Sen. Dean Heller (R-Nev.) at a news conference last week in Las Vegas in which he announced he would vote against the Senate health-care bill. (Erik Verduzco/Las Vegas Review-Journal via Associated Press)
You have to hand it to Republicans. When they get it into their heads to do something stupid, there is no holding them back. One of the clever aspects of the Affordable Care Act was to avoid big, disruptive health-care changes right before an election. Not so with Republicans’ bill. The Kaiser Family Research Foundation reports:
Overall, marketplace enrollees would pay on average 74 percent more towards the premium for a benchmark silver plan in 2020 under the BCRA [Better Care Reconciliation Act] than under current law. Younger enrollees would see modest increases on average (10 percent for those under age 18; 17 percent for those ages 18 to 34), while average premiums would more than double for enrollees ages 55 to 64. … Marketplace enrollees with incomes below 200 percent of poverty would see an average increase in their premium costs of 177 percent, while higher income enrollees would see an increase of 57 percent.” There is not a single age group that would pay less under the Senate bill for the Silver plan than they do under the ACA. Those 55-64 years old have the biggest hike — 115 percent. Likewise, all income brackets will pay more. Once again Americans age 55-64 yrs. old get hit the worst, that is older poorer people. They get a 294% increase. It was as if they set out to create a bill unpalatable to every one and devastating to Trump’s base.
It doesn’t get much better if Americans drop down to the Bronze Plan. That isn’t much help to older Americans or to those who want to pay less out-of-pocket.
For younger marketplace enrollees, they generally would pay less under the BCRA to purchase a bronze level plan than they would pay for a silver plan under current law; older enrollees, however, generally would pay more for a bronze level plan under the BCRA than they would pay for a silver plan under current law. Moving down to bronze level plans, however, would expose enrollees to much higher cost sharing than in silver plans, and for many enrollees who now receive cost-sharing subsidies, the increases would be very large. The BCRA would eliminate the cost sharing subsidies provided under current law beginning in 2020.
And yes, all of this happens in 2020, when the presidency, one-third of the Senate seats and all House seats will be up for grabs. It is almost as if Democrats devised legislation most likely to flip all three to Democratic control.
How did Republicans manage to come up with a bill that so adversely affects so many? (And let’s not forget those who won’t have Medicaid or will have reduced benefits.) The reason is simple: If you want to “shrink government” and give the rich jumbo tax cuts, you will wind up with cruddier health-care insurance for just about everyone else. Conservative “reformers” who have been praising the GOP should identify and explain themselves. Are they ideologically opposed to government support for health care, or do they simply have limited options given Republicans’ insistence on tax cuts for the rich? If it is the former, they should have the courage to defend their thinking rather than falsely claim that no one will be worse off. If it is the tax cuts, the so-called reformers on the right should re-label themselves as tax-cut advocates. They sure aren’t in the business of looking out for the most vulnerable among us.