Senate health plan debuts to mixed reviews

June 23--U.S. Senate Republicans unveiled their plan to repeal and replace the Affordable Care Act Thursday, and local health care experts say it would deal a major blow to health care access across socioeconomic lines.

The draft of the Senate version of the American Health Care Act released Thursday morning would curtail federal Medicaid funding and repeal taxes on the wealthy that helped pay for President Barack Obama's ACA. It would also end the tax penalties under the ACA for people who don't buy insurance -- the individual mandate -- and on larger companies that don't offer coverage to their employees.

Kosali Simon, a nationally known health economist and Herman B Wells endowed professor at the Indiana University School of Public and Environmental Affairs, said the Senate's plan -- introduced and drafted behind closed doors by Senate Majority Leader Mitch McConnell -- is a slightly softer approach than the U.S. House of Representatives bill passed in May, falling somewhere between that bill and the ACA, which is sometimes called Obamacare.

Unlike the House bill, the Senate's version of the AHCA would base subsidies for private insurance on age and income, rather than just age, Simon explained. It also mirrors several of the ACA protections for individuals with pre-existing conditions, something the House bill did not do.

Additionally, states that expanded coverage under the federal-state Medicaid program for low-income people would receive additional funds through 2020, then the funds would be gradually reduced until being entirely eliminated in 2024.

"Still, this is going to be a pretty big blow to Medicaid, and not just to the expansion coverage, but also to its bread and butter. That means children, disabled people, those who rely on this system," Simon said.

Nancy Richman, executive director at Volunteers in Medicine of Monroe County, said the AHCA is likely to be "one of the most harmful pieces of legislation in American history."

"I think this bill is nothing short of disastrous," she said. "And not just for people in poverty. This is middle-class. This bill will affect everyone."

Richman noted that the nonpartisan Congressional Budget Office said the House bill would cause 23 million people to lose coverage by 2026.

"That by itself is disastrous. There is a direct link between Medicaid being slashed and people losing their medical services," said Richman, which in turn would lead to increased emergency room visits, increased bankruptcy among individuals saddled with hospital bills, and an inability to effectively combat the opioid crisis. "You're creating an economy that is completely threatened by people's health."

The CBO's analysis of the Senate measure is expected in the next few days.

Indiana Gov. Eric Holcomb said Anthem Inc. and MDwise Marketplace's exit from the health insurance marketplace in Indiana on Wednesday was a sign that reform is needed.

"Indiana isn't alone; insurers are pulling out of Obamacare in states across the country. This underscores the need for reform, and Indiana is poised to lead the way if given the flexibility and time to tailor the best solutions to meet the needs of our people," Holcomb said in a statement.

U.S. Sen. Joe Donnelly, D-Ind., said he believes Hoosiers are tired of "almost a decade of partisan debates about health care."

"The bill before us was drafted in secret and behind closed doors, and I'm very concerned that the Senate is racing toward a vote without the necessary input, analysis or even a single Senate hearing. The stakes are incredibly high -- this is about the health, well-being and economic security of families, children and adults with disabilities and older Hoosiers," Donnelly said in a statement. "I continue to urge my colleagues to work together to improve the health care system."

U.S. Sen. Todd Young, R-Ind., agreed that something had to be done as he spent Thursday reviewing the draft of the Senate bill and speaking with constituents. Young also used Anthem and MDwise's departure as evidence that the ACA is fatally flawed.

"One thing is clear: Doing nothing is not an option. Obamacare has failed Hoosiers as prices have skyrocketed; insurers have left the marketplace, leaving severely limited choices; and deductibles have risen to a level where for some, insurance is useless," Young said in a statement. "I am committed to improving our nation's health care system so everyone has the opportunity to access high quality and affordable care."

___

(c)2017 the Herald-Times (Bloomington, Ind.)

Visit the Herald-Times (Bloomington, Ind.) at www.heraldtimesonline.com

Distributed by Tribune Content Agency, LLC.