Republicans in the U.S. Senate are reportedly working on health care legislation that could come up for a vote as early as next week. Unfortunately, the two proposals they are working from would be a disaster for Minnesotans. Both the Better Care Reconciliation Act (BCRA) and the Obamacare Repeal Reconciliation Act (ORRA) would make billions of dollars in cuts to health care supports that reach more than a million Minnesotans.
Policymakers continue to discuss minor tweaks to these fundamentally flawed bills. That means Minnesotans, including the elderly, people with disabilities, and those with low incomes, still face threats to their ability to find affordable health care. The country’s senators and representatives should admit that these health care bills cannot be fixed, and instead focus on improving Americans’ access to health insurance.
The BCRA and ORRA would both cut Medicaid by more than $750 billion over a decade. This will inevitably put treatment and care out of reach for some of the more than 1 million Minnesotans who can only find affordable heath insurance through Medical Assistance, our state’s tried-and-true Medicaid program.
That’s because Medicaid is already targeted to our most vulnerable neighbors. In Minnesota, 84 percent of the money spent on Medical Assistance is spent on health care for seniors, people with disabilities, and families with children, and the remainder covers people with no other options for affordable health insurance. Of Medical Assistance’s non-elderly adults without disabilities, two-thirds live in a family with at least one full-time worker. Nationally, the unemployed served by Medicaid are likely to be caring for a relative, or to be laid off. All struggle to make ends meet on very low incomes.
Like the Affordable Health Care Act (AHCA) passed by House Republicans, the Senate’s BCRA would cut $31 billion in Medicaid funding for Minnesota over about 10 years. By one estimate, the BCRA could increase the number of non-elderly Minnesotans without insurance by 334,000 in 2022, more than double the number expected to be uninsured under current law. These cuts are achieved by arbitrarily capping federal Medicaid funding and effectively ending the Medicaid expansion. The bill would also raise health care costs for many people buying insurance on the individual market, and severely weaken protections for those with pre-existing conditions. While it makes some tweaks to earlier versions, the outcome is essentially the same: the most recent estimate of the BCRA projects that 22 million more Americans would be left without health care by 2026.
At the same time the bill makes radical reductions in assistance for affordable health care, it bestows hundreds of billions of dollars in tax cuts on wealthy Americans, insurance companies, and other medical industry players.
The ORRA is a piece of legislation that would simply repeal the Affordable Care Act (ACA) without putting anything in its place to assist those who struggle to afford health insurance. It would give the wealthy and the health care industry the lion’s share of $606 billion in tax breaks, eliminate the Medicaid expansion, and destroy all of the assistance to bring down costs built by the ACA while offering no alternative in its stead. The nonpartisan Congressional Budget Office estimated that it would leave 32 million more Americans uninsured in 2026.
The ACA made comprehensive health insurance affordable for millions of households for the first time. Policymakers should investigate ways to strengthen the gains of the past few years by making comprehensive health insurance affordable to all Americans instead of pulling it away from those who often need it the most.