Study says number of uninsured may rise by 353,000

NASHVILLE — The number of uninsured Tennesseans could soar nearly 49 percent in the next five years under the now-stalled U.S. Senate Republican health plan, according to a new analysis by a Washingtonbased research institution.

The liberal-leaning Urban Institute projected the number of uninsured non-elderly residents would rise by some 353,000 people, going from the current 726,000 persons, or 12.9 percent of the population, to 1.079 million people, or 19 percent.

Analysts performed the state-by-state look at the impact of the

GOP proposal, called the Better

Care Reconciliation Act of 2017.

But because he was unable to get enough support from fellow Republicans, Senate Majority Leader Mitch McConnell, R-Ky., has delayed a vote on the Senate health care plan. He hopes to come up with a new compromise to overhaul the 2010 Affordable Care Act, widely known as Obamacare.

Senate Republicans are looking at ways to put together the required votes, and Tennessee Republicans emphasized the Senate GOP bill very likely will change.

“Delaying the vote shows that we understand that and want to get it right,” Sen. Bob Corker, R-Tenn., said in a statement earlier this week as the GOP measure stalled. At least five Senate Republicans balked because it went too far, or didn’t go far enough,

in dismantling Obamacare.

Corker said the GOP “will continue working over the next several days to improve this legislation and resolve a number of legitimate issues.”

Sen. Lamar Alexander, R-Tenn., who was part of a small group that helped McConnell come up with the plan, said the majority leader “made a wise decision … to delay voting on the Senate health care bill and give senators time to reach an agreement.”

Alexander, chairman of the Senate Health, Education, Labor and Pensions Committee, added that “senators are actually closer to an agreement than it might appear.”

Neither Corker nor Alexander were among Senate Republicans publicly raising various objections to McConnell’s “discussion draft” legislation.

The Urban Institute’s examination provides a more detailed look at the impact of the GOP proposal than the Congressional Budget Office’s report, which was released earlier this week.

According to the institution’s state-by-state look, an estimated 300,000 of the 353,000 Tennesseans who would become uninsured by 2022 are enrollees in Medicaid, the state and federally funded health care program for low-income mothers, disabled and elderly Tennesseans, and also the federal Children’s Health Insurance Program for lowincome children.

Medicaid, operated as TennCare in Tennessee, covers some 1.5 million of the state’s estimated 6.6 million people.

Another 119,000 people who get their coverage through the ACA’s insurance exchanges, which provide subsidies based on income, would no longer have coverage, according to the Urban Institute’s examination. The Senate GOP plan maintains the exchanges but subsidies would be less generous.

The Urban Institute’s projections found that 66,000 more people would have coverage from their employers.

Urban Institute analysts wrote that the Senate GOP bill “would eliminate much of the Affordable Care Act, ending the individual and employer mandates, eliminating tax revenue sources, significantly changing premium tax credits and eliminating cost-sharing subsidies for private nongroup insurance coverage, and substantially altering the financing of the Medicaid program.”

According to the institution, the federal government is spending about $10.54 billion in Tennessee under the Affordable Care Act, a figure that includes Medicaid. That would drop by $2.87 billion, or 27.2 percent, by 2022, the Urban Institute projects.

Medicaid is now operated as an open-ended entitlement with the federal government providing matching funds to states’ expenditures. Instead, states could be reimbursed on a per-person set amount or through block grants.

The effect of the Senate GOP plan is less dramatic in Tennessee than in a number of other states. That’s because Tennessee GOP majority state legislators refused to go along with Republican Gov. Bill Haslam’s effort to extend Medicaid coverage to an estimated 280,000 lowincome adult men and women under Obamacare.

Still, the GOP plan would reduce long-term federal spending on Medicaid. Health policy experts say that would put financial pressure on states to kick people off the program, slash benefits or do a combination of both.

Tennessee Democrats, meanwhile, are sharply criticizing both Corker, a former Chattanooga mayor, and Alexander.

State Democratic Party Chairwoman Mary Mancini charged both Republicans have “abdicated their responsibility to be acccessible” by refusing to hold public meetings with constituents who face losing health coverage under the Senate GOP plan.

Corker, who is up for re-election in 2018, has also come under fire from announced Democratic U.S. Senate candidate James Mackler, a Nashville attorney and Iraq War veteran. Mackler recently told Twitter followers the “Senate health plan threatens rural healthcare, limits women’s access & drastically cuts Medicaid. Tell Corker ‘no.’”

The senator’s spokeswoman, Micah Johnson, said Corker’s office “has met with Tennesseans and reached out to hundreds of individuals, including patient advocacy groups, hospitals, physicians, insurers, and state health, finance and insurance officials.

“The senator will make a decision based on whether the final version of the legislation, on the whole, is better than what is in place today,” she said.

Alexander spokeswoman Ashton Davies said Alexander “talks with and meets several times a week in his office with constituents to discuss issues including how to repair the damage caused by Obamacare.”

She said his staff also “regularly meets with constituents and hears directly from Tennesseans about their concerns and interests. As chairman of the Senate health committee, he has held roundtables with health sector stakeholders and state insurance commissioners to learn how best to repeal and replace Obamacare.”

Contact Andy Sher at asher@timesfreepress.com or 615-255-0550. Follow him on Twitter at @AndySher1.