Healthcare Bill is Dead…for now

By Ryan Kelly –

It was announced recently that leadership in the US Senate would not pursue a vote on the recently proposed healthcare bill, the Better Care Reconciliation Act of 2017,  to match the American Health Care Act passed out of the US House of Representatives last month.

It is reported that the Senate will not take up a vote because the do not have the necessary 51 votes to have the bill pass.  The Senate consists of 52 Republicans (including the Vice President) and 49 Democrats.  It is widely believed that a vote would be made down partisan lines.

So why did the bill fail to gather votes?  Essentially, it’s because we are a divided country that reflects a divided party system.  Far right Republicans do not believe that the bill went far enough to privatize insurance and move away from policies of The Affordable Care Act.  Moderate Republicans believe the legislation went too far at reducing Medicaid funding and punishing states that expanded Medicaid.

So essentially, it modified Medicaid too much and it did not open the markets far enough.  These represent two extreme issues and stances that did not work for both sides of a GOP body that needed it to work for everyone in order to pass.

What would the two bills have done in Mississippi?

The insurance marketplace would not have had the freedom needed for insurance plans to openly determine the risk of clients and assign premiums based on this risk.  The marketplace, rather would have been opened more than under the ACA but not enough to significantly reduce individual cost.

Secondly, Medicaid would have been transitioned from an unlimited federal match payment program to either a per capita rate per enrollee or a bundled payment to each state.  The greatest concern of this transition is that states would bear the greatest cost of paying for Medicaid patients, which means that most states would try to find some way to cut programs or services to save cash.  Since Mississippi receives the highest federal match of any state in the union, this would have likely affected Mississippi more than anyone else.  Although the specific impact in Mississippi has yet to be determined due to a lack of information about the specific amount of funding that would be block-granted or supplied per enrollee, the consensus is largely that it would not be good for Mississippi.  This likely would result in reduced payments for services and a reduction of covered services.  It would also likely result in a tax increase to cover the expected state shortfalls.

But, this is not done.  At the time of this writing, legislators are working on a true “repeal bill” that would take away all aspects of the Affordable Care Act.  No details have been released at this time, and many believe that such an effort would fail for the same reason that the afore mentioned legislation failed.  There is also rumor of additional healthcare legislation being crafted that attempt different ways to reform the ACA or replace it with alternative ways to care for patients.

There is large consensus on one thing – the Affordable Care Act was not perfect and further reform is needed.  Whether that involves repealing and replacing or simply modifying the ACA is open for debate.  As the Association is a 501(c)3 organization that does not take a partisan stance, our desire is to see a bill that improves healthcare for all rural citizens and providers.  We want expansion of markets, reduced cost, greater access, and financial stability of the healthcare system.
It seems like the pieces are in place, we just need to find a way to make smart reforms and bring everyone to the table for a consensus on our direction moving forward.

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