Senate Healthcare Bill Thread - UPDATE: 9/26 Graham-Cassidy Bill is Offically DEAD! Free Daps/Reps!
- Thread starter Black Panther
- Start date
Repealing Obamacare may be Senate Republicans' main goal, but it's also easy to see how the BCRA could benefit the GOP in coming elections. The provisions that stand to be more popular (and less harmful to many Americans) are front-loaded, occurring before the 2018 midterms. Cuts to premium subsidies and Medicaid come after that, and many of them are delayed until after the 2020 presidential election.
To better see how this bill could affect future politics, we've put together a timeline of when major BCRA changes would go into effect in relation to the dates of coming elections.
Immediately
Prior to this point, the individual mandate — one of the most unpopular parts (maybe the most unpopular part) of Obamacare — will have been repealed. That could make midterm voters happy — and inclined to vote for Republicans — despite the fact that Obamacare has, in general, gained in popularity since Trump took office. According to the Congressional Budget Office, the elimination of the individual mandate would lead to 15 million more uninsured people in 2018 alone.
In addition, several Obamacare taxes will have been repealed by now, overwhelmingly benefiting the highest-income Americans. Those changes could please a crucial group of GOP supporters.
Not only that, but the bill will not have yet removed cost-sharing subsidies — payments to insurers that help lower-income customers afford coverage — and it will not have yet kicked in the (generally) less-generous premium support subsidies.
The Medicaid expansion likewise will not have yet been rolled back. That rollback will eventually affect millions — by 2026, it would mean 15 million more people would be off the Medicaid rolls than there would be under current law, according to the CBO.
In short, many of the potentially less-popular provisions of this law — provisions that would lead to higher premiums or deductibles (which could in turn lead to more people choosing not to buy coverage), as well as lower Medicaid enrollment — wouldn't go into effect for a while and could save the GOP some pain at the ballot box.
Jan. 2019
By now, some pain may have kicked in for some Americans. Some who were formerly eligible for tax credits for individual market insurance premiums — that is, those between 350 and 400 percent of the federal poverty level — will no longer be eligible.
The cost-sharing reduction payments that benefit lower-income people on the exchanges will also end. That could lead to lower-income people paying premiums near where they are now, but also having much higher deductibles, the CBO reported this week. In other words, health care would be more expensive for many lower-income people in the individual markets, so many may simply choose not to purchase insurance.
And the amount the federal government spends to reimburse states for Medicaid will be dropping by then. If states want to maintain current levels of coverage, they will have to spend more and more of their own money.
January 2021
Still more factors could affect these elections, particularly Medicaid cuts. These could be getting sharper in many states, with "churn" in the system having taken people off the rolls who now won't be able to get back on, with the expansion dialing back.
Jan. 2024
Federal Medicaid expansion funds fully rolled back
Nov. 2024 — presidential election
The federal spending on the Medicaid expansion would be gone entirely by now — states could maintain the expansion if they had enough money, but for many states, that's unlikely. As the left-leaning Center on Budget and Policy Priorities reports, some states would have to up their spending by 400 percent in 2024 to maintain the expansion.
Jan. 2025
Medicaid per capita growth now pegged to a lower inflation rate (meaning lower spending in the future)
Nov. 2026 — Midterm election
By now, Medicaid will be drastically changed from what it was before the bill, with work requirements in some states, caps on spending (meaning it won't adjust for recessions, for example), and much lower enrollment in general.
In addition, by now, premiums in the marketplaces will have shifted sharply. Older adults in particular could face some massive increases in premiums, as the CBO report showed.
How The Senate GOP Health Care Bill Could Affect The Midterms And Beyond
To better see how this bill could affect future politics, we've put together a timeline of when major BCRA changes would go into effect in relation to the dates of coming elections.
Immediately
- Individual and employer mandates repealed (retroactive to Dec. 31, 2015)
- Planned Parenthood funding ends for one year
- States can much more easily waive aspects of ACA, including "essential health benefits"
- States get funding "for purposes of submitting an application for a waiver"
- Taxes on health savings accounts, prescription drug manufacturers and importers, health insurance providers, and investment income repealed
- States can impose work requirements on Medicaid recipients
- Tanning tax repealed
- Restrictions on using tax credits to buy plans that cover abortion go into effect
- Limits on flexible spending account contributions repealed
- Tax on medical devices repealed
Prior to this point, the individual mandate — one of the most unpopular parts (maybe the most unpopular part) of Obamacare — will have been repealed. That could make midterm voters happy — and inclined to vote for Republicans — despite the fact that Obamacare has, in general, gained in popularity since Trump took office. According to the Congressional Budget Office, the elimination of the individual mandate would lead to 15 million more uninsured people in 2018 alone.
In addition, several Obamacare taxes will have been repealed by now, overwhelmingly benefiting the highest-income Americans. Those changes could please a crucial group of GOP supporters.
Not only that, but the bill will not have yet removed cost-sharing subsidies — payments to insurers that help lower-income customers afford coverage — and it will not have yet kicked in the (generally) less-generous premium support subsidies.
The Medicaid expansion likewise will not have yet been rolled back. That rollback will eventually affect millions — by 2026, it would mean 15 million more people would be off the Medicaid rolls than there would be under current law, according to the CBO.
In short, many of the potentially less-popular provisions of this law — provisions that would lead to higher premiums or deductibles (which could in turn lead to more people choosing not to buy coverage), as well as lower Medicaid enrollment — wouldn't go into effect for a while and could save the GOP some pain at the ballot box.
Jan. 2019
- Continuous-coverage provision (six-month waiting period before obtaining insurance) kicks in
- Funds appropriated for "Long-Term State Stability and Innovation Program," a pot of money states can spend to support high-risk people in the individual markets, helping push premiums down and keeping markets stable
- Age-rating limits change, allowing insurers to charge older people up to five times higher premiums than younger people. (Under Obamacare, older people can only be charged three times more.)
- Sunsets ACA's minimum medical loss ratio, which makes sure insurance companies spend a certain percent of revenue from premiums on health care claims and improving quality, rather than in other areas, like profits and marketing
- Actuarial value for benchmark plans drops, meaning plans would cover a smaller share of costs
- Cost-sharing reduction payments to insurers stop
- Tax credits for premiums change, no longer available to people between 350 and 400 percent of the federal poverty level
- Medicaid per-capita growth for non-disabled capped at the rate of inflation for medical care
- Tax on employee health insurance premiums and benefits repealed
By now, some pain may have kicked in for some Americans. Some who were formerly eligible for tax credits for individual market insurance premiums — that is, those between 350 and 400 percent of the federal poverty level — will no longer be eligible.
The cost-sharing reduction payments that benefit lower-income people on the exchanges will also end. That could lead to lower-income people paying premiums near where they are now, but also having much higher deductibles, the CBO reported this week. In other words, health care would be more expensive for many lower-income people in the individual markets, so many may simply choose not to purchase insurance.
And the amount the federal government spends to reimburse states for Medicaid will be dropping by then. If states want to maintain current levels of coverage, they will have to spend more and more of their own money.
January 2021
- Medicaid expansion starts to roll back: matching rate for the expansion population starts to decline
- "Trigger laws" start going into effect, ending Medicaid expansion altogether in some states
Still more factors could affect these elections, particularly Medicaid cuts. These could be getting sharper in many states, with "churn" in the system having taken people off the rolls who now won't be able to get back on, with the expansion dialing back.
Jan. 2024
Federal Medicaid expansion funds fully rolled back
Nov. 2024 — presidential election
The federal spending on the Medicaid expansion would be gone entirely by now — states could maintain the expansion if they had enough money, but for many states, that's unlikely. As the left-leaning Center on Budget and Policy Priorities reports, some states would have to up their spending by 400 percent in 2024 to maintain the expansion.
Jan. 2025
Medicaid per capita growth now pegged to a lower inflation rate (meaning lower spending in the future)
Nov. 2026 — Midterm election
By now, Medicaid will be drastically changed from what it was before the bill, with work requirements in some states, caps on spending (meaning it won't adjust for recessions, for example), and much lower enrollment in general.
In addition, by now, premiums in the marketplaces will have shifted sharply. Older adults in particular could face some massive increases in premiums, as the CBO report showed.
How The Senate GOP Health Care Bill Could Affect The Midterms And Beyond
Good post. I was talking about this with my buddy the other day.
ADevilYouKhow
Rhyme Reason
Smfh
Why can't the dems get their shyt together? These republicans are a disaster for health care.
@smitty22 this man is saying nice things about your governor. come educate him on how compassionate he is and how much he cares for the regular folks of ohio.
anyway, one of the things i noticed is that the republican party going so extreme to the right with scum like donald trump, ted cruz, etc has made the kasich's of the world look down right reasonable and they aren't much better.
Why can't the dems get their shyt together? These republicans are a disaster for health care.
Why is this the Dems' fault?
They've voted pretty solidly against Rethuglican health initiatives, and were shut out of negotiations for the Obamacare replacement.
Their bills haven't been considered in committee with Republicans, and they don't have the ability to force legislation through.
What exactly are you expecting them to do?
this isn't (all) the Dems fault. I'm saying they need to get their shyt together cause they are the only ones that can make this right.Why is this the Dems' fault?
They've voted pretty solidly against Rethuglican health initiatives, and were shut out of negotiations for the Obamacare replacement.
Their bills haven't been considered in committee with Republicans, and they don't have the ability to force legislation through.
What exactly are you expecting them to do?
their party is fractured and corrupt. However, they are the best chance this country has of getting decent health care.
There's not much they can do, even if their party wasn't as fractured as it is. The issues within the DNC have not translated to disunity in congressional votes among Dems.
The best they can do, unfortunately, is use the failure of the Senate bill as an opportunity for bipartisan negotiation. I think Rethugs are getting close to admitting that repeal/replace is a stupid idea.
Bleed The Freak
Superstar
Crazy part is instead of repeal this is the perfect opportunity to Expand Medicaid on their gotdman terms.
Job requirement- check
Private insurance - check
Cost sharing- check
Copay- check
These nikkas is delusional
Job requirement- check
Private insurance - check
Cost sharing- check
Copay- check
These nikkas is delusional
Republicans are giving the people what they want.
Why can't the dems get their shyt together? These republicans are a disaster for health care.
And people who don't vote what they deserve.
b-b-b-but I thought the Dems won the popular vote??
so is this REALLY what the ppl want or are you guys just gonna keep playing silly games.
Yes, because the branch of government that is responsible for creating the laws is overwhelmingly republican.
The people spoke.
You're conflating Hillary, who is a Democrat, winning the popular vote in the 2016 election with the Democrats in Congress, who currently don't have a majority.
Electoral college, as far as I know, doesn't apply to congressional elections.
Please take a Civics course.