GOP War on Health Care Alive and Well
Republicans are at it again – attacking health care on multiple fronts. They want to hike costs and rip away care from millions of Americans in their latest budget proposal, including taking away Medicare’s power to negotiate lower drug prices for seniors. They are threatening a reckless government shutdown that would only make matters worse, and proposed a continuing resolution that would compound the growing health crises as it seeks to cut 8 percent of almost all federal spending. And the legislation they are championing in the House would send us back to the days when insurance companies could make the rules and weaken protections for preexisting conditions. If the GOP gets their way, they would throw millions of people off of Medicaid, reverse prescription drug savings for seniors under the Inflation Reduction Act, and make health care coverage more expensive for families purchasing coverage on their own through the Affordable Care Act.
Here’s a closer look at what the GOP is proposing;
The Budget Details
What The Republican Budget Proposal Means for Americans:
- GONE: Medicare’s power to negotiate lower prices for the most expensive prescription drugs.
- GONE: Premium savings for 14.3 million Americans who buy insurance on their own — averaging $2,400 per family.
- GONE: Medicaid for millions of Americans including people with disabilities, new mothers, and children who can’t meet the bureaucratic paperwork burdens imposed by a work requirement.
- GONE: Nearly $4 billion in funding for research on cancer, Alzheimers, and long COVID.
- GONE: Over $500 million in savings under the Affordable Care Act.
Medicare’s Price Negotiation Power Will Be Stripped Away by Republicans. Currently, negotiations are underway for ten drugs that make up around 20 percent of all Medicare Part D spending. Americans currently pay two to four times more for prescriptions than people in other countries and if Republicans have their way it will stay like that. The Arrington budget would slash Medicare’s power to negotiate and make sure prices stay high for Americans and federal spending is needlessly inflated.
Republicans Want to Make Health Care More Expensive For Millions By Repealing The Inflation Reduction Act’s Premium Subsidies. House Budget Chair Jodey Arrington’s budget proposal would scrap the Inflation Reduction Act’s premium subsidies, which has helped save over 13 million Americans an average of $2,400 per year on health care. It also ensures that no individuals making under $20,000 or families making around $41,000 will have to pay health care premiums at all. These subsidies have led a record breaking 14.3 million people to enroll in affordable health plans. The Republican plan will cause over 3 million people to lose coverage entirely.
Medicaid Work Requirements Would Kick Millions of Americans, Including Mothers and Children, Off of Rolls. Despite all evidence and case studies showing that implementing work requirements on Medicaid kicks off people who do meet the work requirement but can’t jump through the additional bureaucratic reporting hoops and increases the program’s total costs due to increased administrative oversight, Republicans have proposed an 80 hour a month work requirement for Medicaid. Over 60 percent of Medicaid enrollees already work, so an additional work requirement will likely only kick off the 11 percent not able to work due to illness or disabilities, 13 percent not able to work due to caregiving, and 6 percent not able to work due to school attendance. This program will leave disabled Americans, those caring for families, the children of parents who have lost coverage, and those seeking education to better their job opportunities in the future without care.
Critical Research into Cancer, Alzheimers, Long COVID, and Other Diseases Will Be Halted. Republicans plan to cut over $3.8 billion in funding to the National Institute of Health and eliminate funding entirely for the Agency for Healthcare Research and Quality. With NIH funding accounting for 99.4 percent of all FDA approved drugs from 2010-2019, these cuts will significantly undermine novel pharmaceutical innovation and development.
Repealing Bans on Physician Self-Referral Will Increase Health Care Costs and Jeopardize Communities’ Access to Care. In the FY 2024 budget, House Republicans have proposed ending the Stark Law, which would allow physicians to self-refer patients to facilities and services in which they have a financial stake. Importantly, these controversial physician-owned hospitals provide limited or no emergency services, cherry pick the most potentially profitable patients, and incur significantly higher costs on the Medicare program. According to the HHS, up to one-third of these hospitals may violate Medicare requirements by relying on publicly funded services to stabilize patients while still charging the patients exorbitantly. The Affordable Care Act’s closing of the “whole hospital” exception loophole in the Stark Law reduced the federal deficit by half a billion dollars over ten years; Republicans repealing it will cost the federal government and the American people millions of dollars annually.
If Republicans Shut Down the Government Or Fail To Reauthorize Critical Health Programs
If Republicans don’t get their way to cut Medicaid, the Affordable Care Act, and the Inflation Reduction Act, it is more and more likely that they will shut down the entire federal government. Along with crucial federal programs not being funded during a shutdown, there are a range of other health initiatives that need to be reauthorized before the end of fiscal year 2023 on September 30, which Republicans are also neglecting to prioritize. Instead of governing, it seems the Republican party seeks to hold the entire American health care system hostage.
Over 300 Community Health Centers Will Be At Risk. The Community Health Center Fund provides around 70 percent of federal funding to over 300 grantees across the country running vital health centers which integrate local health equity efforts into broader health care. The funding for this program expires September 30th, and without additional resources the lapse in funding could cause a collapse in employment in these centers.
Federal Funding That Offsets Uncompensated Care Hospitals Provide Will Dry Up. In a letter sent by America’s Essential Hospitals, the group warned that the $8 billion cut to DSH payments, which would go into effect on October 1, could dramatically undermine America’s health and safety. As well without this funding, access to life-saving services could disappear for many low-income or otherwise marginalized Americans.
The Global Fight Against HIV/AIDS Will be Undermined. A government shutdown could cause The President’s Emergency Plan for AIDS Relief (PEPFAR) to not be reauthorized. This will sunset seven provisions at the end of fiscal year 2023 which involve how to allocate spending and U.S. contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Funding the Fight Against the Opioid Epidemic Would Dry Up. Without reauthorization, many programs launched in 2018 aimed at tackling the growing opioid crisis would lapse.
Pandemic Preparedness Would Collapse and Drug Shortages Continue. Due to an ongoing fight in the House, Republicans have held up reauthorizing the Pandemic and All Hazards Preparedness Act (PAHPA). Democrats have fought to address the growing drug shortages using the PAHPA, but Republicans have delayed the reauthorization, now causing it to potentially lapse out entirely due to a Republican shutdown.
The Republican Continuing Resolution Would Only Make Matters Worse
A Short Term CR Offered By Some Republicans Would Slash Federal Spending And Undermine Critical Research And Public Health Programs. Instead of shutting down the government, some Republicans have offered up a short-term funding bill which will keep the federal government running until October 31st. This continuing resolution will only compound the growing health crises as it seeks to cut 8 percent of almost all federal spending. Not only will these cuts increase wait times, slash public spending on disaster initiatives, and undermine critical pharmaceutical research, but it will also drastically decrease access to vital public health services as tens of thousands of Americans face obstacles in maintaining stable social determinants of health.
Republican Legislation Would Weaken Protections For Millions Of Americans With Pre-Existing Conditions
Legislation Offered By Republicans This Summer Would Promote “Junk” Insurance Plans And Undermine the ACA. The Association Health Plans Act and Self Insurance Protection Act passed by the Education & Workforce Committee this summer would expand access to association health plans (AHPs) and other non-ACA compliant health care plans, weakening protections for the over 135 million Americans with pre-existing conditions. AHPs are health plans that are offered to members of trade associations, professional groups, or other organizations. Compared to plans available on state marketplaces, AHPs provide weaker cost and protection coverage and are not required to hold up the same protections that plans under the ACA do. AHPs do not have to participate in the ACA’s single-risk pool rule and can set premiums lower for healthier people and higher for those with pre-existing conditions or who are at risk for health issues in the future.