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Senate health care bill 'unacceptable,' bishop says after budget office report

U.S. Capitol, Senate side, public domain.

The Senate's health care bill remains "unacceptable," one U.S. bishop insisted after a non-partisan government office estimated it would result in millions more uninsured.

"This moment cannot pass without comment," said Bishop Frank Dewane, chair of the U.S. bishops' domestic justice and human development committee, in response to the scoring of the draft Senate health care bill by the Congressional Budget Office on Monday.  

"As the USCCB has consistently said, the loss of affordable access for millions of people is simply unacceptable," he said of the office's estimate that the number of uninsured could increase by 22 million by 2026. "These are real families who need and deserve health care."  

The Congressional Budget Office released its scoring of the Senate health care bill on Monday, H.R. 1628, the Better Care Reconciliation Act of 2017.

The bill eliminates the individual and employer mandates of the Affordable Care Act, replacing the individual mandate with a six-month waiting period for new insurance in non-group plans if one goes without insurance for more than 63 days.

Also, the bill makes it easier for states to waive essential health benefits, or the list of benefits like emergency services and maternity care that was mandatory in health plans under the Affordable Care Act. The elderly can be charged up to five times more than younger persons in their premiums by insurers, as opposed to the limit being three times more than younger people.

The bill could reduce the federal deficit by over $320 billion over 10 years, according to the CBO, largely because of cuts to the rate of increased spending on Medicaid over that time (almost $800 billion in cuts) and cuts in the amount of federal subsidies for health plans.

The Medicaid cuts would take place through "per capita" caps on federal Medicaid funding of states. Thus, the funding in the future would be dependent upon the populations of the states.

An estimated 22 million more people would also be uninsured by 2026, increasing the projected number of uninsured from 28 million to 49 million.

Some of those uninsured would be persons who voluntarily forego having health insurance because of the removal of the individual mandate, which levies heavy fines on those without health insurance.

Instead, the new bill would fine persons with a gap in coverage once they sign up for insurance again, at a rate of 30 percent of their new premium.

In the short-term, this would be the "primary" reason behind the increase in the number of uninsured, the CBO said. However, after several years, other policies could increase the number of uninsured, like the cuts to Medicaid spending and federal subsidies.

For instance, for persons under the age of 65 by the year 2026, Medicaid enrollment would be down 16 percent, the office estimated.

The White House panned the CBO estimates in a statement released on Monday evening.

"The CBO has consistently proven it cannot accurately predict how healthcare legislation will impact insurance coverage," the White House stated. "In 2013, the CBO estimated that 24 million people would have coverage under Obamacare by 2016.  It was off by an astounding 13 million people – more than half – as less than 11 million were actually covered."

"To date, we have seen average individual market premiums more than double and insurers across the country opting out of healthcare exchanges," the White House continued, urging action to be taken to reform health care.

Bishop Dewane, meanwhile, promised to pray for the Senate "to keep the good aspects of current health care proposals, to add missing elements where needed, and to not place our sisters and brothers who struggle every day into so great a peril on so basic a right."

Last week, the bishop had outlined his serious concerns with the draft legislation. The bill, he said, in some ways made the problems with the House health care bill on health coverage for low-income persons worse.

"It is precisely the detrimental impact on the poor and vulnerable that makes the Senate draft unacceptable as written," he said on Thursday. The cuts to Medicaid funding in particular would "wreak havoc on low-income families and struggling communities, and must not be supported," he insisted.

Bishop Dewane also noted the lack of language protecting "conscience rights" of those in the health care industry from mandates that they perform morally objectionable procedures like abortions or gender-transition surgeries.

He did praise the language protecting tax credits from being used to pay for abortions, but showed caution in warning that the language could very well be removed by the chamber's parliamentarian because it could be ruled as not pertaining to the budget.

Other parts of the health care bill that the CBO scored included changes to premiums for persons in non-group plans.  

The average premiums for these plans would increase in the short-term, the CBO estimated, but by 2020 would drop to 30 percent lower than the premium estimates under the current health care law.

However, some could still see their health care costs rise because their benefits might be cut and their out-of-pocket health costs could be higher, especially those living in states which choose to waive the essential health benefits.

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The marketplaces for non-group health insurance would still be stable in the coming years, the CBO estimated, but in certain areas for "a small fraction of the population," insurers might not participate in non-group coverage.

This would be because fewer people would sign up for health plans due to fewer available subsidies, or even if the insurers participate in marketplaces, the plans themselves might be more expensive.

When asked on Monday if the White House would take CBO scores into account to the extent that they would go "back to the drawing board" on the bill if necessary, press secretary Sean Spicer answered that the White House would continue its current plan on health care reform.

"We feel very confident with where the bill is," he stated. "And he [President Donald Trump] is going to continue to listen to senators who have ideas about how to strengthen it. But it's going to follow the same plan as we have."

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