Senate Bill – Fact Checked

Senator Lamar Alexander released a statement about the Better Care Reconciliation Act (BCRA), the Senate version of the American Health Care Act (AHCA) on June 22, 2017 and another on the subsequent CBO score of the BCRA on June 26, 2017.

The many problems with Sen. Alexander’s analysis are detailed at alexanders-statements-bcra/.

Here’s a summary:

Sen. Alexander contends, the BCRA “makes no change in the law protecting people with pre-existing conditions, no change in Medicare benefits, and increases Medicaid funding— that’s TennCare—at the rate of inflation.”

In reality—

  1. The BCRA will allow states to waive essential health benefits (EHBs), which undermines certain ACA provisions that make adequate coverage more affordable. So, people with pre-existing conditions may not be able to afford a plan with all the services they need.
  2. The BCRA repeals the Medicare payroll tax on high-income earners – a source of funding for hospitals, skilled nursing facilities, and home health and hospice benefits. Also, the BCRA’s estimated $772 billion cuts to Medicaid would severely affect the one in five Medicare beneficiaries who rely on Medicaid to cover their Medicare premiums.
  3. The “rate of inflation” used in the BCRA is lower than medical inflation. The Congressional Budget Office (CBO) has pointed out that the effect will be to shift to states, and state taxpayers, the burden of additional inflation, which will grow to billions of dollars with each passing year, eventually amounting to a one third cut in Medicaid.
  4. Also, the change in Medicaid funding structure effectively ends the federal-state partnership, and states will bear a large portion of the costs of medical inflation, epidemics, medical innovation, and economic recessions.
  5. An estimated 22 million people will become uninsured in the next decade, including 634,000 Tennesseans.

The other “benefits for Tennesseans” that Sen. Alexander found in the draft bill are empty promises. Out-of-pocket costs will rise for many people, even if they get premium tax credits, according to the CBO. Entrusting the future of Tennesseans’ health and financial security to state legislators is a bad idea, despite “more flexibility” being hyped as a benefit. An overwhelming majority of Tennesseans support Gov. Haslam’s Insure Tennessee plan, but the state legislature has refused for 3 years to even bring it to a vote. Talks of “repealing” the ACA and reneging on promises to pay insurers for costs they have already incurred created market instability. Instead of fixing the problems, this bill makes the situation worse.

The BCRA will put adequate, affordable coverage out of reach for millions of people, will deter others from buying insurance, and will drive more hospitals out of business. For these reasons and many others, a long list of healthcare organizations, including the American and Tennessee Hospital Associations, Children’s Hospitals of America and the National Rural Health Association have spoken out in opposition to this bill. Sen. Alexander should explain his position in light of these facts. 6-30-17