Category Archives: Health Policy

AHCA Medicaid Cuts Would Hit Rural Areas Hardest

According to an analysis conducted by the Georgetown University Center for Children and Families, the Affordable Care Act’s (ACA) Medicaid expansion disproportionately benefited rural Americans over their urban counterparts.  The American Health Care Act’s (AHCA) proposed cuts to Medicaid, rolling it back to below funding levels established by the ACA, would negatively affect millions of kids and adults.

Rural and small town voters–those  often credited with Trump’s 2016 election victory, could stand to lose the most if the president’s health-care overhaul is signed into law. Both nationally and in Colorado, the report found, higher percentages of people in small towns and rural communities are covered by Medicaid than in cities.

Medicaid plays a larger role in providing health coverage to families living in small towns and rural communities than it does in metropolitan areas, a trend that is particularly striking among children. About 45 percent of children in small towns and rural areas rely on Medicaid for their coverage, compared to 38 percent in metro areas. In 14 states, more than half of the children outside of metro areas receive health benefits from Medicaid and the Children’s Health Insurance Program (CHIP). County level urban and rural Medicaid coverage across the US are available on this map: https://ccf.georgetown.edu/map/the-percent-of-children-in-small-towns-and-rural-areas-covered-by-medicaid-201415/

in Colorado, rural area Medicaid coverage grew 11% with the ACA. 42% of rural kids in CO are covered by #Medicaid.

Impact of AHCA Medicaid Cap on Children

A recent analysis by Avalere projected the impact of federal Medicaid cap proposals on overall and state-by- state federal spending on children currently in Medicaid. The report estimated that the House-passed #AHCA would cut Medicaid for kids by $43 billion by 2026. In Colorado, these cuts would amount to $571 million.

While this study focused exclusively on non-disabled children, the high costs associated with disabled children in Medicaid would likely make the total impact of the AHCA on kids significantly greater.

http://buff.ly/2rXcEW0IMG_7128

Fact Check: the Colorado Case for Repeal of the Affordable Care Act (and replacement with the Affordable Health Care Act) is a False Narrative

The Affordable Health Care Act (AHCA or “Trumpcare”) will cut 24 million from insurance by 2026 including 410,600 from Colorado (use this interactive feature to see how many will be impacted in your state).  Colorado’s own Senator Cory Gardner has expressed his reservations about the 14 million projected to lose Medicaid, describing Medicaid as providing “access to life-saving health care services” for the 1.3 million Coloradans—and 72 million Americans—who get their insurance through Medicaid, including the Medicaid expansion part of the Affordable Care Act (ACA). Given the ominous projections about the AHCA’s impact compared to staying with the ACA, how did Republican legislators end up with such a destructive bill after 8 years of decrying the disastrous results of the ACA? The unfortunate reality of what the ACA-to-AHCA transition would mean highlights the accomplishments of the ACA as it is on the verge of elimination: it has improved healthcare access and outcomes for millions of Americans.

The mythology on which the Republican members of congress have based their anti-ACA rhetoric is exemplified by the talking points used by our Colorado legislators. Senator Gardner has reiterated his anti-ACA talking points in his two recent tele-town halls.   As he has before, Senator Gardner gave three arguments for why the ACA must be repealed:

  • Health insurance premiums in Colorado are rising because of the ACA
  • Coloradans lost their health insurance because of the ACA
  • Coloradans can’t access their doctor because of the ACA

Each argument bent the truth, casting the ACA as causing the problem rather than what the data shows it is: part of the solution. If the ACA did not cause the problem, repeal is not the solution.

  • Premiums are rising.  True, but we don’t know how much is due to the ACA and the rise is exaggerated. Premiums were rising before the ACA. This year’s rise brought lower-than-predicted premiums into line with the 2017 rates predicted by the CBO in 2009. The 400% rise cited by Senator Gardner in both tele town halls– of “people whose premium rose from $300 to $1500 a month”—grossly overstates the average rise of 20.4% in Colorado–an increase that primarily impacts those who buy individual policies—about 3% of the population–and is often offset by subsidies.
  • Hundreds of thousands of Coloradans lost insurance: Not true.   By “lost insurance”, the Senator is referring to “churn”—transitioning between plans, sometimes a result of canceled plans—and not about a net loss in insured people in Colorado. The rate of churn was not increased by the ACA. Most cancelations—about 250,000—involved limited benefit plans that were not ACA-compliant, and thus had to be either made ACA-compliant or dropped when the ACA was enacted.  Despite the churn, Colorado has nevertheless seen a net increase of over 530,000 in the number insured. In fact, Coloradans continue to enroll in plans in record-breaking numbers, with a 12% increase seen over the same time last year in the 2017 open enrollment period.
  • People can’t see their doctors because of high deductibles. Not true.  The 2015 Colorado Health Access Survey shows that, since the ACA was passed, increased coverage has meant increased access. Coloradans have steadily increased their rate of preventive health visits by 7% (from 61.9% in 2013 to 66.1% in 2015) and have lowered their rate of skipping doctors’ visits due to costs by 15% (from 12.3% in 2013 to 10.4% in 2015).

Although rising premiums, churn and barriers to accessing doctors were not eradicated by the ACA, this review of Colorado data shows that the ACA is part of the solution, not part of the problem. To do what is best for Coloradans, Senator Gardner needs to step away from his false narrative about the ACA and address real issues reflected in Colorado data.  He has taken a first step in raising concerns about threats to Medicaid. There are ways to strengthen the ACA to address some of the real issues in healthcare, but to repeal it based on a false narrative disseminated by Senator Gardner and his Republican colleagues would be a tragedy.  Let’s look at the facts, and work together to make the system better, for Colorado and the rest of America.

 

 

CBO report on the AHCA: 24 million will lose coverage

The nonpartisan Congressional Budget Office has released their report on the GOP’s Affordable Care Act (ACA) replacement plan. The numbers released in this report are grim, and will only make it more difficult for Republicans to explain why their legislation will outperform the ACA.The bottom line is that 14 million will lose coverage under this plan in 2018, rising to 21 million in 2020 and 24 million in 2026. In the non group market, premiums will rise 15-20% in 2018 and 2019.