What You Need to Know about the Senate’s Rumored “Fixes” to the House’s ACA Repeal Bill

Photo credit: Gage Skidmore

No one knows much about the Senate’s “bill” to repeal the Affordable Care Act (ACA) – including the Members themselves.  Even though we don’t know much, we do have information about some of the “fixes” to the House bill that may be included in the Senate version.  Spoiler alert: this bill will not fix any of the problems in the House ACA repeal bill.  According to Senate Majority Whip John Cornyn, the Senate bill will be “80% the House bill”– a bill that has an 8% public approval rating and that Trump himself called “mean, mean, mean.”
Here are four things you need to know about the Senate’s rumored proposed “fixes” to the House repeal bill:

1. Preexisting Conditions:

Members have promised that they are fixing the House bill’s provision allowing insurance companies to deny coverage for individuals with preexisting conditions – such as cancer, acne, migraines, or just being a woman.  But unless they go back to the language in the ACA, they aren’t.  Rumored fixes so far just change the language from the House bill, but the result will be the same: insurance companies will be able to charge people with preexisting conditions sky-high premiums, possibly pricing them out of the insurance market completely.

2. Medicaid Cuts:

The House ACA repeal bill and President Trump’s budget cut Medicaid by $1.4 trillion.  The nonpartisan Congressional Budget Offices estimates that the House bill’s cuts alone will take Medicaid coverage from 14 million people.  Much of this loss is due to the cutting of Medicaid expansion – throwing millions of individuals back to a time they did not qualify for Medicaid and also could not afford private coverage.  It’s rumored that some Senators have proposed a “7 year phase out” for Medicaid expansion.  This is not a solution.  Pushing back the timing of when people are going to get kicked off their health insurance does nothing – all 14 million people will still lose coverage eventually.  Moreover, the Senate is still rumored to be fundamentally altering the Medicaid program right away by instituting a per capita caps system, which means less money to the states, fewer people covered, and fewer jobs.

3. The Opioid Crisis:

Some senators are reportedly proposing an “opioid fund” to help states dealing with the opioid crisis.  This fund appears to be a fund in name only.  In reality, it will do nothing to fill the void left by Medicaid.  In fact, substantially more people receive treatment for opioid addiction in states that have expanded their Medicaid programs than in states that have not.  Moreover, the proposed fund does not include requirements for insurers to cover opioid-related physical and mental health services.

4. Increased Premiums for Older Individuals.

Under the House ACA repeal bill, premiums are estimated to rise by 20% in 2018.  Premiums are expected to be even worse for older individuals.  Some Senators are rumored to be proposing a small increase in tax credits for older individuals, but not nearly enough to make up for the “age tax” in the bill.
These proposed “fixes” are no more than empty political rhetoric.  These politicians think we can’t see through fake attempts to the make the wildly unpopular House bill “20% better.”  If they are coming up with such great solutions, why can’t the public be a part of it? Maybe they are keeping it secret because they know it will be terribly unpopular.