Tuesday, June 27, 2017

CBO Reveals Winners, Losers In Senate Health Care Plan : Shots - Health News : NPR

What you should know about the House and Senate bills to repeal/amend the Affordable Care Act.  



CHART: CBO Weighs Who Wins, Who Loses With Senate Health Care Bill


The nonpartisan Congressional Budget Office weighed in on the Senate health care bill on Monday, saying that 22 million people would lose health coverage in the next 10 years under the Senate's plan. Of those, 15 million would lose Medicaid coverage. It's projected to lower the deficit by billions over 10 years, and also cut taxes on corporations and the wealthy.
Medicaid covers low-income people including children, pregnant women, older people in nursing homes and the disabled. Under the Affordable Care Act, the federal government offered subsidies to help states to cover more people, though 19 states chose not to accept the federal money.
For individuals who purchase health coverage on the exchanges, the CBO says prices will vary — some will see lower premiums, especially in states that opt out of some consumer protections, which will allow insurers to sell plans that offer fewer benefits. However, for people would like to purchase plans that cover the essential health benefits mandated by the Affordable Care Act, including mental health coverage, addiction treatment, maternity care and prescription drug coverage, costs could go way up.
Other provisions in the Senate proposal would reduce subsidies and cause out-of-pocket costs to rise, the CBO says. As a result, starting in 2020, "despite being eligible for premium tax credits, few low-income people would purchase any plan."
AFFORDABLE CARE ACT (OBAMACARE)
Can get insurance through a parent’s plan or buy independently.
HOUSE BILL: AMERICAN HEALTH CARE ACT
Stays the same.
SENATE DRAFT: BETTER CARE RECONCILIATION ACT
Stays the same.

Adults under 65

AFFORDABLE CARE ACT (OBAMACARE)
Can buy insurance on health exchanges, with tax credits and subsidies if they meet income requirements up to 400 percent of poverty level. Cost of insurance is based on tobacco use and age, with the people nearing 65 paying no more than three times what the youngest pay. Premiums can’t cost more than 9.5 percent of income. Those with very low or no income qualify for Medicaid.
HOUSE BILL: AMERICAN HEALTH CARE ACT
Will see tax credits to pay premiums based on age, not income, and that max out at $4,000, much less than under the ACA. The oldest people under 65 can be charged five times more than the youngest, and maybe more depending on state rules. Medicaid cut after 2020.
SENATE DRAFT: BETTER CARE RECONCILIATION ACT
The CBO report says 22 million people would lose health insurance over the next 10 years, with people between 50-64 disproportionally impacted. The oldest people under 65 would pay five times more than younger people on the exchanges. Subsidies to help pay for insurance would be less and end at incomes of 350 percent of poverty level. Federal contributions to Medicaid start to decline in fiscal year 2020.

Low-income nursing home residents

AFFORDABLE CARE ACT (OBAMACARE)
Skilled nursing care covered by Medicare up to 100 days. Medicaid is available based on income.
HOUSE BILL: AMERICAN HEALTH CARE ACT
Skilled nursing care covered by Medicare up to 100 days. Medicaid services could be cut as states see federal funding decline.
SENATE DRAFT: BETTER CARE RECONCILIATION ACT
Skilled nursing care covered by Medicare up to 100 days per illness. Medicaid coverage for nursing home services could be cut as federal payments to states decline.

People with pre-existing medical conditions

AFFORDABLE CARE ACT (OBAMACARE)
Coverage cannot be denied or cost more.
HOUSE BILL: AMERICAN HEALTH CARE ACT
States can get permission to let insurers charge more for some pre-existing conditions and to exclude some people altogether. States would have access to federal money to help those with expensive policies or conditions.
SENATE DRAFT: BETTER CARE RECONCILIATION ACT
Insurance companies would be required to accept all applicants regardless of health status. But the draft bill lets states ask permission to reduce required coverage, also called “essential health benefits,” which would give insurers some discretion over what they offer in their plans. That could result in “substantial increases” in costs for people who want those services, according to the CBO. Caps on annual and lifetime spending by patients would no longer apply if the benefit is no longer classified as essential.

People who go to Planned Parenthood

AFFORDABLE CARE ACT (OBAMACARE)
Federal programs reimburse for most Planned Parenthood services.
HOUSE BILL: AMERICAN HEALTH CARE ACT
A one-year block will be placed on federal reimbursements for care provided by Planned Parenthood.
SENATE DRAFT: BETTER CARE RECONCILIATION ACT
A one-year block will be placed on federal reimbursements for care provided by Planned Parenthood. The CBO estimates 15 percent of women would lose access to family planning care, increasing birth rates and Medicaid spending for childbirth and children’s insurance. But those increases would be offset by Planned Parenthood cuts.

People with disabilities

The majority of Medicaid dollars go to people with disabilities.
AFFORDABLE CARE ACT (OBAMACARE)
May qualify for Medicare and also Medicaid.
HOUSE BILL: AMERICAN HEALTH CARE ACT
Services covered by Medicaid could be cut as federal funding to states declines over time.
SENATE DRAFT: BETTER CARE RECONCILIATION ACT
Services covered by Medicaid could be cut as federal funding to states declines over time. The CBO report suggests that by 2026, Medicaid enrollment would fall by more than 15 million people.

People who use mental health services

AFFORDABLE CARE ACT (OBAMACARE)
Covered by all plans under essential health benefits.
HOUSE BILL: AMERICAN HEALTH CARE ACT
Could lose coverage in states that get waivers from covering essential health benefits.
SENATE DRAFT: BETTER CARE RECONCILIATION ACT
States could request waivers to opt out of requiring essential health benefits. If a state opted out of coverage for mental health care, the CBO says insurance that includes mental health care coverage could become “extremely expensive.”
Either plan leads to reduced access to plans for patients. Medicaid plans would be impacted.

CBO Reveals Winners, Losers In Senate Health Care Plan : Shots - Health News : NPR
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