CALL TO ACTION: Senate to Vote on Graham-Cassidy Bill Next Week

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Senate Republicans plan to try to repeal ObamaCare for a second time next week as Republicans face an end-of-the-month deadline. This bill will not receive a full CBO score, and will not have enough time to hold public hearings, much less to debate and amend it thoroughly.

CALL NOW: 202-224-3121

We need everyone to call Capitol Hill now to defeat the Graham-Cassidy Bill. This bill would be devastating to the country and to Maryland. Today, one in five Marylanders are covered by Medicaid and the Children's Health Insurance Program. This bill could end coverage for 294,000 newly eligible Marylanders through the ACA and ultimately destroy the largest provider of health insurance in our nation.

Here are some tools and resources:

HHS slashes funding to groups helping ACA consumers enroll by up to 92%

"Navigator groups perform a range of services during the ACA’s annual enrollment season and throughout the year. They help individuals learn which health plans offered on state and federal insurance exchanges would best suit them, walk consumers through the sign-up process and conduct general outreach to communities about how to obtain coverage under the law. The program’s supporters argue that it is particularly critical during the upcoming six-week enrollment period, which is half as long as last year and comes after Republicans’ high-profile attempt to repeal the 2010 health-care law."

Ironically, and perhaps unintentionally, these cuts will hit red states the hardest. The move last month to cut 90% of funds to spur signups for is likely to lead to fewer young and healthy people in the insurance pool — and thus higher costs in states with majority Trump voters, according to experts. 39 states rely on the federal government and federal insurance exchange in some form; 90% of those are Republican majority states.

The funding cuts, along with the reduced enrollment period, led the CBO to issue its first full update on anticipated government spending on the subsidized individual health insurance program since March 2016.  The CBO now predicts that enrollment on the ACA health insurance exchanges in 2018 and later years is expected to be less than previously forecast. You can read the CBO report here.

Hot topics: Single-payer; ACA repeal (again); and CHIP

Single Payer:  Vermont Senator Bernie Sanders (I) was met with cheers when he announced his single-payer bill today with the backing of 16 Senate Democrats.  Get the details here and learn more about the proposals to finance it. 

ACA Repeal Again: At the same time, Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) were launching a last ditch effort to repeal and replace the ACA before the budget reconciliation deadline of September 30. Under their proposal some 15 million Americans would lose their insurance next year and more than 30 million would do so within a decade (based on analyses of an early version of the bill, which was similar to previous Republican health bills). The Center on Budget Policies and Priorities found that the Cassidy-Graham bill would decimate Medicaid and cause an imbalance of funding among the states. David Leonhardt of the New York Times reports on other perspectives. 

Realistically, neither of these bills is likely to pass in the current Congressional environment. But there are other, incremental options, for single payer efforts that might, as Ron Pollack lays out in a recent Hill article. These include:

  • Expanding Medicaid in the 19 states that haven't done so already
  • Fix the "family glitch" to allow households to purchase plans on the exchange outside their employer
  • Provide coverage for immigrants
  • Reauthorize CHIP

CHIP: Senate Finance Committee leaders announced bipartisan support for a 5-year extension of the CHIP program on Monday evening. The bill markup should come next week and a vote before the September 30 deadline. Stay tuned.

New Census Data: Number of Uninsured Dropped by 1 Million in 2016, with Young Adults Continuing to Make Large Gains - The Commonwealth Fund

"The number of uninsured Americans under age 65 declined by an additional 1 million people in 2016, three years after the major insurance reforms of the Affordable Care Act (ACA) took effect, according to a new federal survey of 94,000 people released by the U.S. Census Bureau today (Exhibit 1). Using data from the Current Population Survey (CPS), Census reported that 10.1 percent of the U.S population under age 65, or 27.5 million people, were uninsured in 2016, down from 15.3 percent in 2013 (Exhibit 2)."

More at the link.

Putting Children's Health at Risk in Maryland

142,327 children in Maryland were covered by the Children’s Health Insurance Program (CHIP) in 2015. Their access to care is now threatened because the required federal funds to support the program have not been authorized by Congress. Without action, it is predicted that Maryland will exhaust needed funds in April 2018. 

It is more complicated than that, though. Because of the way the program is set up, Maryland must continue to fund the program through 2019 even without the federal dollars. This means that Maryland will face difficult budget choices in order for the Medicaid program to remain solvent, which could result in other vital programs being subject to drastic cuts.

Tricia Brooks, Senior Fellow at the Georgetown Center for Children and Families provides a useful perspective on the complexity of the issues.  CHIP must be reauthorized by the end of September - Congress must act now!

The following is a select list of resources.  It includes a breakdown of the numbers of children covered by Congressional and school district, race and ethnicity, and County.

At This Rate...

The Maryland Insurance Administration (MIA) published the approved rates for healthcare insurers in MD yesterday. CareFirst, the state's largest insurer for next year's individual market, sought an average rate increase of about 50.4 percent for its HMO plans, and regulators will allow just under 34.5 percent. The carrier requested an average rate increase of about 58.8 percent for its PPO plans, and regulators approved about 49.9 percent.

For Kaiser, insurance regulators plan to allow the insurer to raise rates an average of just over 22.6 percent, slightly less than the requested 23.4 percent.

Consumer Health First expressed deep concern about the effects of such a high rate increase on Marylanders and the stability of the state's insurance marketplace. From an article in today's Baltimore Sun:

“The state’s decision will have devastating consequences for consumers and the long-term sustainability of the individual market,” said Leni Preston, president of Consumer Health First. “We believe these rate increases are also inconsistent with CareFirst’s statutorily mandated mission to provide affordable and accessible health insurance to its members.”

Data shows that between 2014 and 2016, CareFirst's premiums on a per-member monthly basis increased 30 percent while its claims increased 16 percent and its expenses increased 24.2 percent. 

Experts say that if premiums are now covering claims, as this data suggests, enormous premium increases are not justified at this time. Insurers like CareFirst can still make a profit with smaller premium increases and by finding administrative efficiencies.

“We would urge Governor Hogan and our elected officials to continue to look for further steps to stabilize the individual market, such as a state reinsurance program, and to require the commissioner to expressly consider CareFirst’s statutory mission when reviewing rate filings in the future,” said Beth Sammis, former acting commissioner of the insurance administration and a Consumer Health First board member."

Consumer Health First issued a more detailed Press Release and further comments on these rates, and it can be read in its entirety here.