House Republican Health Plan Would Mean More Uninsured, Shifts Costs to States

The House Republican health care bill — the American Health Care Act, or AHCA — would dramatically increase the uninsured rated and shift billions of health care costs onto states, which are themselves strapped for cash, experts said.

A Center on Budget and Policy Priorities analysis of the bill, which is now stalled in Congress shows that 1 in 10 non-elderly Americans who’d have health insurance under current law (the Affordable Care Act, or ACA) would lose it under the House bill. And many who didn’t lose coverage under the House bill would end up with worse or less affordable health insurance. The House bill would effectively end the ACA’s Medicaid expansion and would radically restructure Medicaid funding in all states, cutting federal Medicaid spending by $839 billion over ten years and causing 14 million people to lose Medicaid coverage.

Overall, the bill would cause 24 million people to lose coverage by 2026, the Congressional Budget Office estimates.

And it would slash subsidies that help people afford coverage and care in the individual market.

The bill would cut more than $1.1 trillion from Medicaid and marketplace subsidies and dedicate most of the savings to tax cuts for high-income people and corporations. The House bill isn’t fixable: almost every piece of it would cause people to lose coverage, make coverage less affordable or less comprehensive, or cut taxes for high-income people. And House Republicans are reportedly considering making the bill even worse by rolling back ACA rules that protect people with pre-existing conditions (such as heart disease, diabetes, or mental illness) and that require health plans to offer comprehensive coverage.


It could be devastating for the states.

For example, New York would have to raise taxes or cut other parts of its budget by $50 billion over ten years to maintain New York Medicaid, including the Medicaid expansion to lowincome adults, under the House Republican health plan, the Urban Institute estimates.

In practice, the plan would effectively end the Medicaid expansion by requiring the state to spend up to 5 times more to cover people who enroll starting in 2020. Some 259,500 low income New Yorker adults who’ve newly gained coverage under the expansion would lose it.

The plan would also cap annual federal Medicaid funding for New York and other states by forcing each state to choose between a “per capita cap” or block grant. Under either policy, federal Medicaid funding would grow more slowly each year than states’ actual Medicaid costs, leading to deeper cuts over time.

Breaking the link between federal funding and the actual needs of states and beneficiaries would leave New York holding the bag. These cuts would jeopardize the health and well-being of seniors, people with disabilities, children, and adults who rely on Medicaid today.   The cuts would be deepest precisely when need is greatest, since federal Medicaid funding would no longer increase.

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About Frank Klimko

Frank Klimko is a nationally known journalist, grants expert and speech writer/speaker. He has years of experience helping nonprofits devise lists of the right funding opportunities and secure funding from these foundations and corporate entities. Clients have focused on an array of areas including child care, homeless, hunger and K-12 education. Additionally, he is a Freedom of Information Act expert, who has helped numerous clients with securing proprietary information from the federal government. Currently, Frank Klimko writes the Children & Youth Funding Report and Private Grants Alert, which are Washington DC-based publications. CYF is a daily publication covering Congress, the Education Dept. and the various federal regulatory agencies. PGA, another daily publication, covers the world of private philanthropy.
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