May 26, 2017

CBO Releases AHCA Score, Bill Remains Catastrophic in Terms of Coverage Loss

Congressional Budget Office score shows latest version of American Health Care Act passed by the U.S. House would result in massive loss of vital health care coverage for 23 million people, including families, adults with disabilities, children, seniors and people with pre-existing conditions

LAKE MARY, FL – The Florida Policy Institute (FPI) today highlighted the Congressional Budget Office’s (CBO’s) newly released score on the American Health Care Act (AHCA), pointing to its finding that 23 million Americans would lose coverage by 2026. The U.S. House leadership made last-minute amendments to the bill in early May and, in an unusual step, passed the AHCA before the CBO was able to complete its analysis. This analysis or “score” shows the legislation’s devastating impact on children, families, seniors, people with disabilities and people with pre-existing conditions.

“Constituents, advocacy groups, medical professionals and health care experts alike skewered this mess of a bill, but the House didn’t listen. Instead, they passed health care legislation that would endanger the health and lives of millions of Floridians,” said Joseph F. Pennisi, executive director of FPI. “The CBO score confirmed what we already knew — that a terrible bill is still terrible.”

Notably, under the AHCA:

  • The number of uninsured across the country would rise by 14 million people just next year, growing to 23 million by 2026. That is 82 percent higher than the current rate of uninsured residents.
  • All of the coverage gains expected under the Affordable Care Act (ACA) would be eliminated and the uninsured rate among the non-elderly would revert back to the 2010 level, before the ACA took effect. The uninsured rate has fallen to a historic low of 9 percent under the ACA. (In Florida — according to U.S. Census data — the uninsured rate was reduced to 13.3 percent in 2015, significantly down from 21.3 percent in 2010, prior to enactment of the ACA.)
  • Federal Medicaid spending would be cut by $834 billion over the next 10 years, due to the effective elimination of the Medicaid expansion and conversion to capped federal Medicaid funding. Fourteen million Medicaid beneficiaries would lose coverage and would likely end up uninsured.
  • Millions would face much higher premiums and out of pocket costs for skimpier benefits. Low-income and older people would be the hardest hit.
  • States would be permitted to get waivers so that insurers could charge more for people with pre-existing conditions. Insurers would also be allowed to drop coverage for essential health benefits such as maternity care and mental health and substance dependence treatment.

Floridians stand to lose a lot. There are 1.4 million residents who currently receive financial help to purchase individual coverage through the insurance marketplace created under the ACA– more than any other state. The AHCA’s elimination of tax credits tied to income and cost-sharing subsidies would put coverage out of reach for most low- and moderate-income Floridians.

The 4.3 million Floridians receiving Medicaid benefits — a lifeline for children (who constitute more than half of the program’s beneficiaries), seniors and persons with disabilities — would be particularly hurt by the AHCA’s capped federal Medicaid funding.  The exploding population of elderly residents and people with disabilities in Florida would inevitably lead to enormous cost-shifts to the state and deep Medicaid cuts.

Further, critical life-sustaining services for Florida’s most vulnerable residents would be at risk. This includes:

  • home and community-based services keeping the elderly and younger people with disabilities out of more expensive nursing homes;
  • preventative care and treatment for children – investments with life-long pay-offs; and
  • substance dependence treatments to combat Florida’s opioid crisis.

“The U.S. Senate must oppose any bill that causes millions to lose coverage, effectively ends Medicaid expansion by phasing out federal match funding, shifts billions in Medicaid costs to the state through capped federal funding or makes coverage less affordable for low- and moderate-income families. I urge Senators Marco Rubio and Bill Nelson to listen to their constituents in Florida and reject any bill that includes any of these damaging provisions,” added Pennisi.

The Florida Policy Institute is an independent, nonpartisan and nonprofit organization dedicated to promoting widespread prosperity through timely, thoughtful and objective analysis of state policy issues affecting economic opportunity.

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