While Republicans have postponed a vote on the repeal of the Affordable Care Act (ACA), I opposed this bill from the very beginning because it would rip insurance away from millions of Americans, it would force people to pay more for less coverage and it would fail to protect up to 129 million individuals with pre-existing conditions, all while giving huge tax breaks to wealthy Americans and special interests. Here are just a few reasons why I was planning to vote no:
- Rips coverage away from millions of Americans. The Congressional Budget Office (CBO) has estimated that 24 million Americans would lose their health insurance over the next decade under this bill.
- People will pay more for less. The average subsidy under the Republican plan would be about 50 percent less than it was under the ACA and deductibles and copays would increase by approximately 25 percent with moderate-income individuals paying $2,500 more per year.
- Older Americans will be hurt. Premiums for individuals age 50 and older would go up by 20-25 percent. Increased premiums combined with lower tax credits means that a 64 year old who paid $1,700 in premiums under ACA would pay $14,600 under the GOP plan. CBO concludes that by 2026, the uninsured rate for those age 50-64 earning less than $30,000 per year would more than double, from 12 percent to 30 percent.
- Medicaid will be dismantled. The bill would cut $880 billion from Medicaid by ending the Medicaid expansion and imposing a per-capita cap or block grant. This guts the financing structure of the Medicaid program by limiting payments to states and would inevitably result in cutting the number of people who are eligible for the program, reducing benefits or decreasing payments to providers. 14 million fewer people would be covered by Medicaid – a 17 percent drop – and most of those individuals would likely end up uninsured. This would also disproportionately impact individuals with disabilities and the elderly who rely on Medicaid for long-term care coverage.
- Fails to protect people with pre-existing conditions. These protections only apply for those who maintain continuous coverage. If an individual has a lapse in coverage – maybe because you lost your job, or fell on hard times – insurance companies would be able to charge a 30 percent surcharge on your premiums for an entire year.
- Eliminates coverage for treatment of mental illness and substance use disorders. Removing essential health benefits from the Medicaid expansion population and the health insurance exchanges would strip addiction and mental health treatment services away from millions of people, including many who are receiving treatment for opioid addiction.
- Employer coverage will decrease and get more expensive. Because the employer and individual mandates are repealed, 7 million fewer people would get employer-sponsored coverage by 2026. That may result in higher premiums for those who keep their employer-sponsored insurance if young, healthy people opt out.
In Maryland, over 400,000 individuals have gained insurance coverage since the ACA became law. Repeal of the ACA would put these individuals and families at risk of losing that insurance. Our state’s economy would also suffer if the ACA is repealed with the loss of critical federal funding and thousands of jobs. Eliminating the Medicaid expansion would strip billions of dollars in Federal Medicaid Assistance Percentage (FMAP) funds from Maryland and would affect the state’s ability to provide comprehensive, affordable health coverage for millions of otherwise uninsured low-income Marylanders and would also weaken the state’s ability to address public health emergencies and other crises that require quick and immediate action.
House Republicans rushed their repeal bill to the floor, despite the fact that they haven’t held a single legislative hearing in any committee and not a single expert witness has been able to testify about the potential impact of their plan. They kept the text of the bill secret for weeks – literally hiding it under lock and key, guarded by the Capitol police – releasing it for review less than 48 hours before it was to be voted out of committee. This was done so quickly that the nonpartisan Congressional Budget Office didn’t have time to analyze the bill and issue a report prior to the markup that estimated the cost and impact on coverage.
By contrast, in 2009 when Democrats were developing the Affordable Care Act, the process was open and transparent and lasted almost an entire year. In the House, we held 79 bipartisan hearings and markups and heard from 181 witnesses from both sides of the aisle. During the markup, we considered 239 Democratic and Republican amendments and accepted 121 amendments, 30 of which were introduced by Republicans. The original House bill was posted online for 30 days before the first committee began their markup and more than 100 days before we introduced a merged bill that incorporated the work of three different committees.
All told, it was 116 days from the time House Democrats introduced our version of the health care bill until it was passed. Republicans scheduled a vote on their bill just 18 days after it was made available to the public. It is abundantly clear that the Republicans were trying to rush this bill through before anyone fully understood what it would mean for the American people and the American health care system.
But I understand what it would mean – and I fought against it. I am proud to serve on the Health Subcommittee of the Energy & Commerce Committee, one of the two House committees with jurisdiction over this bill. After Republicans announced that we would markup this legislation, my Democratic colleagues and I debated the bill for 27 hours straight, arguing that the GOP repeal plan would result in the loss of health insurance coverage for millions of Americans. Moving forward, I will continue to push to make sure that Americans have affordable, accessible, high-quality health care for themselves and their families.