The amended version of the Senate health bill, released July 13, maintains the same core features as previous versions of the legislation and would have essentially the same harmful impacts. It would still:
- End Medicaid expansion to low-income adults, including the Arkansas Works program which allowed 300,000 Arkansans to gain coverage;
- Cut Medicaid spending over time while giving tax breaks to corporations and the wealthy; and
- Increase out-of-pocket spending and raise premiums and deductibles, especially for low-income and older Arkansans.
Also, many of the proposed fixes are inadequate, and some of the provisions would make things worse. For instance, the amended version of the Senate bill adds an additional $45 billion in funding for opioid treatment over the next decade. But the costs of covering treatment for opioid addiction in that time frame would be more than $200 billion. On top of this, even some conservative senators are concerned that creating a separate fund for addiction coverage could create barriers between addiction treatment and physical health care. These additional funds for opioid addiction would also be greatly outweighed by the bill’s deep Medicaid cuts and other fundamental changes to the Affordable Care Act that would cost millions of people their health care coverage and leave many opioid sufferers without the care they need to recover.
One of the biggest changes comes from the “Cruz Amendment” (an amendment introduced by Senator Ted Cruz). This amendment allows insurers to sell plans that do not comply with consumer protections put in place by the ACA, as long as they sell at least one plan that does comply. This means that insurers would only have to offer one plan that includes essential health benefits, where premiums would not vary based on health status. Other non-compliant plans could vary greatly by the health status of the individual and offer a skimpier benefits package.
This would remove consumer protections in every state and allow insurers to charge people with pre-existing conditions higher premiums, which a number of Senate Republicans have pledged not to do. In practice, healthier people would gravitate toward cheaper plans with fewer benefits, and people with pre-existing conditions would enroll in more robust plans, which are likely to have sky-rocketing premiums.
Bottom line: the latest Senate bill – like every version of this bill – would cause millions to lose coverage. While we are waiting a Congressional Budget Office score to detail the full impact of this bill, we know enough to know that it will put millions of Americans at risk, including the 367,000 Arkansans who would lose coverage or become uninsured.