May 25, 2017

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House health plan would take America backwards

by | May 25, 2017

Any plan to reform the nation’s health care system should aspire to make health care better, more affordable and readily available for all Americans.

Unfortunately, the U.S. House of Representatives’ latest attempt to repeal and replace the Affordable Care Act (ACA) does exactly the opposite by slashing hundreds of billions of dollars from the country’s health care infrastructure, removing protections to make health insurance accessible for older people and those with pre-existing conditions, while giving tax breaks to the rich.

Yesterday’s analysis from the Congressional Budget Office (CBO) quantified the disastrous implications of the American Health Care Act (AHCA). In short, the CBO score found that 23 million people will lose health insurance coverage if the AHCA — approved hastily and narrowly by the House earlier this month — is passed by the U.S. Senate and signed into law by President Trump.

To add insult to injury, the CBO determined the AHCA will destabilize the private insurance market, increase health costs for everyone, raise premiums for older Americans and price people with pre-existing conditions out of the market.

What does this mean for Colorado? Consider these facts:

* The ACHA will cut $800 billion from federal Medicaid funds, causing 14 million Americans and at least 600,000 Coloradans to lose coverage. This will result in a revenue loss of $14 billion for Colorado by 2030. Not only would this put the health of individual Coloradans at serious risk, it would force those needing immediate medical attention to get care through emergency rooms, shift health costs to consumers with coverage and likely force financially strained rural hospitals to shut their doors to patients.

* The ACHA allows states to modify the requirements for essential health benefits, which set the minimum standards for the benefits that insurance in the non-group and small-group markets must cover. In states that are granted waivers, community-rated premiums would rise overtime and those with pre-existing medical conditions would be unable to purchase comprehensive non-group health insurance – causing many people to become uninsured. Though the AHCA earmarks some federal funds to help defray coverage costs for those with pre-existing conditions, Colorado’s pre-ACA “high-risk pool” proved to be prohibitively expensive for consumers who needed it. If Colorado succumbed to market pressure to file such a waiver, many Coloradans with pre-existing conditions might simply be forced to “go without” health insurance coverage – a potentially costly proposition for them and their families if they get sick.

* Older Coloradans who lack the benefit of employer-sponsored plans and are too young to qualify for Medicare would pay significantly more for insurance plans under the AHCA because the legislation reduces or eliminates subsidies currently available under the ACA as well as removing protections for older enrollees. According to Kaiser Family Foundation, a 60-year-old living in Morgan County eligible for tax credits would pay $2,680 today for insurance through Colorado’s health insurance exchange, Connect for Health Colorado – about 8 percent of that person’s income. Under the AHCA, that same person would pay $13,160 for insurance — or 40 percent of that person’s income. While the CBO found that the AHCA would reduce premiums for younger insurance enrollees, it does so at the expense of older Americans.

* Congress promised that any alternative to the Affordable Care Act would reduce out-of-pocket health care costs but the CBO analysis makes it crystal clear that costs will rise precipitously. “Out-of-pocket spending on maternity care and mental health and substance abuse services could increase by thousands of dollars in a given year for the non-group enrollees who would use those services,” the CBO’s analysts wrote. Furthermore, “Some enrollees could see large increases in out-of-pocket spending because annual or lifetime limits would be allowed.”

* About 1.75 million veterans – 41,000 in Colorado – could see their health care coverage weakened or lost entirely if the AHCA became law, according to a report released May 22 by Families USA and VoteVets.

It seems to be a point of pride among certain House members that the American Health Care Act will “end Medicaid as we know it,” and relieve Americans from the obligation to buy insurance coverage. But yesterday’s CBO score reveals that the AHCA also will gut the American health care system on the backs of low- and middle-income families, while providing more than $600 billion in tax breaks for the rich and corporations. Though there’s certainly room for improvement with the ACA, bankruptcy rates have dropped by 50 percent in the U.S. since its passage in 2010. Yet, Congress is proposing to strip millions of Americans of the basic security that health insurance provides.

House leaders claim this version of the AHCA is an “improvement” over the first draft (which did not get enough support to clear the House floor), but the CBO score reveals the long-term effects of this incarnation are even more devastating for most Americans. While Colorado’s U.S. Sen. Cory Gardner has called for a “glide path” to give states flexibility to reform health care, the AHCA is clearly a navigational route for a “crash landing.”

As Senate leaders reportedly work on their own plan to repeal and replace the ACA, Coloradans need to let Senators Gardner and Michael Bennet know that they object to any proposal that makes health insurance less available and more expensive.

Please join us in calling U.S. Senators to work on a bipartisan solution to improve upon the ACA and make the basic need of health care better, more affordable and available to all.

Recent articles

HEALTH:
HEALTH FIRST COLORADO (MEDICAID)

To maintain health and well-being, people of all ages need access to quality health care that improves outcomes and reduces costs for the community. Health First Colorado, the state's Medicaid program, is public health insurance for low-income Coloradans who qualify. The program is funded jointly by a federal-state partnership and is administered by the Colorado Department of Health Care Policy & Financing.

Benefits of the program include behavioral health, dental services, emergency care, family planning services, hospitalization, laboratory services, maternity care, newborn care, outpatient care, prescription drugs, preventive and wellness services, primary care and rehabilitative services.

In tandem with the Affordable Care Act, Colorado expanded Medicaid eligibility in 2013 - providing hundreds of thousands of adults with incomes less than 133% FPL with health insurance for the first time increasing the health and economic well-being of these Coloradans. Most of the money for newly eligible Medicaid clients has been covered by the federal government, which will gradually decrease its contribution to 90% by 2020.

Other populations eligible for Medicaid include children, who qualify with income up to 142% FPL, pregnant women with household income under 195% FPL, and adults with dependent children with household income under 68% FPL.

Some analyses indicate that Colorado's investment in Medicaid will pay off in the long run by reducing spending on programs for the uninsured.

FOOD SECURITY:
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)

Hunger, though often invisible, affects everyone. It impacts people's physical, mental and emotional health and can be a culprit of obesity, depression, acute and chronic illnesses and other preventable medical conditions. Hunger also hinders education and productivity, not only stunting a child's overall well-being and academic achievement, but consuming an adult's ability to be a focused, industrious member of society. Even those who have never worried about having enough food experience the ripple effects of hunger, which seeps into our communities and erodes our state's economy.

Community resources like the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, exist to ensure that families and individuals can purchase groceries, with the average benefit being about $1.40 per meal, per person.

Funding for SNAP comes from the USDA, but the administrative costs are split between local, state, and federal governments. Yet, the lack of investment in a strong, effective SNAP program impedes Colorado's progress in becoming the healthiest state in the nation and providing a better, brighter future for all. Indeed, Colorado ranks 44th in the nation for access to SNAP and lost out on more than $261 million in grocery sales due to a large access gap in SNAP enrollment.

See the Food Assistance (SNAP) Benefit Calculator to get an estimate of your eligibility for food benefits.

FOOD SECURITY:
SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC)

Every child deserves the nutritional resources needed to get a healthy start on life both inside and outside the mother's womb. In particular, good nutrition and health care is critical for establishing a strong foundation that could affect a child's future physical and mental health, academic achievement and economic productivity. Likewise, the inability to access good nutrition and health care endangers the very integrity of that foundation.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides federal grants to states for supplemental foods, health care referrals, and nutrition information for low-income pregnant, breastfeeding and non-breastfeeding postpartum women and to infants and children up to age five who are found to be at nutritional risk.

Research has shown that WIC has played an important role in improving birth outcomes and containing health care costs, resulting in longer pregnancies, fewer infant deaths, a greater likelihood of receiving prenatal care, improved infant-feeding practices, and immunization rates

Financial Security:
Colorado Works

In building a foundation for self-sufficiency, some Colorado families need some extra tools to ensure they can weather challenging financial circumstances and obtain basic resources to help them and their communities reach their potential.

Colorado Works is Colorado's Temporary Assistance for Needy Families (TANF) program and provides public assistance to families in need. The Colorado Works program is designed to assist participants in becoming self-sufficient by strengthening the economic and social stability of families. The program provides monthly cash assistance and support services to eligible Colorado families.

The program is primarily funded by a federal block grant to the state. Counties also contribute about 20% of the cost.

EARLY LEARNING:
COLORADO CHILD CARE ASSISTANCE PROGRAM (CCCAP)

Child care is a must for working families. Along with ensuring that parents can work or obtain job skills training to improve their families' economic security, studies show that quality child care improves children's academic performance, career development and health outcomes.

Yet despite these proven benefits, low-income families often struggle with the cost of child care. Colorado ranks among the top 10 most expensive states in the country for center-based child care. For families with an infant, full-time enrollment at a child care center cost an average of $15,140 a year-or about three-quarters of the total income of a family of three living at the Federal Poverty Level (FPL).

The Colorado Child Care Assistance Program (CCCAP) provides child care assistance to parents who are working, searching for employment or participating in training, and parents who are enrolled in the Colorado Works Program and need child care services to support their efforts toward self-sufficiency. Most of the money for CCCAP comes from the federal Child Care and Development Fund. Each county can set their own income eligibility limit as long as it is at or above 165% of the federal poverty level and does not exceed 85% of area median income.

Unfortunately, while the need is growing, only an estimated one-quarter of all eligible children in the state are served by CCCAP. Low reimbursement rates have also resulted in fewer providers willing to accept CCCAP subsidies.