Senate Republicans unveil details of plan to replace Obamacare

A Senate health care bill unveiled Thursday takes another shot at repealing an Affordable Care Act that has provided coverage for millions of Americans and that is blamed by conservatives for expensive insurance premiums.

The bill drafted by Senate Republicans would maintain income-based subsidies that allowed consumers in California to buy affordable insurance on the individual market. But fewer moderate-income consumers would be eligible for the subsidies and would be faced with buying health plans with far higher deductibles, health advocates said.

Like the House of Representative’s plan to repeal Obamacare, the Senate bill would phase out the Affordable Care Act’s Medicaid expansion that provided health care for 65,000 low-income residents of Stanislaus County. The expansion would be rolled back between 2021 and 2024.

The Republican-led Senate would eliminate the ACA’s taxes on the wealthy and repeal the individual mandate that since 2014 has required people to have health insurance. Protections for people with preexisting health conditions would remain in place, though states could opt out of other insurance regulations in the Affordable Care Act.

Like the repeal plan approved by the House of Representatives in May, the Senate bill would dramatically change the federal method for funding Medicaid (called Medi-Cal in California), instituting caps that health officials have said could force the state to cut benefits and services for millions of adults and children.

According to experts, the dramatic shift would place a larger burden on California for funding everything from in-home supportive services to regional centers for the developmentally disabled and payments for nursing home care.

Left-leaning groups were quick to condemn the newest GOP plan to replace Obamacare. “Republicans should be ashamed,” said Craig Obey, deputy executive officer of Families USA. “After insisting they would do better than the House of Representatives, they have proposed a repeal plan that is more harmful and equally heartless.”

Rep. Jeff Denham, R-Turlock, who has been under fire from constituents for supporting the House repeal legislation, did not issue a statement. Republican leaders said that insurance premiums had doubled under Obamacare from 2013 to 2017 and that Americans need to be freed from the Affordable Care Act’s mandates.

For the next two years, the Senate bill would continue cost-sharing subsidies for health plans sold through the Covered California exchange, which have helped low-income residents with co-payments and other out-of-pocket medical expenses. It would do away with reimbursements for health services provided by Planned Parenthood.

Wednesday evening, about 50 people attended a rally at the Modesto Planned Parenthood health center on McHenry Avenue to support the nonprofit.

Cheri Grevin, a spokeswoman for Planned Parenthood’s Mar Monte region, said that in addition to abortion services, 95 percent of the health services provided at the center were under attack. Many women have relied on the center for breast exams, cervical cancer screenings, contraception counseling and screenings for sexually transmitted diseases.

Those services accounted for more than 40,000 patient visits at Planned Parenthood clinics in Stanislaus and southern San Joaquin County last year, the group said.

The Washington Post reported Thursday that a dozen Republican senators were opposed or had concerns with the repeal legislation that was drafted behind closed doors. Those backing the partisan bill could push for a vote next week and need all but two of the 52 Republican senators to support it. The legislation would then move to the House of Representatives.

Democrats and Republicans alike are awaiting a Congressional Budget Office report on the ramifications of the bill, which is certain to stir intense debate. Advocacy groups estimated the number of uninsured would grow by four to five million in California.

Under the new proposal, the eligibility range for the income-based subsidies for Covered California health plans would shrink, from 100 percent to 400 percent of poverty level to 100 percent to 350 percent of poverty level. That means an individual earning less than $42,000 a year, or $86,000 a year for a family of four, would be eligible for tax credits to lower their premiums. The current limits are $47,520 a year for an individual and $97,200 for a family of four.

An ACA policy that consumers not pay more than 9 percent of income for Silver Plan coverage through Covered California would change to 16 percent of income.

“This bill is asking many low and moderate income families to pay more for far less coverage,” said Anthony Wright, executive director of Health Access of California.

This story was originally published June 22, 2017 at 5:13 PM with the headline "Senate Republicans unveil details of plan to replace Obamacare."