Senate Republicans have finally release the Obamacare repeal bill they've been working on in secret (the Orwellian “Better Care Reconciliation Act of 2017") and it's worse than anyone predicted.
The Senate GOP bill actually cuts Medicaid deeper than the House Republican bill by cutting expansion and the base program,
The ACA’s Medicaid expansion would still be wind-down, as in the House bill, but in a more gradual process. The so-called transition phase would be longer under the Senate version, starting in 2021, with the federal match rate for the expansion population reducing overtime until 2024.
To appease conservatives wary of the longer period of expansion funding, the Senate bill introduces steeper cuts to the traditional Medicaid program. Like the House bill, the GOP Senate bill would transform the program from its current unlimited match rate into a system where states would be given a limited amount of money per enrollee in their program each year. The caps, starting in 2020, would rise at an inflation rate known as “consumer price index-medical” or CPI-M, which is slower than traditional Medicaid spending, meaning that over time the government spending on Medicaid would not keep with up with health care costs. However, starting in 2025, that inflation metric would switch to the consume pricer index-urban consumers — an even slower rate than the House bill, which stuck to CPI-M — meaning that the cuts would be further compounded in the long term.
Like the House bill, the Senate bill also repeals Obamacare's essential health benefits, meaning insurers would no longer be required to cover pregnancy or mental health or ambulance services, among many other things.
And speaking of pregnancy, here's a gobsmacking detail:
There it is. People who can remain eligible to enroll for any remaining Medicaid expansion benefits.
Sorry, ladies. pic.twitter.com/m51OvzpTxr
— Nish Weiseth (@NishWeiseth) June 22, 2017
That's right, women who are pregnant will be banned from what remains of Medicaid expansion until the program is shut down entirely. The Senate GOP's bill also defunds Planned Parenthood.
There are many other terrible details we'll discuss going forward.
You can read the bill here: