Last week, Senate Republican leaders released a “new” version of their health care bill. We wrote before about how the first draft of this bill would make Americans pay more for worse health coverage and how it would undercut the health care safety net. Unfortunately, the new draft does not fix the original Senate bill’s core problems and makes some of them worse.
The Senate bill would drastically cut Oklahoma’s Medicaid program, SoonerCare, reducing federal support an estimated 26 percent by 2026, with larger cuts to come as health care costs grow. Oklahoma would have to make up the difference either by raising taxes or cutting services for the hundreds of thousands of low-income people with disabilities, seniors, and families with children who rely on SoonerCare. These cuts would also threaten thousands of jobs in the state, since health care is Oklahoma’s largest employment sector and 25 percent of those jobs are supported by Medicaid.
The legislation still slashes tax credits and ends cost-sharing assistance for millions of Americans who buy coverage in the individual marketplace. These changes would especially harm older Oklahomans, who would see the third largest premium increases and tax credit loss in the nation. In a new development, the bill’s “Cruz Amendment” would also gut consumer protections put in place by the Affordable Care Act, leaving many of the 31 percent of Oklahomans with pre-existing conditions without access to affordable coverage for those conditions.
“Senator James Lankford said he wants a bill ‘that provides more affordable coverage options for everyone, with the goal in mind of doing no harm to current enrollees.’ This bill clearly does not pass that test.”
This latest draft does nothing to avert the cuts to Medicaid and to marketplace financial assistance. That means the Congressional Budget Office’s estimate that it will cause 22 million Americans to lose health insurance is unlikely to get any better. Within the state, the Urban Institute estimates the Senate bill would cause 134,000 Oklahomans to go uninsured, a 22.2 percent spike in our uninsured rate.
Some Senate Republicans claim they have fixed problems with the bill by providing additional “stability” funds for states. But these funds do not come close to making up for the millions of low-income Americans who would lose Medicaid coverage as a result of the bill or for moderate-income people hurt by the bill’s marketplace subsidy cuts. Even as state and tribal leaders in Oklahoma are filing lawsuits to fight a deadly opioid epidemic, this bill’s coverage losses would hit hardest in the areas struggling most with opioids, and the funds that it provides for addiction treatment are far less than experts estimate we need.
The Senate bill is making these extremely unpopular cuts just to give $400 billion in tax cuts to wealthy individuals, drug companies, insurers, and other big corporations. All of that is why the major groups representing doctors, nurses, seniors, and others who would be most affected by this bill have spoken out in strong opposition — including the American Medical Association, the American Nurses Association, the AARP, and a consortium representing nearly every national disability group in the country.
Now Senate Republicans are trying to rush this bill through with not nearly enough time for the public to fully understand what’s in it or share their concerns. Oklahoma’s U.S. Senators have so far been noncommittal about the bill, with Senator James Lankford saying he wants a bill “that provides more affordable coverage options for everyone, with the goal in mind of doing no harm to current enrollees.” This bill clearly does not pass that test.
Oklahoma’s Senators should reject this and any other bill that causes large coverage losses, cuts SoonerCare, or guts critical protections for people with pre-existing health conditions. They should go back to the drawing board and work on a bipartisan basis with patient advocates, doctors’ groups, and numerous other affected Americans who have been excluded from the GOP’s secretive bill-writing process. Anything less would be breaking their promises to the people of Oklahoma.