Vice President for Health Policy
A new study supports our finding that a leading congressional Republican health plan, from which House Republican leaders may borrow for their own plan, would likely cause millions to end up uninsured or underinsured.
We’ve already noted in a recent blog post series that if House Republican leaders unveil a health plan alternative to the Affordable Care Act (ACA) in June, as House Speaker Paul Ryan has indicated they will, it may resemble or include elements of a proposal from House Energy and Commerce Chair Fred Upton, Senate Finance Chair Orrin Hatch, and Finance Committee member Richard Burr. We’ve also explained that the Upton-Hatch-Burr plan would likely leave millions more uninsured or underinsured.
Now, RAND Corporation analysts have estimated the Upton-Hatch-Burr plan’s expected effect on health care coverage and conclude that relative to current law, it would “insure fewer people, raise the federal deficit and impose greater financial burden on some vulnerable groups, including older adults and people with incomes under 138 percent of the FPL [or the federal poverty line].”
Specifically, RAND finds that the plan would:
Moreover, relative to current law, the increase in the number of uninsured would be much larger over the long run. That’s because the RAND analysts estimate coverage levels only for 2018. As a result, they find only relatively small federal funding cuts deriving from the Upton-Hatch-Burr proposal to also cap federal Medicaid funding at levels below that of current law. As the RAND analysts note, “[b]ecause we model outcomes for 2018 (only two years past 2016), the amount of divergence between Medicaid funding levels and actual program costs will be relatively minor over this window.”
But as we’ve explained, under the Upton-Hatch-Burr plan, states’ federal Medicaid funding shortfalls would likely grow significantly over time. That’s because the capped federal funding would rise slower than projected increases in Medicaid spending, enlarging the cuts each year. As a result, states would have to contribute more and more of their own funds or, more likely, use the greater flexibility they would likely receive to deeply cut eligibility, benefits, and payments to health care providers. Millions of poor Medicaid beneficiaries would likely become uninsured or underinsured in coming years as a result.