Last week was truly a week of March Madness. The Congressional Budget Office (CBO) released its score of the Republican-led House “repeal and replace” health reform bill, and as of now, we expect the bill to be considered by the full House this Thursday, 5/23 — the anniversary of the ACA. In addition, President Trump released his “skinny” budget last Thursday, laying out his spending priorities for the upcoming fiscal year.
President Trump’s Skinny Budget
As noted in a new blog post from CBPP, Trump’s “skinny” budget “contains substantially less detail than “skinny” budgets of the last five administrations going back to Ronald Reagan. The Trump budget includes only estimates for fiscal 2018 and only for its proposed changes to discretionary programs (those funded through the annual appropriations process) — even though discretionary programs make up less than one-third of the federal budget.”
CBPP President Bob Greenstein’s Commentary on the Trump Budget
CBPP President posted a commentary to Trump’s “skinny” budget laying out how the budget request would do severe damage to an array of investments that help many of the very people that President Trump has said would be his priority — people who have been left behind by today’s economy or live in distressed urban or rural communities.
As noted in the commentary, the cuts in programs for individuals and communities that the President has promised to help include:
- cuts to job training that helps workers upgrade their skills;
- cuts to Labor Department funding that likely would seriously weaken federal actions to ensure that factories and mines are safe, workers are paid what they have earned, and minimum-wage and other laws to protect workers are complied with;
- cuts to student aid and work-study programs that help low- and moderate-income students afford college;
- cuts to economic development funding for both cities and rural communities;
- cuts to housing assistance for hard-pressed families struggling to pay the rent; and
- elimination of the Low Income Home Energy Assistance Program, which helps low-income households, including many poor seniors, pay for heat, especially in cold winter months.
Read the full commentary here.
Republican Health Bill Heads to the House Floor
The House Budget Committee approved 19-17 a motion last Thursday to send the Republican health bill, The American Health Care Act, to the full House for consideration.
Three conservative Republicans — Reps. Sanford (SC-1), Brat (VA-7) and Palmer (AL-6) joined all Committee Democrats in voting against the motion.
The panel also approved four other “motions” offered by GOP lawmakers that directed the House Rules Committee to allow certain amendments to the bill – all of which move the measure further to the right. Those include allowing states to switch to federal block grant funding for the Medicaid program and immediately freezing enrollment in the health law’s Medicaid expansion. The other two would authorize states to impose work requirements on able-bodied adults without children in the Medicaid expansion and restructure the tax credits to provide more funding to lower-income individuals. These motions are noteworthy for one reason: they may augur the specific changes the House Republican leadership is considering making to the legislation to win over more conservatives and have the votes to pass the bill.
The process: The legislation will now go to the Rules Committee where Republicans hope to make several changes to the bill, though conservative and moderate factions of the party remain divided on what direction those changes should take. After the Rules Committee, the legislation heads to the floor for debate and vote(s), though there are growing concerns from Republicans about the bill and it’s possible that action on the bill will slip. However, we must continue to work as if the House will act next week and the Senate will take up the bill the following week.
Majority Leader Sen. McConnell’s goal is to complete action on the health reform bill during the week of March 27th. Just 20 hours of debate are allowed under reconciliation, providing a very limited debate for such a consequential piece of legislation. Numerous senators have voiced their opposition to the House health plan. At this point, it appears that the Senate will NOT vote on the House plan (however that is modified); instead it appears that a revised measure – a substitute – may be offered by Sen. McConnell. This substitute might address purely technical drafting issues – or it might include substantive changes sought by key Republicans whose votes are needed to pass the Senate.
McConnell wants to finish the health bill that week, allowing the first week of April (which is the last week before the spring recess) to be used to reconcile differences between the House and Senate health bills.
Here’s a good new resource:
Senator Bob Casey (D-PA), Ranking Member of the Senate Special Committee on Aging, released a 50 State Report detailing the impacts of TrumpCare on older Americans.
CBO Releases a “Score” (or Estimate) of the House Plan
The Congressional Budget Office (CBO) has released its score on the House Republicans’ health plan (the legislation adopted by the Ways and Means and Energy and Commerce Committees). The CBO report confirms the path Congressional leaders are on to dismantle the Affordable Care Act and end Medicaid as we know it.
The CBO estimates find that the House Republican health plan would cause 24 million people to lose insurance coverage by 2026. It would not only effectively end the ACA’s Medicaid expansion but go further by ending Medicaid as we know it – shifting costs to states, hurting local economies, and putting quality coverage for seniors, people with disabilities and families with kids at risk.
- 24 million people would lose health coverage under the House Republican health plan by the end of the decade.
- 14 million people would lose coverage next year and 21 million would lose coverage by 2020.
- CBO finds that the House plan would eventually eliminate allof the coverage gains expected under the ACA and the uninsured rate among non-elderly would be at or above the rate prior to the ACA.
- The House Republican health plan will end the Medicaid expansion and end Medicaid as we know it – slashing federal Medicaid spending by $880 billion over the next 10 years and causing 14 million people to lose Medicaid coverage.
- The House Republican plan takes away coverage from millions of people to help pay for $600 billion in tax cuts primarily for the wealthiest Americans, as well as drug and insurance companies.
- Millions will pay substantially higher premiums due to large cuts in tax credits that outweigh the slight decrease in average premiums.
- The premium decrease that Republicans are citing is the average change in the sticker price of health insurance, without accounting for the House plan’s large reductions in tax credits.
- That means consumers will pay a considerably greater share of total premium costs than under current law — so even if average premiums fall, what many people actually pay will rise.
CBPP Blogs on the House Republican Health Bill
- CBO: Millions Would Pay More for Less Under House GOP Health Plan
- President Trump’s Health Promises Don’t Match Facts, CBO Report Shows
- CBO: 24 Million People Would Lose Coverage Under House Republican Health Plan
- House Republican Health Plan Would Weaken Medicare
- Little-Noticed Medicaid Changes in House Plan Would Worsen Coverage for Children, Seniors, and People with Disabilities and Increase Uncompensated Care
- Commentary: No, the House GOP Health Bill Won’t Protect Medicaid Beneficiaries
- House Republican Plan Needs $100 Billion Fund to Maintain Individual Insurance Market
- For House GOP Health Bill, Deficit Reduction and Coverage Loss for Millions Go Together
- Medicaid Offers Access to Needed Care; House GOP Health Bill Would Undermine It