Durbin: Republican Health Care Repeal Bill Fatally Flawed

CHICAGO – U.S. Senator Dick Durbin (D-IL) said today the new version of the Senate Republican health care repeal bill will still force millions of Americans to lose their health insurance, increase costs, and put critical health care services beyond the reach of hard-working American families—all to give wealthy corporations, including insurance and drug companies, a tax break. 

“Senate Republicans unveiled their most recent bill to repeal the Affordable Care Act last week and it’s just as bad as the last version, if not worse,” Durbin said. “It is past time for Republicans to give up their partisan approach to health care and work with their Democratic colleagues to improve the health care system for all Americans. No matter where I hold a health care event around the state—Bloomington, Carbondale, Taylorville, Nashville, Jerseyville, Downers Grove, Chicago and elsewhere—the message from Illinoisans has been the same: don’t repeal the Affordable Care Act, strengthen it.” 

The non-partisan Congressional Budget Office (CBO), analyzed the first version of the Senate Republican health care repeal bill and determined it would cause 22 million people to lose their health coverage by 2026, including one million Illinoisans. The CBO score of the new bill is expected to be released early this week.

Here are some of the major changes included in the new version of the Republican repeal bill: 

  • Availability of “Sham Plans”:  The bill would allow insurers to sell “sham” or “junk” plans would not have to cover essential health benefits and could charge those with pre-existing conditions more, so long as they also offer an ACA-compliant plan in that state. Under the Republican bill, if a person with a “sham plan” gets diagnosed with a disease or condition that their plan does not cover, that person would have to wait six months to enroll in an insurance plan that actually covers the care they need.
  • Opioid Funding:  The bill includes $45 billion over 10 years in funding for substance abuse treatment—a figure experts say is a fraction of the needed funding in the face of the current epidemic. Even worse, 2.8 million people with a substance use disorder would be among the 22 million people kicked off their health insurance by the underlying bill.
  • Medicaid Expansion:  The updated bill purports to allow states to keep the Medicaid expansion by allowing the expansion population to be factored in to a state’s “block grant” calculation. However, given the huge cuts to Medicaid, the effect is no different—states would be forced to end their expansion coverage, with Illinois’ expansion to 650,000 individuals, slated to end in 2021. 
  • Tax Provisions:  Given public backlash over massive tax cuts for the wealthy in the original bill, Senate Republicans opted not to include two significant tax cuts for the wealthy in their updated repeal bill. However, the Republican repeal bill still includes hundreds of billions in tax giveaways for pharmaceutical companies and insurance companies.

While work on the Affordable Care Act featured more than 50 hearings, more than 150 Republican amendments and more than a month of committee “markups” to arrive at the final legislation, the Senate Republican leadership has written both versions of their health care repeal bill in secret, without input from outside experts or Democrats, and have tried to rush votes on each one.

The Republican Senate health care repeal bill would end the Medicaid expansion, hurting 650,000 Illinoisans who gained insurance as a result of the Medicaid expansion.  Illinois would lose more than $40 billion in Medicaid funding over a decade.  Those cuts will impose huge new financial burdens on Illinois’ hospitals especially rural and critical access hospitals. The Illinois Hospital Association predicts 60,000 jobs will be lost as a result of the cuts. 

In addition, Illinois schools currently receive about $144 million in Medicaid funding each year to provide vision and dental screenings to lower-income children and to provide services for students with disabilities. Last year, Illinois schools used this funding to help provide services for many of the 280,000 Illinois children with disabilities and health care screenings for many of the 1.5 million lower-income Illinois kids with Medicaid.

Both the House and Senate Republican bills allow states to obtain waivers from the “essential health benefits” requirement—allowing insurers to waive any of the 10 currently required benefits (including mental health and substance abuse treatment, maternity/newborn care, hospitalizations, prescription drugs,) and could allow employer plans to once again impose annual or lifetime limits. This would be especially problematic for people with pre-existing conditions, since care they need may no longer be covered.

Both Republican bills also impose an age tax on people over the age of 50, allowing them to be charged five times more than younger people, a large increase over the current 3:1 ratio. The Senate bill also eliminates the Prevention and Public Health Fund, which would cut $9 billion from the CDC’s budget over the next decade and potentially hamper the response to deadly disease outbreaks.

The list of medical and patient advocacy groups voicing their opposition to the Senate Republican health care repeal bill is growing by the hour. To date, the following organizations have come out in opposition to the Senate Republican repeal bill: the Illinois Health and Hospital Association, American Medical Association, American Academy of Pediatrics, American Nurses Association, AARP, American Cancer Society, American Diabetes Association, American Lung Association, American Psychiatric Association, SEIU and Trust for America’s Health.

In addition, Blue Cross Blue Shield and America’s Health Insurance Plans said the Senate Republican bill, which includes the “sham” or “junk” plans, is “simply unworkable in any form and would undermine protections for those with pre-existing medical conditions, increase premiums and lead to widespread terminations of coverage for people currently enrolled in the individual market.”