individual market, and in fact will result in higher premiums, fewer choices for consumers, and fewer people covered next year. We would oppose an approach that eliminates the individual coverage requirement, does not offer alternative continuous coverage solutions, and does not include measures to immediately stabilize the individual market.” [AHIP, 7/27/17]

Association For Community Affiliated Plans: “Simply Repealing The Individual Mandate Without An Equivalent Mechanism To Encourage Participation May Well Be The Trigger That Incites A Death Spiral In The Marketplaces.” “However, we remain concerned about the proposed skinny plan and the impact it would have on the Marketplaces. Simply repealing the individual mandate without an equivalent mechanism to encourage participation may well be the trigger that incites a death spiral in the Marketplaces. And it would place ACAP’s member plans in the untenable position of having to choose whether and for how long they can remain in an unstable marketplace, jeopardizing the coverage of millions of Americans receiving coverage from safety net plans. ACAP urges the Senate to reject the so-called “skinny plan” and instead work with stakeholders in a bipartisan manner to fix the Affordable Care Act. We stand ready to work with both the House and the Senate, as we have stood ready for many months, to identify, pass, and implement fixes to the Affordable Care Act and underlying health care system.” [ACAP, 7/27/17]

Consumers Union: “This So-Called ‘Skinny Repeal’ Would Not Only Still Leave Millions Uninsured, Destabilize The Insurance Markets Further, And Trigger Skyrocketing Premiums, But Is Also An Attempt To Try To Breathe New Life Into The Harmful Ideas In Both The American Health Care Act And The Better Care Reconciliation Act.” “Rather than finding a new way forward to strengthen the insurance markets, Senate leaders are using smoke and mirrors to make it seem as if this latest proposal is somehow different or better than the ones just voted down in the Senate. Don’t be fooled. This so-called ‘skinny repeal’ would not only still leave millions uninsured, destabilize the insurance markets further, and trigger skyrocketing premiums, but is also an attempt to try to breathe new life into the harmful ideas in both the American Health Care Act and the Better Care Reconciliation Act — both hugely unpopular proposals that have been rejected by Senators repeatedly.” [Consumers Union, 7/27/17]

American Medical Association: “Skinny Repeal” Will Lead “To Adverse Selection That Would Increase Premiums And Destabilize The Individual Market.” “There has been considerable speculation regarding a so-called “skinny package” that would primarily eliminate penalties related to the individual and employer mandates and provide tax cuts to device manufactures and the health insurance industry. Eliminating the mandate to obtain coverage only exacerbates the affordability problem that critics say they want to address. Instead, it leads to adverse selection that would increase premiums and destabilize the individual market.” [AMA, 7/26/17]

Blue Cross Blue Shield Association: “A System That Allows People To Purchase Coverage Only When They Need It Drives Up Costs For Everyone.” “If there is no longer a requirement for everyone to purchase coverage, it is critical that any legislation include strong incentives for people to obtain health insurance and keep it year-round. A system that allows people to purchase coverage only when they need it drives up costs for everyone.” [New York Times, 7/26/17]

American Academy Of Actuaries Health Practice Council: Repealing The Individual Mandate Would Raise Premiums And Costs To The Federal Government. “Eliminating the mandate, by lowering financial penalties or exempting particular categories of individuals from its requirements, would likely have significant implications for health insurance coverage and costs both to consumers and the federal government….Eliminating the individual mandate would lead to premium increases….Higher premiums could lead to increased federal government costs for premium subsidies.” [American Academy of Actuaries, 7/25/17]