A group of activists rally against the GOP health care plan outside of the Metropolitan Republican Club, July 5, 2017, in New York City. (Photo: Drew Angerer / Getty Images)
In a last-ditch effort to save their bill to repeal the Affordable Care Act (ACA), Senate leaders are reportedly offering $200 billion to win the votes of senators from states that expanded Medicaid under the ACA. This new fund would presumably supplement private coverage for those who gained Medicaid coverage under the expansion but would lose it under the Senate bill. No senator should fall for it. While $200 billion seems like a lot of money, it’s only 17 percent of the bill’s $1.2 trillion in cuts: $756 billion from Medicaid and $427 billion from subsidies to help low- and moderate-income people buy coverage in the individual market, according to the latest Congressional Budget Office (CBO) estimates (see first chart). It wouldn’t even fill the federal funding gap left by repealing the Medicaid expansion — let alone prevent the harm from the bill’s per capita cap on federal funding for all of Medicaid and the loss of subsidies and erosion of market reforms for people with individual market coverage.
Effectively ending the expansion accounts for about three-quarters of the $756 billion cut in Medicaid, according to CBO. Providing affordable private coverage to poor and near-poor individuals would likely cost more than covering them through Medicaid — that is, far more than the $200 billion that Senate leaders are proposing. That’s because Medicaid coverage costs 22 percent less for comparable beneficiaries, even though Medicaid provides more comprehensive benefits and far greater financial protection. Today’s CBO score shows how big a hole supplemental coverage would have to fill under the Senate bill. The private plans available to people would have deductibles of $13,000 by 2026 (see second chart).
Moreover, news accounts suggest that the additional funding — like the bill’s…