Trump's 'victory' on health care. Look who's cheering. | Arkansas Blog

Friday, May 5, 2017

Trump's 'victory' on health care. Look who's cheering.

Posted By on Fri, May 5, 2017 at 7:43 AM

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The reviews are brutal on the health coverage bill passed by the Republican House yesterday.

Here's a New York Times summary of winners and losers. In short, the rich and healthy win. The old, poor and sick lose. U.S. Rep. French Hill of Little Rock is among the House Republicans crowing about how this is an improvement on Obamacare. (Even Rep. Bruce Westerman isn't ready to say THIS bill is going to become law.)

The bill (which won't pass the Senate in this form) utterly wrecks the Obamacare Medicaid expansion/Private Option/Arkansas Works program that has brought so much money, so many jobs and so much health care to more than 300,000 Arkansans.

David Ramsey, who's been covering health issues for us extensively, says that Arkansas Works would be dead, because the House bill ends the Medicaid expansion. At best, it would be a phase-out. At worst, cold turkey. He writes:

Also, as a separate matter, it would issue a huge funding cut to the rest of Medicaid (elderly in nursing homes, blind, disabled, kids, poor parents, etc.) via a per-capita version of block grants, putting pressure on state budget and forcing cuts even beyond eliminating the Medicaid expansion.

Finally, on the exchange, starting in 2020, it would change the subsidies and regulations to give dramatically less help to lower-income people and older people (and people in areas with high premiums). People in the 100-138 group that Hutchinson wants to move to the exchange would have to pay massively more in premiums than they do under the ACA and many would simply not be able to afford it. The AHCA also completely eliminates the ACA's cost-sharing reductions so even if low-income people scraped together the money to pay higher premiums, they would be hit with much higher deductibles and co-pays than people in this income group could realistically afford.

But the AHCA eliminates Medicaid expansion anyways, so in the long run Hutchinson's tinkering would be moot. People 0-100 FPL would be in the same boat, with tax credits insufficient for the cost of insurance given their income and no help with cost-sharing.
Gov. Asa Hutchinson's promise that the 60,000 he's kicking off Medicaid coverage could seamlessly transition to the same coverage at the same cost on the federal marketplace was already dubious. Under the House bill, there will be no marketplace subsidies to speak of any longer. Not to mention higher rates and far worse coverage in the private insurance market in which poor people are supposedly going to be able to afford insurance thanks to tax credits. (Insurance with crummy coverage, huge deductibles and more co-pays.) Thanks, French.

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