Health advocates: Tax bill could cut Medicare, impact other health care programs

Dec. 05--The tax bill passed by the U.S. House and Senate members could have tremendous impacts on health care, including marketplace users, Medicaid and Medicare recipients, health advocates said.

Several nonprofit leaders spoke about potential changes during a news teleconference organized by the Pennsylvania Health Access Network on Tuesday.

For instance, by eliminating the individual mandate of the Affordable Care Act, which requires every American to have health insurance, an estimated 13 million fewer Americans would have health insurance by 2025, according to The Center for American Progress.

"About 500,000 fewer people in Pennsylvania will have health insurance, and that's equivalent to about 1,000 premature deaths in Pennsylvania every year," said Marc Stier, director of the Pennsylvania Budget and Policy Center. "The premiums will also go up, so that by 2027, for those who buy insurance on the individual market, the entire tax cut will pretty much be eliminated."

Older and lower income residents will also be impacted through Medicare and Medicaid cuts. That includes a potential $400 billion cut in Medicare programming over the next decade, said Ray Landis, an advocacy manager with AARP.

"The impact of these cuts would be incredible on older Pennsylvanians who are already struggling, facing higher drug costs, higher premiums for their supplemental plans," Landis said. "... It's going to strain the program even more in an era where we know that the demographics of Pennsylvania, certainly, and the country as a whole, are changing. So taking money out of the program when we're having more older Americans, older Pennsylvanians relying on the program, is really a recipe for significant reductions in the healthcare that these individuals get."

One of the versions of the tax bill would also eliminate tax deductions for medical expenses.

"The consequences of this pressure to cut taxes and spending could be devastating for Medicaid recipients in our state," Stier said, adding that nearly three-fourths of Pennsylvania Medicaid spending would no longer be eligible for deductions under the bill.

Those deductions offset high medical costs for seniors, Landis said.

"The medical expense deduction is critical to older Pennsylvanians that are facing high medical costs," he said. "And the elimination of that deduction as it is in the house bill right now would be devastating to millions of Pennsylvanians who rely on this deduction to make ends meet."

Essentially, during a time when health care resources are needed, the tax bill could instead cut.

"We're also concerned in the midst of an opioid epidemic, which particularly impacts families and communities, that we're instituting a potential tax cut that will drain $1.5 trillion of potential revenue that cities and states and municipalities," said Rosemarie Halt, director of Health Policy and Practice at the Philadelphia-based Maternity Care Coalition. "Everybody's looking for increases, and we're limiting that in this proposed tax cut."

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