Update: It’s out. The full text of a “discussion draft” is here.
Original post: A conservative think tank feared a whiff of Obamacare Lite. A West Palm Beach supporter of the Affordable Care Act compared it to a terrible Back To The Future scene that somehow crawled off the cutting-room floor.
Details of a U.S. Senate bill to replace Obamacare and roll back Medicaid began to emerge ahead of an expected meeting between Majority Leader Mitch McConnell and other senators Thursday morning, carrying big implications for the physical and financial health of millions in Florida.
The Senate plan would largely mirror the House bill, which cuts close to $1 trillion in taxes, but extend some subsidies to low-income people to lower their premiums, the Washington Post reported about a draft circulating among aides and lobbyists.
Florida leads all states using the federal Affordable Care Act marketplace with about 1.5 million customers, and nine out of 10 get subsidies. Under the Senate plan, government help to pay premiums would go to people making up to 350 percent of the poverty level, Axios.com reported, a continuation of controversial Obamacare subsidies but at a reduced level compared to the ACA’s 400 percent eligibility. For its part, the House bill replaces ACA subsidies with tax credits tied to age.
The Senate plan is said to wind down Medicaid expansion more gradually than the House version but there were reports Wednesday it could make deeper cuts in spending over the long run. Medicaid covers 4 million people in Florida, including about half the childbirths and 70 percent of seniors in nursing homes and 41 percent of Palm Beach County’s children.
The political goal is to come up with a plan that will get enough votes to pass muster with the GOP’s slim majority in the Senate and have a chance of passing the House on a return trip. There’s talk of a Senate vote as early as next week, though the question is just how much tweaking will do the trick to revamp a House bill President Donald Trump reportedly called “mean.”
“If the House bill was ‘mean,’ this bill is cruel,” said Anna Galland, executive director of liberal advocacy group MoveOn.org, on Wednesday evening. “Shockingly, this bill’s cuts to Medicaid are even deeper than those passed by the House—at a moment when Medicaid and Medicare should be dramatically expanded.”
But groups on the other side of the ideological fence questioned whether the Senate bill will go far enough in undoing Obamacare.
Heritage Action’s chief executive officer Michael A. Needham said Wednesday, “Conservatives are rightly frustrated with the process of repealing and replacing Obamacare that has played out this year. It is clear that significant portions of the Republican Party have no intention of actually repealing Obamacare despite campaigning on that objective for years.”
He continued, “Conservatives will evaluate legislative language when it becomes available, looking particularly at whether the legislation empowers states to get out of the onerous insurance mandates imposed by Obamacare, maintains and improves the House’s Medicaid reforms, and repeals Obamacare’s stifling taxes.”
Also closely watched in Florida will be the impact on older residents, including those 50 to 64. The House bill would let insurers charge them five times more than younger people, up from three times now. Groups including AARP have been calling for more transparency this week. “When someone is being THIS secretive about a bill, it’s usually a bad sign,” AARP Advocates tweeted.
“It’s a like a Back To The Future episode they scrapped on the editing floor,” said Mark Pafford, a former Democratic state legislator from West Palm Beach who is a board member of the advocacy group Florida CHAIN (Community Health Action Information Network). “It will essentially return the health care system not just in Florida but around the country to the broken system we had before.”
On Thursday, Health and Human Services Secretary Tom Price issued a statement:
“Under Obamacare, premiums have skyrocketed across the country – on average doubling what Americans are paying for health insurance coverage. Because of these rising costs, millions of Americans have dropped their unaffordable coverage and others have been forced to pay a penalty to Uncle Sam just for the right to go without. Patients, doctors, job creators, and Americans from all walks of life are being harmed and losing access to affordable coverage and the care they need. We have heard their voices. Dudley Bostic, the owner of a local pharmacy in Tennessee, recently explained how access to affordable healthcare is disappearing for so many in her community. And Dr. Ryan Stanton from Kentucky shared the importance of putting patients and doctors in charge of healthcare, not Washington D.C., and protecting the doctor-patient relationship.
“That’s why we welcome the Senate’s proposal to provide Americans with much needed relief from Obamacare. The Senate’s proposal is built on patient-centered reforms that put the American people in charge of their healthcare decisions, not government, protecting patients, bringing down the cost of coverage, and expanding choices.
“The Trump Administration is committed to the health of all Americans. Here at the Department of Health and Human Services, we have already taken steps to reduce Obamacare’s burdens for the American people.”