The Congressional Budget Office’s report on the Senate’s health-care bill made clear that its nationwide impact would be similar to that of the House-passed American Health Care Act. Now, with a multitude of state-level analyses available, it’s clearer than ever that the Senate’s Better Care Reconciliation Act would not, in fact, result in “better care” in Louisiana. Instead, it would cause a 120 percent increase in the number of Louisiana residents without insurance, a 105 percent increase in premiums for Louisiana consumers, deductibles up to $6,000, and the return of lifetime and annual limits on coverage.
Senators are reportedly negotiating changes to their health care bill. But none of the proposed changes address the core features of the bill: deep cuts to Medicaid that get worse over time, massive declines in coverage, and higher out-of-pocket costs for older and less-healthy consumers.
New data from the Urban Institute estimates that 410,000 fewer Louisianans would have health insurance under the Senate bill by 2022 compared to under current law. Forty-three thousand people would lose private insurance they bought on the individual marketplace and 384,000 fewer would be enrolled in Medicaid or CHIP. Of those who would lose coverage in the state, 1 in 7 are children.
The Senate bill would also result in Louisiana losing $14.2 billion in federal funding for Medicaid by 2026. The largest funding reduction would come from elimination of the Medicaid expansion, but the per-capita caps would also reduce federal funding for the traditional Medicaid population by $2.1 billion. If the state chose not to raise taxes or cut other areas of spending, it would be forced to reduce and eliminate optional Medicaid services such as home-care services and hospice care and eventually reduce eligibility.
If the state applied the $2.1 billion cut evenly across all traditional enrollee categories, it would result in nearly $1 billion less in Medicaid funding for people with disabilities. The state would also have to cut $400 million from Medicaid services for each of the other enrollment groups: children, the elderly, and low-income parents.
The per-capita cap’s squeeze on the state’s Medicaid program would become tighter each year as the capped funding amount would fall increasingly short of the cost of maintaining the same level of Medicaid services. As a result, it would become more and more difficult for future governors and legislatures to craft a balanced budget without inflicting deep pain on children, the elderly, and people with disabilities who rely on Medicaid. The budgetary pressure would also strain state resources for other important priorities like higher education.
Finally, the Senate health-care bill would eliminate 22,200 jobs in Louisiana by 2026, including 13,700 in the health-care sector, according to new research from The Commonwealth Fund. The loss of jobs and business output would add insult to injury to the state budget by decreasing income and sales tax collections each year.
In short, the Senate health-care bill, in its first iteration and with the changes under consideration, would create serious hardships for Louisiana’s residents and the state at a time when the legislature is already struggling to fund existing programs and services. Additionally, the Senate bill does nothing to address existing problems in the health-care system and actually makes some of them worse.