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The new GOP health-care measure goes further than the failed one
Many states would see permanent major funding cuts. The poor/elderly/disabled are going to get chopped off at the knees. The Cassidy-Graham bill also does away with the ACA "Essential Health Benefits" mandate...
--Ambulatory patient services (outpatient care you get without being admitted to a hospital)
--Emergency services
--Hospitalization (like surgery and overnight stays)
--Pregnancy, maternity, and newborn care (both before and after birth)
--Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
--Prescription drugs
--Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
--Laboratory services
--Preventive and wellness services and chronic disease management
--Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)
I have no idea how/why Cassidy-Graham consider this monstrosity superior/more palatable to previous GOP repeal and replace measures. It's actually worse.
The measure would actually cut federal health-care spending even more than BCRA, and aim the cuts more directly at states that expanded Medicaid under the Affordable Care Act. It was the governors and senators from those states who were most deeply worried about Medicaid cuts to begin with. It would work roughly like this: Starting in 2021, the federal government would lump together all the money it spends on subsidies distributed through the ACA marketplaces and expanded Medicaid programs covering poor, childless adults living at up to 133 percent of the federal poverty level.This approach would generally result in less money for states that expanded Medicaid under the ACA and more money for states that didn’t. That’s because Graham-Cassidy would redistribute the money allotted to the 30 states that opted to expand Medicaid under the ACA and spread it out among all 50 states. Cassidy’s own state, Louisiana is among the states that stand to lose the most funding under this approach. Others include California, Connecticut, Delaware, Hawaii, Kentucky, Maryland, Massachusetts, Minnesota, Montana, New Hampshire, New Jersey, New York, North Dakota, Oregon, Rhode Island, Vermont and Washington, whose Medicaid expansion dollars would be cut anywhere from 35 to 60 percent. By 2026, the federal government would be spending 17 percent less on subsidies and Medicaid expansion overall than under current projections, according to an analysis by the Center for Budget and Policy Priorities.
Then, in 2027, states would face a big fiscal cliff, when the Cassidy bill would halt all that spending. That’s a major step further than BCRA, which would have retained the marketplace subsidies (despite reducing them somewhat) and allowed states to keep Medicaid expansion (albeit paying for these enrollees at the normal matching rate and not the ACA’s expanded matching rate). But there’s another way the Cassidy bill goes further than previous Obamacare rollback measures: It would allow states to opt out of the law’s “essential health benefits,” the baseline services insurers must cover. That means there will no longer be a rock-solid prohibition on charging higher premiums to people with preexisting medical conditions, although states would need federal waivers. The bottom line is this: The Cassidy bill will appeal to most conservatives in the House and the Senate, who can make the case to their base that they’re unshackling states from federal mandates and giving them huge leeway to construct a health-care approach that works best for them. But if the moderate Republicans go along with this latest approach, they’d have to ignore the type of hefty Medicaid cuts they had previously opposed.
Many states would see permanent major funding cuts. The poor/elderly/disabled are going to get chopped off at the knees. The Cassidy-Graham bill also does away with the ACA "Essential Health Benefits" mandate...
--Ambulatory patient services (outpatient care you get without being admitted to a hospital)
--Emergency services
--Hospitalization (like surgery and overnight stays)
--Pregnancy, maternity, and newborn care (both before and after birth)
--Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
--Prescription drugs
--Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
--Laboratory services
--Preventive and wellness services and chronic disease management
--Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)
I have no idea how/why Cassidy-Graham consider this monstrosity superior/more palatable to previous GOP repeal and replace measures. It's actually worse.