After the Senate’s recommendation for repeal-and-replace of the Affordable Care Act (ACA) failed due to lack of support, Majority Leader Mitch McConnell is now suggesting a repeal-and-delay strategy that, if passed, is predicted will leave 32 million individuals without health coverage by 2026, and 17 million without coverage by next year. That’s 1 million more than were predicted to be without coverage under the initial repeal-and-replace tactic.
In anticipation of this new recommendation, President Donald Trump has urged Senators to delay their August recess further in order to send him a bill.
Several Republicans Senators have already spoken out against repeal-and-delay, stating that they will not vote for the bill, including Senator Susan Collins of Maine (who voted against the same bill in 2015), Lisa Murkowski of Alaska and Shelley Moore Capito of West Virginia. Their concerns regarding the bill lie in an unsure future for healthcare coverage, with no guarantee for what the delayed replacement will mean for the individual market.
The repeal-and-delay bill would, however, cut less out of Medicaid than the initial repeal-and-replace bill. The new bill would still end the enhanced match for Medicaid expansion but it would not change funds available for the children, disabled adults, parents of young children and elderly people covered under the program.
If no replacement for ACA is determined, the Congressional Budget Office estimates that premiums will increase by 50% by 2020, and double by 2026.
If the new bill is passed, it’s predicted that:
- About 10 million fewer people will be in the individual markets by next year due to lack of wanting to buy insurance and no mandate to require them to
- By next year, 10% of the population will live in counties without an insurer willing to sell individual policies
- Individual plans will not be available to half of the U.S. population by 2020
- 75% of the U.S. population won’t be able to find a willing seller by 2026, because premiums will be so costly as to be unprofitable, especially with no help to pay premiums. In this scenario, only the sickest individuals would find it beneficial to purchase a policy.
- Hospitals will receive $21 billion back over a 10-year period through the disproportionate share program
- $1.5 billion will be used in the next two fiscal years to fund state grants for substance abuse and mental health needs
- In the current fiscal year, $422 million will be added to the federally qualified health care spending budget
The repeal-and-delay bill designates two years for Senators to determine a replacement.