New Senate Health Care Bill Isn’t Really “New”; Still guts Medicaid and risks coverage for millions

By Suzanne Wikle

After failing to garner support for their first health care bill the Senate Republican leadership has released a new bill, tweaking the language in an attempt to pick up additional votes without making any substantive changes that would increase access to meaningful coverage. As CLASP has stated before, the Senate bill cannot be “fixed.” It needs to be scrapped.  Instead we should have a thoughtful dialogue about how to increase access to affordable health care for all, including those who are working low-wage jobs and struggling to make ends meet.

The new proposal still slashes Medicaid, resulting in a dramatic loss of coverage, and placing extreme burden on state budgets. The independent Congressional Budget Office estimates that the previous version of the Senate bill would have caused 15 million people to lose Medicaid coverage by 2026, and the new bill has no changes aimed at preventing this loss of coverage.

Proposed changes to how Medicaid is financed – both through a per capita cap or a block grant – are a significant cost shift to states. Under the previous bill, states would receive 35 percent less funding for Medicaid over the next 20 years. This would cause states to reduce benefits (such as prescription coverage), create waiting lists for care, and raid other parts of their budgets to help fill the void of federal Medicaid dollars. Postsecondary education funding is likely to be the victim of shifting more Medicaid costs to the states. Additionally, the bill maintains many other provisions that would gut Medicaid, a critical safety-net program for poor seniors, children, and persons with disabilities.

The changes to the bill that supporters claim would make health care affordable would only enable people to buy “bare bones” coverage. Such coverage would not provide what most people need in order to seek primary and specialty care, manage chronic conditions, or receive behavioral health care.  Moreover, because healthy people are more likely to choose such minimal coverage, this is likely to result in much higher premiums for those who need more comprehensive coverage.  While the bill removes some tax breaks for the wealthy that were in previous versions, it retains many others, and expands the opportunity for the well-off to use health savings accounts as tax shelters.

Touted as repealing and replacing the Affordable Care Act (ACA), in reality this bill is a smokescreen for eliminating health care for millions of hard-working but struggling Americans – including many who were covered under Medicaid before the ACA became law. Many senators have rightfully voiced their concerns about gutting Medicaid and maintaining important provisions in the private market (like protecting people with pre-existing conditions). The new bill does not resolve those concerns and should be swiftly rejected.