On Friday, July 7th, with about 200 other people, I attended the Health Care Round Table hosted by Congressman Brad Schneider and the Lake County Health Department at Waukegan High School. The Congressman spoke about the history of the Affordable Care Act, the AHCA and the BCRA and the implications for Illinoisans of the proposed changes. He emphasized that the ACA was the result of 15 months of work, 79 public hearings, testimony by over 180 witnesses, included hundreds of amendments (many by Republicans) and eventually passed with no Republican votes. The ACHA and BCRA have been developed behind closed doors with no hearings, witnesses, amendments, or debates.
Medicaid in Illinois
- over 3 million Medicaid recipients
- covers 50% of childbirth
- covers 47% of children
- covers 18% of seniors and disabled people
Impact of the AHCA (Congressional bill)
- 24 million lose Medicaid in the first decade
- cost of insurance on the exchanges would increase, especially for older people. A 60 year old making $26,000 would see premium go from $1700 a year to $16,000 a year
Impact of BCRA (Senate bill)
- 23 million people would lose Medicaid
- provides a $800 billion tax cut for the 400 wealthiest Americans
- Medicaid would be cut 26% in the first decade
- Medicaid would be cut 35% in the second decade
- almost all premiums would go up
- “age tax” – older people would have the highest increases
- those with income at 200% of the poverty level would see a 96% increase in premiums
- those with income under the 200% poverty level would lose subsidies, premiums increase 300%
- rate of uninsured would rise again to 18% (after falling from 20% to 10% as a result of the ACA).
The Congressman stated that the ACA needs fixing, and supports a bipartisan approach. He thinks the marketplace needs adjustments, something must be done about insurance companies pulling out of the market, the Cost Sharing Reductions must be continued and a public option should be considered.
Mark Pfister, Executive Director of the Lake County Health Department, shared information about the ACA in Lake county.
- 44,436 people accessed insurance because of the ACA
- rate of uninsured went from 11% in 2013 to 3% in 2016
- 21,600 people got Medicaid in 2016 because Illinois opted for Medicaid expansion
- 40,000 patients get health care at Lake County Health Department and 60% are on Medicaid
- pre-ACA, the uninsured rate at the Health Department was 46%; it is now 34%
- ACA created the Public Health Prevention Fund, funds vaccines from CDC for disease outbreaks like Zika or the mumps. The BCRA cuts the fund by 11%
- Mental Health Parity Act (2008) required insurance to cover mental health services as they did other medical services but not implemented until the ACA provided the funds to pay for it. BCRA eliminates those funds resulting in cuts to mental health and substance abuse services
Three constituents shared their stories of how the ACA has helped them including:
- children being covered on their parents’ insurance until age 26
- coverage of pre-existing conditions
- subsidies in the exchanges
- removal of life time caps
During the question and answer period, Congressman Schneider outlined his “fixes” for the ACA
- goal is to provide quality, affordable health insurance
- need comprehensive health care policy, agencies need to be able to address issues
- promote innovation to reduce costs (repeal medical device tax)
- strengthen marketplace, pass the Common Sense Act
- bolster Cost Sharing Reduction Subsidies
- bipartisan effort
One constituent asked what is being done now, in addition to trying to block the passage of BCRA.
- Problem Solving Caucus – 23 Democrats and 21 Republicans
- Bipartisan Working Group – meets once a week
- Similar group being developed in the Senate by Senator Heitkamp
- looking at abuses in the system (Martin Shkreli)
The audience was largely supportive of the Congressman. The negative comments were about the cost of insurance in the marketplace, the lack of local providers for the marketplace plans, costs of medications and long waiting times for appointments.