By Allegra Baider
House and Senate Republicans are working on overdrive to accomplish a goal they share with President Trump: To repeal the Affordable Care Act and strip millions of health insurance in order to give billions to their rich campaign donors and friends.
If they are successful, the GOP legislators may sign into law in the next few weeks that will lead to intense human suffering.
This week Senate Republicans took a huge step toward ending health care as we know it. Last week, they unveiled their bill to repeal the Affordable Care Act. For weeks they promised a complete rewrite of the bill passed by the House, which would lead to 23 million people losing health insurance. It turns out they came up with something entirely similar, and equally (if not more) cruel.
The Senate bill, ludicrously called the “Better Care Act,” would kick millions of Americans off Medicaid, defund Planned Parenthood and the medical care it provides low-income women, abandon people with pre-existing conditions, allow insurance companies to stop covering basic benefits like maternity care or mental health services, and provide less assistance for people who need help buying insurance. Without access to health insurance, some people will die preventable deaths. Or watch their loved ones suffer terribly without access to life saving doctors and medicine. A new study estimates that if 23 million people lose health insurance, it would equate to 217,000 deaths over the next decade.
We now understand why they wrote this bill in secret and planned no hearings to review it. What Republican Senator wants the public to know that they are about to vote on a bill that will harm everyone in order to further enrich a few? That millions of people will no longer be able to see a doctor when they need one in order to fund massive tax breaks to wealthy individuals and corporations?
Both the House and the Senate bill would decimate Medicaid, our nation’s largest public health insurance program, which along with the Children’s Health Insurance Program (CHIP), covers approximately one out of five Americans. That is worth repeating – one out of five people are covered by Medicaid and CHIP.
The Medicaid expansion is a cornerstone of the Affordable Care Act. Thirty-one states and the District of Columbia have taken the option to expand their Medicaid coverage. The expansion brought medical care to 14 million more people. Eliminating it out would be a travesty and phasing federal funding for the Medicaid expansion more slowly (which is the Senate approach) does not make it any more acceptable.
In addition to effectively ending the Medicaid expansion, both Republican proposals attack the fundamental structure of the Medicaid program. For the past 50 years, the federal government has paid for Medicaid by matching a state’s Medicaid spending. Both bills would end the long standing guarantee that federal funding expands with need and everyone who is eligible receives services. Instead there would be a maximum amount the federal government will receive for every beneficiary with only modest adjustments for inflation going forward. The Senate makes even lower adjustments for inflation than the House, which would lead to much deeper cuts over the long term and more suffering. Capped funding means that funding will no longer increase to meet need, including in a public health crisis, such as a Zika outbreak or the Opioid crisis.
Republicans also want to give states the option to block grant their Medicaid programs and add work requirements. Block grants are nothing more than coded Republican speak for “Cuts to federal funding.” Since 2000, funding for 13 major housing, health and social services programs that use block grants has dropped by more than a third. These proposed changes in funding mean less for Medicaid at the state level, which is why so many Governors from both parties have raised concerns about the proposals. Taking millions of dollars of federal funding for Medicaid means that states will have little choice but to cut services or reduce the number of people who receive them.
While Medicaid cuts will hurt everyone, the impact on women and people of color will be profound. Almost 40 million women rely on the long-term and maternity care and family planning services offered by Medicaid. Half of the people who need Medicaid are people of color.
The Affordable Care Act took a huge step towards ensuring that no one in the richest country in the world dies because they do not have access to doctors or medicine. It would be a travesty if Republicans repeal it. Most Americans do not support efforts to take healthcare away from the people who need it, and are completely opposed to doing so in order to give massive tax breaks to the wealthiest among us. We must demand that Senators and House members keep their hands off our health care. And we must do so today.
Allegra Baider is the deputy director of public policy for the Center for Community Change Action.