Third and State

Now that the Senate Republican effort to repeal and replace the Affordable Care Act has failed, let’s take a step back and understand why no bill based on the Republican approach to health care could have been fixed enough to reduce the pain to levels acceptable to a majority of Republicans in Congress, let alone to the American people. 

The basic design of the bill was deeply flawed from the perspective of anyone who thinks that America has a responsibility to guarantee quality, affordable health care to all. The design only made sense if one, instead, seeks a politically palatable way to reject that responsibility and reduce federal health care spending in order to cut taxes on large corporations and the rich.

What started as a bill to repeal the Affordable Care Act (ACA) became a bill to partly repeal the health insurance regulations and subsidies for insurance purchased in the individual marketplaces, fully repeal the Medicaid Expansion, and radically restructure – and drastically reduce – funding for traditional Medicaid.

The Manatt Health Group and the Robert Wood Johnson Foundation have released a new study of the impact of the Senate health care bill, the Better Care Reconciliation Act of 2017, on the states. Their estimates of the impact of the bill confirms our recent study showing that Pennsylvania will suffer devastating reductions in federal funding for Medicaid.

The new study provides two sets of estimates of how much federal funding each state loses – one if the state keeps the Medicaid Expansion and a second if it does not. According to the study, if Pennsylvania eliminates the Medicaid Expansion in 2021, the state stands to lose $30.1 billion in federal funding between 2020 and 2026 – $25 billion as a result of the elimination of federal funding for the Medicaid Expansion, and $5.1 billion as a result of the impact of per capita caps on traditional Medicaid.

I’m not just a practitioner of political rhetoric, but also a connoisseur of it. I can appreciate a good argument and a well-turned phrase put forward by our ideological opponents. And, rather than get disturbed by what the other side says, I take their best work as a challenge. But what truly does get me angry is when our opponents not only lie, but do so with arguments that are insulting to the intelligence of the people we are trying to influence – the citizens of Pennsylvania and America.

MEMO

From: Marc Stier, Director, Pennsylvania Budget and Policy Center

Date: June 28, 2017

Re: Effects of U.S. Senate Health Care Bill on Pennsylvania

The Pennsylvania Budget and Policy Center will be releasing a number of briefs on the effects of the U.S. Senate health care bill in the next few days. You can see our initial statement in response to the CBO scoring of the bill here. Below is our first brief on the effects of the bill on Pennsylvania.