The Republican health care bill passed by the House last week, quite simply, hurts seniors, the poor and many African-Americans.
“In modifying the original bill to give reluctant Republicans political cover, the House leadership made a bad piece of legislation even worse,” said Max Richtman, the president and CEO of the National Committee to Preserve Social Security and Medicare.
“We can only hope that the Senate majority will kill this reckless legislation before it punishes seniors and millions of Americans for the crime of needing and wanting affordable health care,” he said.
The bill cuts nearly $1 trillion from Medicaid by converting it into a block grant program or imposing per capita caps, which will make it harder for impoverished seniors to access long term skilled nursing care and community or home care.
The Congressional Budget Office, which hasn’t weighed in on the legislation, estimated that 24 million people would have been kicked off the Medicaid rolls in the next 10 years if the initial version of the bill, which was scrapped earlier this year, had become law.
The American Health Care Act (AHCA) reduces Medicare’s solvency by repealing Obamacare’s 0.9 percent payroll tax on wages above $200,000. This could lead to cuts in Medicare, including privatizing the program — harming current and future beneficiaries, Richtman said.
Under the GOP bill, insurers can charge older enrollees five times more than younger ones. The Congressional Budget Office predicts that by 2026 this provision will substantially raise premiums for older people by as much as 25 percent.
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After GOP leaders joined President Donald Trump in the Rose Garden of the White House following the vote to repeal and replace the Affordable Care Act, even some media outlets criticized the gathering for its celebrating a bill that effectively crushes African-Americans and the underserved.
The gathering represented “a bunch of fat, middle-aged, rich white guys,” said Donny Deutsch of MSNBC. “It’s a country club with restrictive membership, obviously, you have to be white, and a male, to be there,” said Joe Scarborough.
The bill hurts poor individuals in that many states would be expected to roll back their expansions of the Medicaid program to cover childless adults without disabilities.
The bill would also substantially reduce subsidies available for Americans just over the poverty line, the group that benefited most from Obamacare’s subsidies.
Poor Americans are much more likely to become uninsured under the bill, according to the Congressional Budget office, and those who retained coverage would pay much more of their limited incomes on premiums and deductibles.
The same factors that make the bill better for many young Americans make it worse for those who are older, according to the New York Times. Insurance companies could charge a 64-year-old customer five times the price charged to an 18-year-old one, to cite the most extreme example.
The changes in the subsidy formula would also require older middle-class Americans to pay a much larger share of their health insurance bill.
The Congressional Budget Office estimates that far fewer older Americans would have insurance coverage under this bill than under the Affordable Care Act.
The bill also allows states to waive rules on minimum benefit standards and rules that prohibit insurance companies from charging higher prices to customers with a history of serious illness — or even minor disease.
And it could mean their insurance covers fewer medical services.
The benefit changes could also affect Medicaid beneficiaries, and they could mean cutbacks on coverage for mental health and drug addiction treatment.
States that waive the rule about prices would be required to set up a program for high-risk customers, and would get some federal funding to do so, but the details are unclear.
The bill cuts back substantially on federal funding for state Medicaid programs and it does not restore any of the Medicare cuts. Hospitals in poor communities where a lot of people signed up for Medicaid would probably experience the biggest hit.
Richard Eskow, host of “The Zero Hour” and senior fellow with the Campaign for America’s Future, said the bill is “an assault on people of color.”
Black Americans are more likely to suffer from the perils of inadequate medical care, Eskow wrote, citing a 2000 study by the Centers for Disease Control and Prevention that found blacks are more than three times as likely as whites to have a lower limb amputated, often due to complications from diabetes, and more than twice as likely to be treated for wound infections and skin breakdowns. Both conditions are associated with inadequate treatment.
Black America is also struggling with an infant mortality crisis, he said.
“The African-American infant mortality rate is more than double the white rate,” Eskow said. “That figure is even worse in some places, like San Francisco, where the infant mortality rate for blacks is six times as high as it is for whites.”
Black Americans still die 3.4 years earlier than whites on average, although the gap has decreased, and African-Americans, especially women, also disproportionately suffer from disabilities as they age.
While whites make up the largest single group of Medicaid enrollees, at 42 percent, most of the people in this need-based program are non-white. Hispanics make up 31 percent, African-Americans are 19 percent, and 8 percent are classified as “other.”
The Republicans also plan to cap Medicaid, which will cut federal support to the program for seniors by $560 billion over the next decade.
“Republicans in the House of Representatives just delivered an economic punch to the gut,” said Sen. Bob Casey (D-Pennsylvania). “What passed isn’t a health care bill, but a scheme to cut taxes for millionaires and big corporations, a giveaway for special interests, and forces middle class families to pay more for their health care.
“This will throw [individuals] with pre-existing conditions into a high-risk pool, forcing them to pay thousands of dollars more for coverage, impose an age tax on older Americans, and leave individuals with disabilities out in the cold — possibly without even the security of Medicaid coverage,” he said “It is outrageous to think that anyone would support legislation that decimates Medicaid, a program designed to help our most vulnerable friends, family members and neighbors.
“Now that this legislation is coming to the Senate, I am redoubling my effort to fight like hell on behalf of families, seniors and individuals with disabilities who will be immeasurably harmed by it,” Casey said.