Spotlight Exclusives

Senate Republican Healthcare Plan Met with Dismay from Poverty Advocates, Lawmakers

Spotlight Staff Spotlight Staff, posted on

The release of the Senate Republicans’ healthcare legislation on Thursday was met with bipartisan concern about the draft bill’s potential impact on low-income families’ access to quality healthcare, particularly through Medicaid.

By 2024, the bill would phase out additional funding provided by the Affordable Care Act to states that have expanded Medicaid coverage. Beginning in 2020, the proposal would limit the amount of Medicaid funding states receive, rather than increase funding as needed to cover eligible patients and procedures.

The Senate bill would also reduce subsidies currently provided to help people without workplace coverage get private health insurance.

The Senate proposal comes on the heels of legislation passed by the House of Representatives. On Medicaid, the Senate version reduces funding more gradually but makes steeper long-term cuts. Center on Budget and Policy Priorities senior advisor Jacob Leibenluft warned against the hope that because Medicaid cuts are further delayed, they might be reversed. “Once Congress both changes Medicaid’s basic structure and enacts large annual savings, those cuts are highly unlikely to be reversed. In fact, those structural changes would create a political dynamic that could lead to even larger cuts in the future,” he wrote.

Democrats in Congress and leaders of progressive think tanks decried the bill as even harsher than the House legislation. “The Senate version of the American Health Care Act is a moral abomination and, in critical ways, is even more cruel than the House version,” said Neera Tanden, president of the Center for American Progress. “After telling us they would start from scratch and write their own bill, Senate Republicans stuck to the House formula: massive cuts to health care for the poor and sick to pay for massive tax cuts for the rich.”

“We live in the wealthiest country on Earth; surely we can do better than what the Republican healthcare bill promises,” Senate Minority Leader Chuck Schumer (D-NY) said on Twitter.

“In some ways, it’s more evil” than the House bill, Sen. Chris Murphy (D-CT) told MSNBC. “In some ways it’s even dumber than the House proposal.”

A handful of GOP senators, including Rob Portman (R-OH), Shelley Capito (R-WV), and Dean Heller (R-NV), reserved judgment on the proposal because of the Medicaid impact. Heller said he has “serious concerns about the bill’s impact on the Nevadans who depend on Medicaid,” and wanted to get the view of Nevada Gov. Brian Sandoval.

Supporters of the bill pointed to changes in subsidies as a potential boost to coverage for low-income families. The ACA’s premium subsidies, or tax credits, which are available to people between the poverty level and four times that threshold, would be continued for two years. Eligibility would then be scaled back to 350 percent of the federal poverty level but extended to more low-income people who don’t qualify for Medicaid.

Other Republican members, including Sen. Rand Paul (R-KY), Sen. Ted Cruz (R-TX), Sen. Mike Lee (R-OK) and Sen. Ron Johnson (R-WI), and several conservative analysts complained that the Senate bill doesn’t go far enough in dismantling the ACA.

“It is clear that significant portions of the Republican Party have no intention of actually repealing Obamacare despite campaigning on that objective for years,” Heritage Action CEO Michael A. Needham said.


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