What The Senate'S Latest Health Care Bill Means For You And Your Family
On Monday, Senate Republicans introduced a new health care bill, known as the Cassidy-Graham bill, which they have 12 days to try and pass through the Senate using a process called "reconciliation."
Republicans in Congress have been trying to repeal the current health care law, the Affordable Care Act (ACA, aka Obamacare), for months, arguing that it's expensive for most Americans and doesn't actually provide people with the care they need. In May, the House passed the American Health Care Act, and the Senate introduced its own version of the bill, called the Better Care Reconciliation Act (which failed). Named for its authors, Senators Bill Cassidy (R-Louisiana) and Lindsey Graham (R-South Carolina), this attempt is being called both the last chance for Republicans to repeal and replace the ACA before the fiscal year ends on September 30, and the "worst yet."
Here are four ways the bill could impact you and your family.
1. The bill allows states to opt out of providing "essential benefits." Currently, the ACA requires that insurers provide coverage for 10 different "essential benefits," which includes prescription drug coverage, mental health care services and maternity and newborn care. Like the (BCRA) that preceded it, the Cassidy-Graham bill lets states apply for a waiver that lets them opt out of that. However, the BCRA would have required states who decided to opt out of providing those essential benefits to consumers to include at least one ACA-compliant plan on the individual exchange that did provide those benefits. The Cassidy-Graham bill includes no such provision, essentially allowing insurers to simply stop providing what's considered a baseline level of benefits without having to replace them. This doesn't guarantee that insurers will all stop providing those benefits, but if they do, the cost of pregnancy for many women could go way up.
2. The bill includes huge cuts to Medicaid. However, this bill doesn't just slash federal funding for Medicaid — in an attempt to equalize spending, the bill redistributes it throughout all 50 states. According to the Washington Post, here's how it would work: The bill would basically lump together the money it spends on subsidies through the ACA as well as expanded Medicaid programs and redistribute it through what's called block grants to each state. The amount of money each state receives in its block grant would be determined by several factors, including the number of low-income adults. This means it's likely that states that didn't expand Medicaid (for example, Texas) would see more money while states that did expand Medicaid (for example, New York) would see less money. Additionally, the Washington Post notes that by 2026, the government would be spending 17 percent less on subsidies and Medicaid expansion than it does now; by 2027, it would halt spending completely.
Medicaid covers almost half of all births in the U.S. and covers family planning services for at least 13 million women, meaning that this bill will disproportionately impact low-income women.
3. The bill prohibits federal funding to Planned Parenthood for one year. Planned Parenthood is the nation's largest network provider of women's health care, and 75 percent of its federal funding comes from Medicaid. The Cassidy-Graham bill excludes Planned Parenthood from Medicaid funding, which means that low-income people on Medicaid wouldn't be able to go to Planned Parenthood for their health care. Critics of Planned Parenthood have argued that community health centers could simply fill that gap in coverage, but a study by the Guttmacher Institute suggests that in order to do so, health centers would need to see an extra 2 million patients.
4. Insurers could charge people with preexisting conditions more. Previous attempts at repealing the ACA have all included some kind of provision that protects those with preexisting conditions or who have let their health coverage lapse for any reason from being denied insurance. As the L.A. Times reports, Cassidy and Graham's bill "throws out that protection" by allowing states to apply for waivers that would allow insurers to charge more "as a condition of enrollment or continued enrollment…on the basis of any health status-related factor."
What happens now?
The Senate Finance Committee has announced that it will hold a hearing on the bill on Monday, September 25. The Senate only has until the end of the fiscal year to pass the bill without any Democratic votes. The Senate can also only afford to lose two votes and still pass the bill, and it's not clear right now that Senate Republicans have all the support they need. Further, the Congressional Budget Office (CBO) needs to analyze and score the bill (according to Politico, Senate Majority Leader Mitch McConnell has been nudging the CBO to do so quickly).
Vox reports that right now the odds are against the bill passing — but that proponents of it are betting on some of their colleagues breaking under the pressure of the looming deadline. What can you do if you're worried about how this will affect your family? Call your elected officials and voice your concerns.
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