U.S. Sen. Bill Cassidy said this week that he might be able to support the Republican health care legislation that appears to be emerging in the Senate. Details on the plan are scarce, but from what is known so far, the Senate plan does not appear to meet Cassidy’s own criteria for reform:
1. Sen. Cassidy says that “coverage matters.” But the Senate bill would effectively end Medicaid expansion in the state by dramatically reducing federal funding and ending the favorable match rate for the expansion population. This change would eliminate coverage for the 426,000 Louisiana residents who have gained coverage under the expansion. Leaving those individuals without health insurance means they will lose access to primary care and instead seek care in emergency rooms and hospitals, which will drive up uncompensated care costs. As Sen. Cassidy wrote in an op-ed, it is a myth “that cutting federal support for coverage saves society money.”
2. Sen. Cassidy says he will only support legislation that meets the “Kimmel test,” which he recently defined as, “someone you love has adequate coverage for the care he or she needs when they need it.” But the Senate plan reportedly would allow states to waive the federal essential health benefits (EHB) in the individual insurance market. This means Louisianans who have pre-existing medical conditions would not be guaranteed coverage for the services they need.
3. Protecting people with medical conditions isn’t only about requiring insurers to offer them a plan. That coverage must also be affordable, cover necessary care and ensure that families are protected from high out-of-pocket costs if they get sick. The AHCA does not achieve that. For example, the substantially reduced premium tax credits in the House bill would leave some low-income Louisiana residents aged 50-64 with net premiums that would consume half of their monthly income.
4. Allowing states to waive the essential health benefits would take coverage backwards, to a time when policies lacked or severely limited certain benefits. For example, in 2011, among people in the individual market:
o 62 percent had plans that didn’t cover maternity care;
o 34 percent had plans that didn’t cover substance use treatment;
o 18 percent had plans that didn’t cover mental health; and
o 9 percent had plans that didn’t cover prescription drugs
Much more detail is needed about the Senate plan before anyone – including Senator Cassidy – can determine whether it sufficiently protects Louisianans with medical conditions and meets his stated goals. We urge him to wait until he and the people of Louisiana have had a chance to review the Senate’s health care bill in full, before deciding whether to support it.