Arkansas must have the sorriest Congressional delegation in America. Steve Womack, Rick Crawford, French Hill and Bruce Westerman all voted for the American Health Care Act (AHCA) of 2017. This is one of the most low-down, dishonest, mean-spirited, and immoral pieces of legislation to ever pass through the House of Representatives. It truly is Robin Hood in reverse public policy that reduces taxes on millionaires and billionaires by hundreds of billions of dollars while simultaneously cutting health care aid to poor people by hundreds of billions of dollars.
These representatives were so proud of their actions that they released statements in an attempt to justify the unjustifiable. Congressman Womack said: “Today, we took a huge step in repealing Obamacare by sending the American Health Care Act to the Senate. I look forward to seeing how this bill will progress through Congress and bring about the changes that are deserved for all Arkansans.”
Womack failed to mention that in voting to pass this atrocious legislation, he rejected the expert advice of all the leading medical provider and patient advocacy groups in the country. This is just a partial list of the responsible groups that publicly opposed the AHCA, and tried to give guidance to the hard headed ideologues in Congress: The American Medical Association, American Nurses Association, American College of Physicians, National Nurses United, National Physicians Alliance, Association of American Physicians and Surgeons, American Academy of Pediatrics, American Hospital Association, Federation of American Hospitals, America’s Essential Hospitals, The AARP, Families USA, The American Cancer Society, The American Diabetes Association, The American Heart Association, The American Lung Association, The Cystic Fibrosis Foundation, March of Dimes, The National Multiple Sclerosis Society, The National Association of Rare Disorders and the National Coalition for Women with Heart Disease.
The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) just finished their report on the cost estimates of the American Health Care Act of 2017. As far as the effect on the federal budget, the CBO found that the AHCA would reduce budget deficits by a nominal average of $12 billion dollars a year over ten years: “CBO and JCT estimate that, over the 2017-2026 period, enacting AHCA would reduce direct spending by $1,111 billion and reduce revenues by $992 billion, for a net reduction of $119 billion in the deficit over that period. The largest savings would come from reductions in outlays for Medicaid ($834 billion) and from the replacement of the Affordable Care Act’s (ACA’s) subsidies for nongroup health insurance with new tax credits for nongroup health insurance ($276 billion).
Those savings would be partially offset by other changes in coverage provisions - spending for a new Patient and State Stability Fund ($117 billion), designed to reduce premiums, and a reduction in revenues from repealing penalties on employers who do not offer insurance and on people who do not purchase insurance ($210 billion). The largest increases in the deficit would come from repealing or modifying tax provisions in the ACA that are not directly related to health insurance coverage—such as repealing a surtax on net investment income, repealing annual fees imposed on health insurers, and reducing the income threshold for determining the tax deduction for medical expenses ($664 billion).”
Concerning the effects on health insurance coverage: “CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under AHCA than under current law. The increase in the number of uninsured people relative to the number projected under current law would reach 19 million in 2020 and 23 million in 2026.”
For the most part, CBO believes that the insurance market would remain stable under either the current law or the AHCA. The most notable exception applies to those states that allow waivers to the community rating of premiums under the AHCA. This would allow insurers to set premiums on the basis of an individual’s health status. “CBO and JCT expect that, as a consequence… community rated premiums would rise over time, and people who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive nongroup health insurance at premiums comparable to those under current law, if they could purchase it at all.. As a result, the nongroup markets in those states would become unstable for people with higher-than-average expected health care costs. That instability would cause some people who would have been insured in the nongroup market under current law to be uninsured.”
The CBO does project that insurance premiums overall would eventually be lower than under current law mostly due to allowing states to obtain waivers for essential health benefits (EHBs) which would facilitate the sale of crappy insurance. The young and healthy and wealthy would see lower insurance premiums but it is a much different story for the old, sick and poor: “Although premiums would decline, on average, in states that chose to narrow the scope of EHBs, some people enrolled in nongroup insurance would experience substantial increases in what they would spend on health care. People living in states modifying the EHBs who used services or benefits no longer included in the EHBs would experience substantial increases in out-of-pocket spending on health care or would choose to forgo the services.
Services or benefits likely to be excluded from EHBs in some states include maternity care and substance abuse benefits, rehabilitative and habilitative services, and pediatric dental benefits. In particular, 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 nongroup enrollees who would use those services.
Moreover, the ACA’s ban on annual and lifetime limits on covered benefits would no longer apply to health benefits not defined as essential in a state. As a result, for some benefits that might be removed from a state’s definition of EHBs but that might not be excluded from insurance coverage altogether, some enrollees could see large increases in out-of-pocket spending because annual or lifetime limits would be allowed. That could happen, for example, to some people who use expensive prescription drugs. Out-of-pocket payments for people who have relatively high health care spending would increase most in the states that obtained waivers from the requirements for both EHBs and community rating.”
The CBO uses an example to show the disparity in insurance premiums between the young and the old under the AHCA and Obamacare. Under Obamacare, a single person with an annual income of $26,500 pays $1,700 in insurance premiums regardless of age. Under the AHCA in those states not requesting waivers for community rating or EHBs, a 21-year-old with that income would pay $1,750 in premiums, while a 40-year-old would pay $2,900. A 64-year-old would face an unbearable insurance premium of $16,100. In those states requesting waivers, the 21-year-old would pay $1,250, the 40-year-old would $2,100 and the 64-year-old would pay $13,600. Incredibly, a person making $68,200 a year would pay premiums in the exact same amount as the lower income workers under either version of the AHCA. Under Obamacare, at that income level, the 21-year-old would pay $5,100, the 40-year-old would pay $6,500 and the 64-year-old would pay $15,300 in insurance premiums.
Most Arkansans will never experience the lifestyle of a Congressman. According to the College of Business at the University of Arkansas Little Rock, the per capita income in Arkansas is $39,725. Our Congressmen have an annual income of $174,000. Additionally, the Congressional Research Service (CRS) reports: “Members of Congress are eligible for a pension at the age of 62 if they have completed at least five years of service. Members are eligible for a pension at age 50 if they have completed 20 years of service, or at any age after completing 25 years of service. The amount of the pension depends on years of service and the average of the highest three years of salary. By law, the starting amount of a member’s retirement annuity may not exceed 80% of his or her final salary.”
According to the CRS, Congressional members and their staff may enroll in health plans through the Obamacare Washington DC exchange. Nearly 13,000 Congressional members and staffers are currently enrolled in gold level small business health option plans on that exchange. “The percentage of premiums paid by the federal government is calculated separately for individual, self plus one, and family coverage, but each uses the same formula. According to the formula, the employer contribution is set at 72% of the weighted average of Federal Employee Health Benefits plan premiums, not to exceed 75% of any given plan’s premium.”
CRS said: “In addition to health insurance coverage under the D.C. Shop, this report describes other health benefits available to members and congressional staff, including the Federal Flexible Spending Account Program; the Federal Employees Dental and Vision Insurance Program; the Federal Long Term Care Insurance Program; the Office of the Attending Physician; and treatment in military facilities.” Also, eligibility for Medicare does not prevent coverage on the exchange. According to the Office of Personnel Management members of Congress are “not subject to the same limitation as the individual exchange which precludes an individual from carrying both Medicare and an individual exchange policy.”
While the vast majority of Arkansans are deserving of the income and benefits that they receive, our four congressmen certainly are not. Their shameful conduct in harming millions and millions of Americans does not merit reward.