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Healthcare Reform News Update for June 30, 2017

Healthcare Reform News Update for June 30, 2017

CBO Publishes Separate Analysis on Medicaid Spending and Its Effects

The Congressional Budget Office (CBO) has published a secondary Medicaid analysis titled the “Longer-Term Effects of the Better Care Reconciliation Act of 2017 on Medicaid Spending.” The analysis finds that under the Better Care Reconciliation Act of 2017, Medicaid spending would decrease by 26% in 2026. That percentage increases to 35% in 2036.

Senator Ted Cruz Proposes Allowing Insurance Companies to Sell Cheap Plans with Fewer Benefits

In order to win over conservatives and introduce plans with lower premiums, Senator Ted Cruz has given the GOP a proposal to let insurance companies sell plans that have fewer benefits. The plans would be less expensive, but may take young and healthy individuals out of the same market pool as sick and older Americans. This could increase costs for the ill and elderly, and it may also lead to adverse selection in the individual marketplace.

Healthcare Reform News Update for June 29, 2017

Changes to the Senate’s Healthcare Bill Underway

Two changes are already being added to the Better Care Reconciliation Act of 2017 (the Senate’s healthcare bill). The White House and Senate Republicans have agreed to add $45 billion in funding in order to address the opioid crisis. Additionally, Senators may soon agree to let Americans pay their premiums with their health savings accounts (HSAs).

Republican Senators Question Tax Eliminations in GOP’s Healthcare Bill

Some Republican senators have started questioning whether the GOP’s healthcare bill should repeal certain taxes on high-income earners while cutting back on subsidies and Medicaid. Susan Collins, Mike Rounds, and Bob Corker have publically criticized the tax repeal.

  • Senator Collins: “I do not see a justification for doing away with the 3.8 percent tax on investment income, because that is not something that increases the cost of health care.”

Senator Corker: “I want to make sure that we’re not in a situation where we’re cutting taxes for the wealthy and at the same time … passing a larger burden on to [lower-income citizens].”

Senators Reiterate Requests After GOP’s Healthcare Vote Postponed

With the GOP’s healthcare vote delayed until after the July 4 recess, Senators on both sides of the aisle are repeating their previous healthcare reform requests. Republican Senator Rand Paul “highlighted a letter he sent to President Donald Trump and Senate GOP leaders with a list of conservative proposals that would help resolve his issues with Senate Republicans’ health care legislation.” While the proposal would please conservatives, the requests detailed in it are likely to alienate moderates.On Tuesday, Senate Minority Leader Chuck Schumer also repeated his previous requests for bipartisan healthcare reform.

President Trump Accuses Democrats of Misstating Facts About Medicaid Spending

In a Tweet posted on Wednesday, President Donald Trump said, “Democrats purposely misstated Medicaid under new Senate bill – actually goes up.” While the total spending for Medicaid would indeed slowly increase, “the accounting he uses to show Medicaid spending is wildly divergent from the way budget analysts, policymakers and many lawmakers account for spending levels.” When accounting for inflation, Medicaid spending would not increase. Instead, there would be a decrease of around $772 billion in federal Medicaid outlays.

Healthcare Reform News Update for June 28, 2017

Senate Healthcare Vote Won’t Happen Before July 4 Recess

On Tuesday, Senate Republicans announced they will delay a healthcare reform vote until after the July 4 recess. Although the GOP planned to have a vote by the end of this week, opposition within the Republican Party over the Senate bill’s current language remains unresolved.

After the announced delay, President Trump told senators at a White House meeting, “This will be great, if we get it done. And if we don’t get it done, it’s just going to be something that we’re not going to like, and that’s OK and I understand that very well. But I think we have a chance to do something very, very important for the public, very, very important for the people of our country that we love.”

Also after the announcement, 3 more Republican senators announced that they would not have supported a healthcare vote this week.

The GOP will revise its healthcare bill over the July 4 recess, which will need a new analysis from the Congressional Budget Office. Republicans hope to vote after the recess.

Healthcare Reform News Update for June 27, 2017

CBO Releases Analysis of Senate’s ‘Better Care Reconciliation Act of 2017’

The Congressional Budget Office (CBO) has released its analysis of the Senate’s healthcare reform bill, called the Better Care Reconciliation Act of 2017 (BCRA). Here are some of the main takeaways:

The Uninsured Rate

  • 15 million more Americans would be uninsured by 2018. This is mostly due to the elimination of the individual mandate.
  • 22 million more Americans would be uninsured (compared to the Affordable Care Act) in 2026.
    • This means that a total of around 49 million Americans would be uninsured by 2026. (Around 28 million would be uninsured in 2026 under the ACA.)
    • For comparison, the House’s bill increased the uninsured population to 23 million.

The Federal Deficit

The federal deficit would decrease by $321 billion by 2026. (The House’s bill decreased the deficit by $119 billion.)


  • Over the next 10 years, the government would decrease Medicaid spending by $772 billion (26%). (The House’s bill reduced Medicaid spending by $834 billion.)
  • By 2026, enrollment in Medicaid would decrease by 16% for those under the age of 65.

The Individual Market

  • In most parts of the United States, the individual health insurance market will remain stable in 2020.
  • Due to state waivers on essential health benefit requirements, some insurance plans that cover certain services will become more expensive in those areas.
    • Individuals who require waived essential health benefits will see substantial increases in their out-of-pocket costs or skip those services.
    • Individuals who live in states that have waived certain services could also see large increases in their out-of-pocket costs because annual and lifetime limits wouldn’t be capped.
  • The average premium will rise faster than the ACA’s average premium until 2020. Then, the increase in premium costs will slow.
  • By 2026, the average premium is expected to be 20% less.
    • This is mostly because 1) plans will cover fewer costs and services and 2) there’s federal funding aimed at lowering premium prices.
    • For example, let’s compare the costs for a 45-year-old male below 200% of the federal poverty level. For the ACA premium after tax credit, he would pay $67. For the Senate’s BCRA premium after tax credit, he would pay $215. See more premium comparisons here.

Tax Provisions

  • Over the next 10 years, the government will lose $541 billion in revenue by repealing the ACA’s tax provisions.
  • Because of the lower actuarial value for a benchmark plan (meaning a plan covers fewer costs) and higher deductibles, few low-income Americans will purchase Marketplace plans in 2020.

After CBO’s Analysis, Republican Senators to Oppose Procedural Vote

Shortly after the Congressional Budget Office (CBO) released its analysis of the Better Care Reconciliation Act of 2017, several Republican senators “threatened to oppose beginning debate.”

  • Susan Collins said she would vote no to the Senate’s bill. In a tweet, she said she’d rather have a bipartisan fix to the ACA.
  • Rand Paul, Dean Heller, Ted Cruz, and Mike Lee are expected to vote against the motion without further changes to the bill.
  • Ron Johnson said he would have a “hard time believing” he had the information he needed to vote for a motion this week.

With the additional savings estimated by the CBO, Republicans have some leeway to try and negotiate with Senators(by editing the healthcare reform bill) in order to win their support.

Senate Adds a Waiting Period to Its Bill

The Senate has revised the Better Care Reconciliation Act of 2017 (BCRA) to include a waiting-period penalty for individuals who let their coverage lapse. “Starting in 2019, people who try to buy a healthcare insurance policy during open enrollment, or because of a life-qualifying event, will not be able to do so for six months if they had a break in coverage of 63 days or longer during the prior year.”

California Won’t See a Single-Payer Healthcare System This Year

The leader of the state Assembly in California announced that he will not proceed with a single-payer healthcare system this year. Although a single-payer bill passed the state Senate, Speaker Anthony Rendon said the bill doesn’t properly detail “delivery of care and cost.”

Senators May Add Penalties for Lapses in Coverage to Healthcare Bill

The “discussion draft” of the Senate’s healthcare bill did not penalize individuals who let their coverage lapse. According to health insurance industry sources, Senators are planning to add a provision that could prevent people from using the individual market for six months if their coverage lapses. The provision may be included to keep healthy people on the market, which balances out the cost for sicker individuals.

President Trump Talks to Reporters About the Senate’s Healthcare Bill

During an interview on Sunday with “Fox & Friends,” President Donald Trump said that he doesn’t think the GOP is “that far off” from finalizing its healthcare reform bill. The Senate is pushing to vote on the bill by the end of this week, despite Senators expressing opposition or concern over the current language.

When referring to the now 5 Republican Senators that have confirmed an opposition to the current bill’s language, the President said, “We have a very good plan. They want to get some points, I think they’ll get some points.”

Trump also complained about the lack of bipartisan efforts on healthcare reform. “It would be so great if the Democrats and Republicans could get together, wrap their arms around it and come up with something that everybody’s happy with. And I’m open arms; but, I don’t see that happening. They fight each other. The level of hostility.”

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