Category: ACA

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STATEMENT: Celebrating the 12th Anniversary of the ACA

  By ACA, Health Care, PA Budget and Policy Center, Statements

Tomorrow, March 23, 2022, is the 12th anniversary of the enactment of the Affordable Care Act. This is a day worth celebrating because of the enormous advances it made in enabling Americans, including almost a million Pennsylvanians, to secure quality, affordable health insurance.   In just twelve years, the ACA has succeeded in cutting the number of uninsured Pennsylvanians in half. The percentage of Pennsylvanians under 65 who are uninsured has declined from 11.9% in 2010 to 6.6% in 2017. The decline has been particularly striking for Black Pennsylvanians between 18 and 64 for whom the percentage of uninsured has declined from 24% in 2010 to 11.4% in 2017 and Hispanic Pennsylvanians, for whom the rate has declined from 32.2% in 2010 to 18% in 2017. The rates at which Pennsylvanians were uninsured increased by a few tenths of a percentage point after 2017 due to Trump administration restrictions on the… Continue reading

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For Many Pennsylvanians, Insurance Premiums Increase Are Greater Than Tax Cuts

  By ACA, Federal Taxes, Health Care, PA Budget and Policy Center, PBPC Blog posts, Taxation

As we have pointed out previously, because it repeals the individual mandate, the Senate tax cut proposal will not only lead to 13 million fewer people having health insurance in the United States, but it will lead to much higher premiums for many who do purchase health insurance on the individual market. The CBO’s estimate was that premiums nationwide would increase by 10%. Last week we presented a very rough estimate of the impact of repeal of the mandate on the average cost of health insurance premiums in Pennsylvania and suggested that the average increase in premiums is likely to be higher than the average savings in taxes under the Senate plan. New research from the Commonwealth Fund provides more detailed information on the increase in premiums for Pennsylvanians at different ages. And their work reinforces our conclusion. In 2019, much of the benefit of the tax cut to middle… Continue reading

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Graham-Cassidy Repeal Bill — Just Plain Bad for Pennsylvania

  By ACA, PA Budget and Policy Center, PBPC Blog posts, US

As I write this, it is possible that the Graham-Cassidy bill to repeal the Affordable Care Act and make major changes to the traditional Medicaid program is already dying or dead. Two Republican members of the Senate, McCain of Arizona and Paul of Kentucky, have said they will vote against it. Senator Collins of Maine has announced that she is leaning against it. I’m hopeful that Senator Murkowski of Alaska will all announce that she is against it.  And when that happens, I expect a substantial group of Senators will join them because this bill is truly dangerous to every state and the only reason it is even being considered is that Senate Republicans fear the short-term political costs of disappointing their base voters and funders more than they fear the long-term costs of doing great harm to their constituents. Once it is clear that there is no path forward… Continue reading

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Don’t Take Skinny Repeal Lightly — The Dangers of the “Just Pass Something” Mentality

  By ACA, Health Care, PA Budget and Policy Center, PBPC Blog posts, Statements

As I write this, the Senate is moving in a somewhat haphazard way to a vote on what has been called a “skinny” repeal of the Affordable Care Act. Not only do we not know exactly what will be included in the skinny repeal, but we, like members of the Senate, are uncertain about the point of passing such a bill. Skinny Repeal as Trojan Horse Most observers of the Senate believe that the goal of enacting a skinny repeal bill is simply to keep the process of repealing, or repealing or replacing, the Affordable Care Act alive. If the Senate acts on some health care bill that is an amendment of the AHCA passed by the House, the next step will be a House-Senate Conference Committee, which would write a final bill that attempts to thread the very narrow needle between more moderate and more conservative Republicans in both… Continue reading

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Senate to Choose Between Health Catastrophe or Something Worse

  By ACA, Health Care, PA Budget and Policy Center, PBPC Blog posts

Mitch McConnell and his Republican allies have one more trick up their sleeves to try to get some health care bill through the Senate. This week they will seek a vote to proceed to debate on the bill passed in the House on the understanding that there will be a process, colloquially known as voterama, in which a series of votes on one or more substitutes to the bill, or amendments, will be introduced. That is, Senators are being asked to proceed to debate without any clear idea what final bill they will eventually vote on. I will say more about the process in a moment. But first I want to urge you to join the Insure PA / Protect Our Care phone bank to ask people in those states with Senators who are unsure about their position to call those Senators and ask them to vote no. (You can… Continue reading

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Statement on the CBO Score of BCRA–We Told You It Couldn’t Be Fixed

  By ACA, Health Care, My Work, PA Budget and Policy Center, Statements

Earlier this week we released a blog post and a long paper called, “It Can’t Be Fixed” that explained why the basic structure of all of the Republican “repeal and replace” necessarily leads to a health care system in which large numbers of Americans and Pennsylvanians lose insurance. The Congressional Budget Office (CBO) evaluation of the last version of the Senates’ Better Care Reconciliation Act (without the Cruz Amendment) released on Thursday confirms our argument once again. The CBO predicts that 22 million people will lose health insurance in the first decade. Our quick analysis of the impact on Pennsylvania shows that over one million will lose insurance in our commonwealth. The basic problem remains that the Republicans are determined to radically reduce federal spending on health care by $1.2 trillion over ten years (and more in the second ten years.). Any bill that aims to reduce spending at this… Continue reading

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It Couldn’t Be Fixed: Policy and Politics in the Republican Health Care Bill

  By ACA, Health Care, PA Budget and Policy Center, PBPC Blog posts

Now that the Senate Republican effort to repeal and replace the Affordable Care Act has failed, let’s take a step back and understand why no bill based on the Republican approach to health care could have been fixed enough to reduce the pain to levels acceptable to a majority of Republicans in Congress, let alone to the American people. The basic design of the bill was deeply flawed from the perspective of anyone who thinks that America has a responsibility to guarantee quality, affordable health care to all. The design only made sense if one, instead, seeks a politically palatable way to reject that responsibility and reduce federal health care spending in order to cut taxes on large corporations and the rich. What started as a bill to repeal the Affordable Care Act (ACA) became a bill to partly repeal the health insurance regulations and subsidies for insurance purchased in… Continue reading

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PRESS MEMO: New Estimates of the Loss of Federal Funding to Pennsylvania from the Senate Health Care Bill

  By ACA, Health Care, Memos, PA Budget and Policy Center, US

The Manatt Health Group and Robert Wood Johnson Foundation have released a study on the impact of the Senate health care bill, the Better Reconciliation Act of 2017, on the states. Their estimates of the impact of the bill confirms our recent study showing that Pennsylvania will suffer devastating reductions in federal funding for Medicaid. It also offers some more fine-grained detail on the nature of these reductions. MEMO To: Editorial Page Editors, Editorial Board Members, Columnists, and Other Interested Parties From: Marc Stier, Director, Pennsylvania Budget and Policy Center Date: July 7, 2017 Re: New Estimates of the Loss of Federal Funding to Pennsylvania from the Senate Health Care Bill The Manatt Health Group and the Robert Wood Johnson Foundation have released a new study of the impact of the Senate health care bill, the Better Care Reconciliation Act of 2017, on the states. Their estimates of the impact of the bill confirms… Continue reading

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Senate Bill Raises Marketplace and Employer-based Premiums for Most Pennsylvanians

  By ACA, Health Care, PA Budget and Policy Center, PBPC Blog posts

We have been focused recently on the impact of the Senate health care bill on Medicaid, mainly because the dangers of both the House and Senate bills to Medicaid have not been well known, and because the Senate bill is far worse than the House bill. So, in this and next post I want to remind you that if you purchase health insurance on the exchanges / marketplaces or receive it from your employer, the Senate bill is bad for you as well. The following table looks at the impact of the Senate bill on the average premiums Pennsylvanians at different ages and income levels will pay for silver plans on the marketplace. For all but 35 year olds at 300% of the poverty, premiums will be higher than under the ACA. For Pennsylvanians who have lower incomes or are older, the premium increases are substantial. For forty-five year olds… Continue reading