The latest version of a Republican-backed plan to replace the Affordable Care Act was introduced today, giving Senators only days to consider it before casting their vote. According to the Congressional Budget Office, the Graham-Cassidy Bill, introduced by Republican Senators Lindsey Graham (SC), Bill Cassidy (LA), Dean Heller (NV) and Ron Johnson (WI), would cause millions of Americans to lose health coverage and impose a federal per capita cap for Medicaid. Unlike under the Affordable Care Act, which has no set funding maximum per state for Medicaid, the federal cap would predetermine the amount of reimbursement each Medicaid enrollee in a state would receive, giving no consideration to likely increases in health care costs or the actual health needs of each recipient. This would leave states responsible for covering the difference, clinics, hospitals, and doctors’ offices to write off additional costs, or even worse, require already struggling Americans to pay more for their healthcare.
Block Grants Would Allow States More Control Over Healthcare Coverage
For all other Americans, block grants would determine how each state handles healthcare coverage for its citizens. At the federal level, subsidies, typically to help pay for coverage of lower and middle income Americans, would be up to the states. States can chose to eliminate subsidies altogether and reallocate those funds from the block grant towards other elements of their healthcare program.
The Graham-Cassidy Bill currently still requires coverage for preexisting conditions, but would allow for states to decide to not cover costs for some conditions. The bill also still requires coverage for ‘essential healthcare,’ which includes maternity care, mental health treatment, and hospital visits, but would allow states to determine what services are considered ‘essential’ and which are not.
Over 4.5 Million Elderly Would be Affected
The government currently has 4.6 million senior Medicaid enrollees, with the highest amount of enrollees in California and New York. Justice in Aging, a legal group that fights for seniors rights, estimates that passage of the Graham-Cassidy Bill would increase annual Medicaid costs per senior by $16,000. In an email to their supporters today, Justice in Aging wrote “By making consumer protections optional, this bill would essentially impose an “Age Tax” on older adults. Without these vital protections and financial assistance, the individual market will return to the pre-ACA days when older adults and anyone with significant health care needs could not get or afford comprehensive health coverage.”
For older Americans who are not yet on Medicare, the Graham-Cassidy Bill allows insurers to charge up to five times more for insurance coverage than for someone younger. Under the Affordable Care Act, premiums for older adults were permitted to be up to 3 times higher.
Capping Medicaid and Cutting Consumers Protections Is Not the Answer
In short, the Graham-Cassidy Bill aims to give individual states more control over healthcare, but allows for a lot of gray area. Major protections that many relied on are likely to be wiped away, leaving millions of Americans without an option for affordable health care. When budgets are on the line and savings need to come from somewhere, the first things to happen will likely be cutting healthcare from the elderly, redefining what qualifies as an ‘acceptable preexisting condition’ and what should be considered ‘essential’ healthcare.
To quote Justice in Aging, “The Graham-Cassidy bill is yet another short-sighted attempt to repeal the Affordable Care Act and heartlessly aims to take down the Medicaid program with it, putting older adults and their families at risk. The Senate must reject the Graham-Cassidy bill, stop attacking health care for older adults, and return to working in a bipartisan matter to improve health care for everyone.”