The ‘skinny’ on the latest ACA repeal effort

The ‘skinny’ on the latest ACA repeal effort

When teenagers want to get away with something, they sneak out in the dark – to the football field after hours, the basement, the unlit corners. In that, they have something in common with Congressional leadership, though teenagers are more likely to have a few beers in mind than a plan to strip health coverage from millions of Americans who – being human – may have a baby on the way or blood pressure that needs controlling, who rely on insulin, who need a strep test, a flu shot, a colonoscopy, radiation treatment, or a few weeks of physical therapy so they can get back to work.

After a brief interlude in the open, Congress is heading back down to the basement. Unable to pass a straight repeal bill or the Better Care Reconciliation Act, the Senate version of repeal-and-replace, the Senate is on the verge of voting for a place-keeper bill – a so-called skinny repeal – that will allow them to return to a secret negotiation process where they can avoid the scrutiny of colleagues and, more importantly, avoid us, the public.

Today, the skinny repeal is a clear and present danger for those who need health coverage. If the Senate’s skinny repeal were to be adopted by the House without changes, it would immediately destabilize the individual health market. Pennsylvania carriers, for example, said they would impose an additional 15 percent hike in 2018 premiums to account for the end of the individual mandate to purchase insurance. By 2026, the skinny repeal would leave 16 million more people uninsured and increase premiums on insurance policies on the exchange by 20 percent, according to an analysis from the Congressional Budget Office.

However, a skinny repeal in the Senate is very likely to undergo big changes in the conference committee that would convene following a Senate vote. And despite what may look like more modest terms, there is every indication that the bill to finally emerge from that committee would retain the elements we’re familiar with: the end of the Medicaid expansion, cuts to the overall Medicaid program that grow harsher over time, skimpier plans on the exchanges and smaller subsidies for most.

Based on state analyses,the original repeal plan would decimate Colorado’s people and Colorado’s budget. As for Colorado’s Senators, Sen. Bennet spoke of devastating consequences and urged a more transparent process.  In March, Sen. Gardner urged caution in a letter to Senate Majority Leader Mitch McConnell, arguing against the draft House repeal and replace bill, and warned that Medicaid restructuring could cause individuals to lose access to “life-saving health care services.”  A Yuma native, Gardner may know that rural counties have particularly high percentages of residents enrolled in Medicaid, and would suffer disproportionately.  After a series of non-statements regarding replace and/or repeal, Gardner showed his allegiance to party over his constituents by voting for the straight repeal along with a Medicaid-slashing replacement plan. Fortunately, neither bill passed.

It should be obvious that all Coloradans sometimes get sick and will continue to do so in the future, whether or not our Senators’ votes allow them to keep their Medicaid coverage or their insurance subsidies. Coloradans age, and will continue to age. People with cerebral palsy will still have cerebral palsy. Nothing in the House or Senate replacement plans tells us how the at least half-million people slated to lose Medicaid in Colorado would get appropriate medical care, let alone the tens of thousands who will find private coverage either unaffordable or too meager to be usable. Nothing in those plans would help change what is now driving up the cost of health care, whether that is pharmaceutical prices or too much medical testing or provider reimbursement systems.

By all means, let’s fix health care. Because health care is not just complicated but positively labyrinthine, a fix will take time and will have to include the best ideas of lots of people. No more backrooms and basements, please. It’s time to let the light in.

Tell Senators Gardner and Bennet to vote NO on any form of repeal that doesn’t include a comprehensive replacement. Tell Senators Gardner (202-224-5941) and Bennet (202-224-5852) that Colorado needs innovative, bipartisan, effective legislation. Let’s make it happen!

– Bethany Pray

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