Three Reasons Why the Senate’s “Better Care” Bill is Anything But
The nonpartisan Colorado Health Institute predicts that we will see 630,000 fewer insured Coloradans and face state budget losses of $15 billion over ten years under the Senate plan.
The U.S. Senate Republicans health plan, or the “Better Care Reconciliation Act" (BCRA), is a lot like the House bill. It won't help most of us pay our rising health bills. It will back Colorado's budget into a corner with billions of dollars of Medicaid cuts. Twenty two million more people will go back to being uninsured, according to analysis Congressional Budget Office. In return, the wealthy and the health care industry will get another tax break.
Here are three specific, major pain points for Colorado under the BRCA:
- Rural Colorado and other communities that rely heavily on Medicaid will be hurt. Rural Colorado has a high number of residents insured by Medicaid. Both the Senate and House plans make disastrous cuts to the Medicaid budget and end the expansion. The BCRA is worse, as it pegs federal funding to a slower measure of growth. Analysis by the Colorado Consumer Health initiative and the Colorado Fiscal Institute quantify the problems. Rural counties will lose double the number of jobs as their urban counterparts, $158 million in wages, and $1.2 billion in local economic activity, not to mention the toll on people’s health.
- Lower- and middle-income Coloradans will face rising out-of-pocket costs. The Senate’s plan, unlike the House’s, ties consumer subsidies to income, just like the ACA. If you make more than 350% of the federal poverty level, you won't get any subsidies. Even if you qualify, the BRCA links the subsidies to plans with higher out-of-pocket costs. This may result in more people purchasing insurance, because it seems more affordable. It could also lower premiums. But you will pay more when you need to use that insurance to get care. This reform is in direct contrast to the top complaint that Americans have with health care: it's too expensive, and they don't get enough help paying for it.
- Its harmful to older Coloradans. The ACA greatly helped older consumers, who as a group are more likely to need health care. The law reformed the ways that insurers charged them more for coverage. Both the Senate and House plans undo these reforms to once again allow insurance companies to create higher-cost plans for older consumers. Coupled with the Senate's new tax credit structure, those over age 40 (yes, that counts as “old”) buying marketplace plans will be paying more for insurance as they age than under the ACA. The ACA’s taxes also strengthened Medicare’s solvency. Their repeal will thus weaken it. Lastly, the Medicaid cuts could dramatically restrict the availability of nursing home care and other valuable, cost-effective support to those who want to get care in their homes or communities. Colorado’s older adult population is growing quickly. We need to find ways to strengthen crucial supports for these Coloradans instead of penalizing them.
The “Better Care” plan is anything but. It exacerbates the cracks in our health system and lets older, sicker, and low- and middle-income people slip right through.