Insurers come out swinging against GOP health care bill
WASHINGTON — The health insurance industry, after cautiously watching Republican health care efforts for months, came out forcefully Wednesday against the Senate’s latest bill to repeal the Affordable Care Act, suggesting that its state-by-state block grants could create health care chaos in the short term and a balkanized, uncertain insurance market.
In the face of the industry opposition, Senate Republican leaders nevertheless said that they would push for a showdown vote next week on the legislation, drafted by Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La.
That puts Republican senators in a squeeze, especially those whose states would lose money under a complicated formula in the bill. Generally, it would shift federal funds from states that have been successful in expanding coverage to states where Republican leaders refused to expand Medicaid or encourage enrollment.
Republican senators from Alaska, Arizona, Arkansas, Colorado, Ohio and West Virginia will all have to decide whether to heed the pleas of consumers who like the current health law — or yield to the will of Republican leaders, donors and voters who demand an end to the Affordable Care Act.
That has put the spotlight not only on the three Republicans who killed the repeal drive in July — Lisa Murkowski of Alaska, John McCain of Arizona and Susan Collins of Maine — but also on those who have been reluctantly supportive, such as Shelley Moore Capito of West Virginia, Cory Gardner of Colorado and Rob Portman of Ohio.
Senate Republicans are already under pressure from 11 governors — including five fellow Republicans and a pivotal Alaskan independent — who earlier this week urged the Senate to reject the last-ditch repeal effort.
The two major trade groups for insurers, the Blue Cross Blue Shield Association and America’s Health Insurance Plans, announced their opposition Wednesday to the GrahamCassidy bill. They joined other groups fighting the bill, such as the American Medical Association, the American Hospital Association, AARP and the lobbying arm of the American Cancer Society.
“The bill contains provisions that would allow states to waive key consumer protections, as well as undermine safeguards for those with pre-existing medical conditions,” said Scott P. Serota, the president and chief executive of the Blue Cross Blue Shield Association. “The legislation reduces funding for many states significantly and would increase uncertainty in the marketplace, making coverage more expensive and jeopardizing Americans’ choice of health plans.”
America’s Health Insurance Plans was even more pointed. The legislation could hurt patients by “further destabilizing the individual market” and could potentially allow “governmentcontrolled single-payer health care to grow,” said Marilyn B. Tavenner, the president and chief executive of the association. Without controls, some states could simply eliminate private insurance, she warned.
At this point, Republicans have not secured the 50 votes they would need to pass the bill, with help from Vice President Mike Pence to break a tie. But President Donald Trump, in New York for meetings with world leaders at the United Nations, said he thought the health care bill had “a very good chance” of passing.
It has “tremendous support from Republicans — certainly we’re at 47 or 48 already,” he said, and “a lot of others are looking at it very positively.”
“A great Bill,” Trump concluded in a tweet later Wednesday.
The latest Republican drive to repeal the Affordable Care Act has created painful choices for Republican senators from states that stand to lose money under the legislation.
The bill would eliminate penalties for people who go without insurance and would funnel federal funds to states in the form of block grants for health care or coverage. States could decide how to spend the money, which is now being used for the expansion of Medicaid and for subsidies to help low- and middle-income people buy private insurance.
State officials were racing to try to figure out the impact, looking to experts to help them do the calculations.
“States such as Alaska, Connecticut, Delaware, New Hampshire, New Mexico, New York, Oregon, Vermont and Washington would see reductions of 25 percent or more over the 2020 to 2026 period,” compared with what they would receive under current law, said a monograph issued Wednesday by Manatt Health, a unit of Manatt, Phelps & Phillips, a national law firm that advises many states on health care issues.
Among the Republicans agonizing over how to vote is Murkowski, who has said the bill’s effect on her state will be her paramount consideration.
Becky Hultberg, the president and chief executive of the Alaska State Hospital and Nursing Home Association, said Wednesday that the cuts in the bill could have a “huge impact” on Alaska.