Republicans on Capitol Hill today unveiled a revised version of the proposed Better Care Reconciliation Act (BCRA), their bill to repeal and replace the Affordable Care Act (or “Obamacare”). But leading Maryland healthcare advocates remain deeply concerned that the bill would cause millions of Americans to lose insurance and make coverage unaffordable for those who need it the most.
The bill features an amendment championed by Senator Ted Cruz of Texas, which is designed to win over GOP conservatives who complained previous versions of the bill did not go far enough in repealing Obamacare. The plan would allow insurers to offer cheaper plans in the individual insurance market that do not adhere to certain requirements under Obamacare, such as covering essential health benefits, as long as they offered at least one plan that did fit those requirements.
Experts and health advocates say that this plan would further destabilize insurance markets by permitting insurers to box sicker people into the more robust plans at higher costs. This means that millions of Americans, including those with pre-existing conditions, could be priced out of the care they need or denied coverage altogether.
“There seems to be a willful ignorance on the part of the drafters of the BCRA and this amendment, in particular, on how health insurance and the individual market works,” said Leni Preston, president of Consumer Health First. “We know that 22 million Americans are forecast to lose coverage under the BCRA. Now we have an amendment that would exacerbate the challenges for those with pre-existing conditions, which is as high as 51 percent of nonelderly Americans. And, by putting all of the sickest individuals into a single pool, you would precipitate a death spiral for the market itself which would impact us all. This is both immoral and unacceptable."
Consumer Health First has been compiling recent analyses that show the state-by-state impact of the original version of the BCRA. Here in Maryland, the consequences would be dire.
An analysis by the Urban Institute shows that by 2022, the uninsured rate in Maryland would rise from 9.8 percent to 21 percent among non-elderly adults and from 1.8 percent to 7.8 percent among children. Another study shows that by 2026, 62,600 Marylanders would lose coverage in the individual market, and another 164,800 would lose Medicaid coverage.
Medicaid cuts proposed in the bill would cause the most harm in Maryland. One in five Marylanders is currently covered by Medicaid, 300,000 of whom are newly insured under the ACA. The bill cuts $8.7 billion in federal Medicaid funding to Maryland by 2026.
The Republican bill would have other enormous consequences for Maryland, including the projected loss of 21,200 jobs, a 49 percent projected increase in uncompensated care costs at Maryland’s acute care hospitals and the loss of $84 million over five years from a repeal of the Prevention Fund, a provision of the Affordable Care Act that invested in prevention and public health programs.
The Congressional Budget Office is expected to release its analysis of the updated BCRA early next week, but advocates do not expect it to show much improvement over the original bill.
“This bill would be especially disastrous for older, sicker, poorer Marylanders, but the significant impacts on our state’s economy and public health mean that at the end of the day, we all lose,” said Preston. “We all have an interest in standing up and demanding a healthcare system that will actually deliver high-quality, accessible and affordable care for everyone.”
Consumer Health First is a statewide, non-partisan, grassroots alliance of 100 organizations and more than 1,800 individuals that seeks solutions and advances reforms that promote health equity through access to comprehensive, affordable, high quality health care for all Marylanders. For more information, visit www.consumerhealthfirst.org.