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Pennsylvania Democratic officials on Monday criticized a Republican plan to replace the Affordable Care Act, saying it would reduce federal money for the state by about $2 billion per year by 2020 and eliminate health care plans for hundreds of thousands of residents.
The House Republican plan, leaked to POLITICO Friday, calls for undoing the federal health law's Medicaid expansion, scaling back required benefits for individual health plans and restructuring the individual insurance marketplace.
More than 700,000 Pennsylvanians have signed up for Medicaid under the expansion, which enabled individuals making up to about $16,000 per year to enroll.
The Republican proposal would reduce what the federal government pays the state to cover medical bills for the next three years and would make bigger changes in 2020, reducing what the state receives by about $2 billion per year, said Department of Human Services Secretary Ted Dallas.
Replacing the lost revenue at a time when Pennsylvania already faces a growing budget deficit would be “obviously extraordinarily difficult for us to do,” Dallas said.
Dallas said the consequences would be “far-reaching” and “devastating” for people with Medicaid and would affect the bottom line of hospitals – especially rural hospitals – that have had to provide millions less in free care since the expansion.
The replacement plan, an early draft with a long legislative path ahead of it, would relax requirements for the “essential health benefits” all health plans have to provide under the ACA, Insurance Department Commissioner Teresa Miller said.
The changes could lower monthly premium prices, which have increased substantially in the last two years on the marketplace in Pennsylvania, but would mean that people would pay more for some of the services considered essential health benefits – such as maternity and mental health services, Miller said.
The plan would provide subsidies based on age to people buying insurance on the individual market, rather than adjusting them to income as the law does now. That would benefit higher-income people while hurting those with lower incomes, she said.
“It certainly may offer the illusion of more affordable care, but I think it's clear that this proposal doesn't really tackle health care costs,” she said.
The proposal would generate revenue by taxing high-end insurance plans with the best benefits, offered by some employers.
President Donald Trump warned Monday that the nation's health care system was in danger of imploding and said Congress must make fundamental changes to the sweeping health law passed by his predecessor.
Trump said at a White House meeting with dozens of governors that he hoped to overhaul the American tax system but that was a “tiny little ant” compared to what he would need to do to remake Obamacare.
The Associated Press contributed to this report. Wes Venteicher is a Tribune-Review staff writer. Reach him at 412-380-5676 or wventeicher@tribweb.com.
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