Sunday, September 24, 2017

Graham-Cassidy Version Of Trumpcare Would Hurt Millions


The Republicans say they want to repeal Obamacare to help all Americans. That is nothing more than a sick joke. Every plan they have come up with would take health care insurance away from millions of Americans. The latest version is the Graham-Cassidy bill, and it may well be the worst plan yet.

The truth is that congressional Republicans don't believe decent and adequate health care is a right of every citizen. For them, health care is just a product to be sold to those who can afford it. That's why every plan they've come up with would hurt the poor, the working class, and many in the middle class.

This latest plan is no different, which is one reason they want to try and get it passed before the CBO can score it. They know it will hurt millions, and really don't care as long as they can undo the help given to citizens by Obamacare.

But while the CBO hasn't yet scored the latest version of Trumpcare, the Brookings Institute has done it -- and here is a tiny bit of their report:

On September 13, Senators Graham and Cassidy, together with two other Republican colleagues, introduced legislation that would repeal major portions of the Affordable Care Act (ACA). Press reports indicate that the legislation has gained considerable support among Senate Republicans, and Senate Majority Leader McConnell’s office announced on Wednesday that the Senate would hold a vote on this legislation sometime during the week of September 25.
This legislation has not yet been analyzed by the Congressional Budget Office (CBO), and CBO has indicated that it will not be able to provide a complete analysis of the legislation before the Senate vote. Notably, CBO stated that its analysis would not include “point estimates of [the Graham-Cassidy legislation’s] effects on the deficit, health insurance coverage, or premiums.” To help fill the gap left by the Senate’s decision to hold a vote in the absence of a complete CBO analysis, this analysis draws upon CBO’s estimates for prior legislation to evaluate how the Graham-Cassidy legislation might affect the number of people with health insurance coverage.
For years prior to 2020, this new legislation broadly tracks prior Republican bills, most importantly by immediately repealing the individual mandate. CBO’s analyses of these prior bills imply that the Graham-Cassidy legislation would reduce insurance coverage by around 15 million in 2018 and 2019. The reduction would be larger if uncertainty about the effects of the more radical changes implemented by the legislation in 2020 caused some insurers to pre-emptively withdraw from the individual market.
Starting in 2020, the Graham-Cassidy proposal would eliminate the ACA’s Medicaid expansion and Marketplace subsidies. Also in that year, the legislation would begin providing block grant funding to states, as well as allowing states to seek waivers from ACA regulations that bar insurers from varying premiums based on health status and require insurers to cover certain health care services.
To estimate the effects on insurance coverage during these years, we consider the various ways in which states might respond to the options provided by the legislation, using prior CBO analyses to evaluate the likely coverage outcomes for each of four broad categories of states. We then make assumptions about how many states will take each broad policy approach.
Based on this analysis, we estimate that the Graham-Cassidy legislation would reduce the number of people with insurance coverage by around 21 million each year during the 2020 through 2026 period. This estimate likely understates the reductions in insurance coverage that would actually occur under the Graham-Cassidy legislation, particularly toward the beginning and end of the seven-year period, because it does not account for the challenges states will face in setting up new programs on the bill’s proposed timeline, the possibility that uncertainty about the program’s future will cause market turmoil toward the end of the seven-year period, or the bill’s Medicaid per capita cap and other non-expansion-related Medicaid provisions. These estimates are, of course, subject to considerable uncertainty, most importantly because predicting how states would respond to the dramatic changes in the policy environment under the Graham-Cassidy proposal is very challenging. What is clear, however, is that the legislation would result in very large reductions in insurance coverage.
The Graham-Cassidy legislation’s adverse effects on insurance coverage are likely to increase after its block grant funding expires at the end of 2026. After that time, the legislation is similar to the “repeal and delay” proposal that the Senate considered in July, which CBO estimated would reduce the number of people with insurance coverage by 32 million people in the long run. Reductions in insurance coverage would likely be somewhat larger under the Graham-Cassidy proposal because of the legislation’s non-expansion related Medicaid provisions, which would further reduce insurance coverage.

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