Senate draft bill drastically cuts health coverage

June 22, 2017

The Washington State Hospital Association is disappointed with the Senate Republican’s attempt to repeal and replace the Affordable Care Act (ACA) – called the Better Care Reconciliation Act of 2017. The bill contains modified versions of many of the provisions from the House’s American Health Care Act (AHCA) and will result in dramatically fewer Washingtonians having access to health care. Our initial reaction is that this bill is worse for our state’s Medicaid program and hospitals and health systems than the House’s version of the bill.

WSHA’s goal in this debate is to preserve health coverage for more than 725,000 lower-income people and families who gained it under the ACA. This bill falls far short of that goal, and WSHA strongly opposes it.

In structure, the Senate bill is similar to the AHCA. The highlights include:

  • Deep cuts to Medicaid over time;
  • Elimination of the individual and employer mandates;
  • Reduction in subsidies for lower-income individuals to purchase insurance coverage and reduce cost-sharing obligations; and
  • Retention of the reimbursement cuts that hospitals agreed to in the ACA to pay for the coverage expansions. The bill maintains the Medicare and Medicaid Disproportionate Share Hospital cuts, as well as Medicare payment cuts.

Analysis of the Discussion Draft.
WSHA is continuing to analyze the bill’s details. Please click here to read our most recent detailed summary of the proposed changes. We will know more information regarding coverage levels and expected insurance premium impacts when the Congressional Budget Office (CBO) scores the bill early next week. The American Hospital Association also opposes the bill and has called for the Senate to “go back to the drawing board.”

Letter to the Senators
WSHA is sending a letter to both of Washington State’s Senators, Patty Murray and Maria Cantwell, thanking them for their continued opposition to proposed reductions in health coverage.

Next Steps in the Process
A vote of the full Senate could come as early as next Thursday or Friday – June 29 or 30. Release of the Senate Republican discussion draft triggers several procedural steps. First, the CBO will analyze the bill’s impact on coverage levels and the federal budget. Then the Senate parliamentarian will review the bill and CBO’s report to determine whether the bill’s provisions are germane under the Senate’s budget reconciliation rules.

If it is, the Senate will begin floor consideration with a vote to shut off debate by Wednesday. If that cloture motion is approved by a simple majority of members, the Senate will have 20 hours of debate on the bill, during which senators can offer unlimited amendments.

If the bill passes the Senate, it goes back to the House, where lawmakers could merely accept it and send it to the president or object. If they object, then a House-Senate conference committee would draft a final bill that would need to be approved again by both chambers. If the measure goes to conference, Republican leaders say they want it wrapped up by August 1 when Congress begins its summer break.

Statement to the Media
In a press statement released earlier today, WSHA President and CEO Cassie Sauer said, “Everyone talks about a better health care system, but the Senate’s bill, like the House’s, purposefully limits health coverage for hundreds of thousands of people in Washington State. Denying people affordable coverage doesn’t improve the system — it only makes people sicker and drives up the cost care for everyone, including employers and working families.”


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