The U.S. Senate released its long-awaited Affordable Care Act (ACA) replacement legislation, the Better Care Reconciliation Act, on June 22. Based on WHA’s ongoing review, the bill falls far short of protecting Wisconsin’s core issues of maintaining access to affordable health care coverage, stabilizing the insurance market and safeguarding Wisconsin’s Medicaid program. In fact, in most respects the bill puts Wisconsin in an even worse situation than the bill passed May 4 by the U.S. House of Representatives.
“It is a complex bill and our review is ongoing, but in the 24-plus hours since its release, a pretty clear and troubling picture is emerging, especially for non-Medicaid expansion states, and particularly Wisconsin,” according to WHA President/CEO Eric Borgerding. “There is a lot at stake for Wisconsin in this bill, not the least of which is billions in lost federal Medicaid funding by perpetuating inequities among states.”
In an interview
with reporter David Wahlberg of the Wisconsin State Journal
June 23, Borgerding said $2.6 billion in Medicare cuts over 10 years to Wisconsin hospitals would remain in both bills. “Everywhere we turn, we’re being penalized in the legislation,” he said.
The Senate made deeper cuts to the Medicaid program than the House bill in part by tying future increases beyond 2025 to the CPI for all urban consumers as opposed to the medical CPI. With respect to tax credits to help consumers buy coverage, the Senate ties them to age, income and geography. The House version would provide a fixed amount based on age only, leading to many concerns about affordability for lower income individuals compared to the ACA. However, the Senate eliminates tax credits for people with income between 350 and 400 percent of the federal poverty level (FPL). It eliminates the requirement that everyone must purchase health insurance, and cost-sharing subsidies would end after 2019.
In a press statement
Borgerding commended Sen. Ron Johnson for taking a circumspect approach, including “advocating for market stabilization first, while wanting time to understand the broader ramifications of the bill through his stated desire to obtain constituents’ reaction and input.”
WHA has been working closely with Johnson, meeting with him in Washington, D.C. and communicating WHA’s position on and voicing concerns with potential repeal and replace legislation. Johnson and three other conservative senators released a statement and expressed their opposition to the bill, but openness to talks.
WHA will continue to advocate to both U.S. Sens. Ron Johnson and Tammy Baldwin that improvements to the Better Care Reconciliation Act are needed. In particular, WHA and our members continue to be concerned with ensuring affordable coverage for low-income and high-risk populations.
WHA staff is currently working on a summary for members of the provisions of the Better Care Reconciliation Act and their potential impact in Wisconsin.