Back in March, after Republican leaders pulled their American Health Care Act off the floor of the House because they lacked the votes, CHI put out a publication titled “What Now? Five Next Steps for the Affordable Care Act in Colorado & Five Lessons Learned from the Repeal and Replace Debate.”
It turns out, we were the ones with an important lesson to learn: A bill is never dead until the gavel falls on the last day of Congress.
That’s worth remembering as we head into the Independence Day holiday with the latest health care measure — the Senate's Better Care Reconciliation Act — seemingly on the ropes as Congress goes into recess for a week.
The momentary pause gives us time to asses where we are in the debate, what Coloradans need to know and how CHI can help.
First, we know the bill would bring fundamental changes (and deep cuts) to Medicaid in Colorado and every other state. Research led by CHI’s Emily Johnson projects that the bill would leave 630,000 fewer Coloradans covered by Medicaid by 2030, with a $15 billion funding cut over the bill’s first decade compared with current law.
Second, tax credits to buy private insurance would get smaller and cover fewer people. At the same time, older people could be charged more for private coverage than the current law allows. These two provisions would slightly lower the cost of insurance for many younger people, while older Coloradans — especially those in rural counties — would face tremendous price increases. The Kaiser Family Foundation has done extensive modelling on this topic.
Several people have asked us about essential health benefits, which states could waive under the current version of the Senate bill. Colorado already had a fairly rich set of coverage mandates before the Affordable Care Act (ACA). Those are summarized in this legislative staff memo from 2011.
Right now, news reports say Senate leaders are scrambling to find votes by adding funding for opioid treatment and maybe retaining some of the Obamacare taxes on wealthy people so that tax credits could be expanded. At the same time, conservatives aim to allow insurance companies to deny coverage or charge more to customers with pre-existing conditions.
All this could change any minute, though. It’s moving rapidly and it’s happening behind closed doors. The speed and secrecy make it difficult for groups like CHI to contribute in-depth analysis to the debate. Still, interest in this bill is extremely high, and we have done our best to provide easy-to-understand resources for analyzing the measure.
Late last week, we published a matrix crafted by Ian Pelto and Brian Clark that compared the Senate and House bills to the ACA. That page attracted 18,000 users to our website in just a few days. For perspective, that’s nearly half the users who visited our website during all of 2016, which was a record-setting year for website traffic for CHI. And 210 people registered for our webinar (pictured above) this week. That’s four or five times our typical attendance.
Both the webinar and the matrix are available on our website, along with an in-depth Q&A document compiled by a number of CHI analysts. We will update this research and add to it as needed after the Senate returns July 10.
However you feel about this debate, I’d urge you to keep in mind the lesson we learned when the bill we thought was dead was resurrected and passed by the House: This bill isn’t dead. Far from it.
Happy Independence Day.