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World

Budget Office Set to Release Report on House GOP Health Bill

Democrats have defended Obama's law for expanding coverage and requiring insurers to provide stronger benefits

Senate Majority Leader Mitch McConnell of Kentucky, (R), speaks to the media with Sen. John Barrasso, Republican Wyoming , after a Republican policy luncheon, Tuesday, May 23, 2017, on Capitol Hill in Washington, photo: AP/Jacquelyn Martin
4 months ago

WASHINGTON – Keeping former President Barack Obama’s health care law is “completely unacceptable and totally unsustainable,” the Senate’s top Republican said Wednesday as the two parties braced for a Congressional Budget Office (CBO) report on a House-passed bill overhauling that statute.

The budget office, lawmakers’ nonpartisan fiscal analyst, planned to release an analysis Wednesday of the impact the GOP-written House bill would have on coverage, consumers’ costs and the federal budget. Its two March reports on earlier versions of the bill projected it would leave 24 million additional people uninsured in a decade, a mammoth number that pushed Republicans onto the defensive.

The new estimates could give talking points to House Republicans, or to Democrats, who voted unanimously against that bill. For GOP senators holding private meetings to sketch out their own legislation, its figures will be a starting point as they consider changing the House’s Medicaid cuts, tax credits and other policies.

Senate Minority Leader Chuck Schumer, Democrat from New York., flanked by Sen. Debbie Stabenow, Democrat from Michigan., (L), and Sen. Mike Crapo, Republican-Idaho, right rear, speaks with reporters following a closed-door strategy session, at the Capitol in Washington, Tuesday, March 28, 2017. Photo: AP/J. Scott Applewhite

Wednesday’s report will be the first time the budget office has gauged the impact of eleventh-hour changes House Republicans made to gain enough votes to pass the bill.

Those provisions included waivers states could get for insurers to raise premiums on some people with pre-existing conditions, and to ignore health benefits that must be covered under Obama’s law. States could also gain permission for insurers to charge older customers far higher premiums.

In addition, the new report could say whether the bill achieved enough budget savings to retain special protections the legislation would have to shield it from a Democratic filibuster in the Senate.

Though it’s considered unlikely, if the bill lacks sufficient savings, the House might have to revise the bill and vote again, which could be an ordeal for GOP leaders. The House approved the bill May 4 by a narrow 217-213 with only GOP votes.

Senate Majority Leader Mitch McConnell, Republican from Kentucky, downplayed the report Wednesday as “a technical procedural step.”

He added, “Whatever CBO says about the House bill today, this much is absolutely clear: the status quo under Obamacare is completely unacceptable and totally unsustainable. Prices are skyrocketing, choice is plummeting.”

Democrats have defended Obama’s law for expanding coverage and requiring insurers to provide stronger benefits.

Senate Minority Leader Chuck Schumer, Democrat from New York, said Wednesday that the GOP bill would “gut Medicaid” and force higher out-of-pocket costs on older people and others.

“We can expect today’s CBO analysis will likely show many of the same grave consequences,” he said.

In March, the budget office said the House legislation would increase premiums by an average 15 percent to 20 percent over the next two years, but push premiums 10 percent lower than they’d otherwise be by 2026. Many Republicans say their chief goal is to reduce premiums.

Besides premiums, other critical components of the value of health insurance are out-of-pocket costs and benefits.

Obama’s law included subsidies to help people with modest incomes cover their deductibles and copayments, and spelled out standard benefits like maternity services that insurers must provide. The House bill would eliminate the subsidies for deductibles and copayments, and let states greatly loosen Obama’s coverage requirements.

The House bill would reduce taxes by around $1 trillion over the coming decade, the budget office said, largely on higher-income people and health care industry firms. It would replace Obama’s tax subsidies for health insurance consumers, based mostly on income and premiums, with GOP tax credits geared more to people’s ages.

Most of those losing coverage would be beneficiaries of Medicaid, the health care program for poor and disabled people, though people buying individual policies or getting coverage at work would also become uninsured. The last budget office report said the House bill would cut Medicaid by $839 billion over 10 years.

Erasing Obama’s health care law was a top promise of Donald Trump during his presidential campaign, and by congressional GOP candidates since its 2010 enactment.

But writing legislation that can pass with only Republican votes has proven agonizing. House Speaker Paul Ryan, Republican Wisconsin, canceled a March vote after opposition from party conservatives and moderates would have sealed its defeat, and the two wings of the GOP spent weeks blaming each other for the bill’s demise.

Meanwhile, the Trump administration released a report that found a doubling of average premiums for individually purchased coverage from 2013, just before Obama’s statute took effect, to this year.

The report from Health and Human Services looked at premiums in the 39 states served by HealthCare.gov, the online exchange for buying coverage. It found the average monthly premium increased from $224 in 2013 to $476 in 2017.

Before 2013, insurers were allowed to turn away people with health problems, and there was no federal requirement for a standard benefits package. Those two “Obamacare” changes made coverage more robust, but also increased the cost.

ALAN FRAM
RICARDO ALONSO-ZALDIVAR

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