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Aviva Aron-Dine @AvivaAronDine
, 12 tweets, 4 min read Read on Twitter
Based on this summary, new ACA repeal plan is similar to the Cassidy-Graham bill described in our new issue brief: cbpp.org/research/healt… – but appears to provide even fewer federal $ for coverage, suggesting it could result in even higher uninsured rates 1/12
Like Cassidy-Graham, the new bill completely eliminates Medicaid expansion (currently covers 12 million people) and ACA subsidies (currently help about 10 million people), replacing them with a deeply flawed block grant 2/12
But the new proposal appears to provide over $300B less funding for the block grant than the earlier bill 3/12
That’s partly because the 2017 tax bill repealed the individual mandate, cutting several hundred $ from ACA coverage programs and using them to pay for tax cuts; the earlier legislation used these $ to help fund the block grant 4/12
It’s also because, according to the summary, the new plan uses 20-25% of the remaining resources to pay for repeal of the ACA’s employer mandate and expand HSAs – provisions that (at best) won’t help mitigate coverage losses 5/12
.@MattAFiedler & @LorenAdler estimated an earlier version of Cassidy Graham would cause 21 million people to lose coverage (brook.gs/2jQKs51) – meaning a resulting uninsured non-elderly rate of about 18 percent (50 million people) v. 10.6 percent today 6/12
With even fewer resources for coverage, the new proposal + already enacted mandate repeal would likely result in EVEN MORE PEOPLE uninsured than the earlier plan 7/12
The new plan would also cause the same massive disruption in individual market as insurance commissioners and others predicted under the earlier bill 8/12
And details are unclear, but it seems like to undermine or eliminate nationwide protections for pple w/pre-existing conditions, as the earlier bill did: cbpp.org/blog/cassidy-g… 9/12
Finally, summary claims new version will drop Cassidy-Graham’s per capita cap. Even if so, seniors, pple w/disabilities, & families with children will be hurt, since millions are covered through expansion and the marketplace… 10/12
And, states facing deep cuts to other federal funding for coverage would likely make cuts in their pre-expansion Medicaid programs 11/12
Bottom line: whatever its near-term prospects, new repeal plan is an effort to lay groundwork for ACA repeal as soon as practicable, based on what some experts termed “the most harmful ACA-repeal bill yet”: nejm.org/doi/full/10.10… 12/12
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