Analysis sees 21 percent premium hike with Obamacare repeal

[I]nsurance premiums for customers on Vermont Health Connect would rise 21 percent if the latest health care bill going through Congress becomes law.

That’s according to the Kaiser Family Foundation, a nonprofit think tank on health care issues that has been analyzing the effects of the U.S. Senate’s proposed Better Care Reconciliation Act.

The think tank also projects that a 60-year-old Vermonter making $30,000 a year would pay $1,510 more in premiums per year under the bill; a 40-year-old making the same amount would pay $590 more; and a 27-year-old earning $30,000 would pay $110 more.

No matter their age, Vermonters making about $44,000 a year would spend $2,480 more on health insurance each year, because the new bill would eliminate financial help for people making between $44,000 and $48,000, according to Kaiser.

Independent economists estimated the bill would lead to 22 million fewer people having health insurance across the country. Republican Senate leadership originally planned to pass the bill before breaking for the Fourth of July but have delayed the vote, a sign it may not have enough support even within that party.

“In all my time in the field — which is now much longer than I’ll tell you — I’ve actually never seen legislation like this,” said Drew Altman, the CEO of the Kaiser Family Foundation. He called the bill “unprecedented legislation” that “achieves broad Republican goals.”

“It also produces 22 million more uninsured. It raises premiums. It significantly raises deductibles,” Altman said. “Uniquely, unlike any piece of legislation I’ve seen, it would produce many more losers than winners, which could come back to haunt Republicans in upcoming elections if it passes.”

Gov. Phil Scott issued a statement Tuesday saying the bill, and a version that the House passed in May, could jeopardize near-universal health insurance coverage in Vermont and the progress the state has made on health care reform.

“Both would be harmful to our state and our people if passed,” Scott said. “I therefore cannot support the current bills and have urged Congress to delay action and work with the states to address our concerns.”

MaryKate Moulman, Scott’s director of health care reform, said the bill is still similar to the original Obamacare repeal bill. At the time, the Agency of Human Services estimated the state would lose $200 million in federal funding for the $1.7 billion Medicaid program.

“Fundamentally, this bill would not be good for Vermont in terms of the substantial loss of federal dollars,” Moulman said. “We would see a reduction in support for premiums through the cost-sharing reduction subsidies and the tax credits.”

The Vermont Medical Society, a trade association that represents primary care physicians and other doctors, issued a statement saying the organization’s members dedicated their careers to improving people’s health care, and the Senate bill does the opposite.

“Protecting society’s most vulnerable – our youngest and oldest citizens, the sick and those with lower incomes – should be the first test of any health care reform legislation,” Dr. Wendy Davis, the president of the Vermont Medical Society, said in a statement.

“Clearly (the Better Care Reconciliation Act) fails in this regard and in fact would cause considerable harm to the very people who need access to affordable care the most,” Davis said.

Ed Paquin, the executive director for Disability Rights Vermont, said the bill’s cuts to Medicaid would be hard on people with disabilities and long-term care needs, who make up about half of what Vermont Medicaid spends on patient care.

In 2015, the state spent $216 million taking care of people who were eligible for both Medicaid and Medicare, $208 million on elders who needed long-term care, $193 million on adults with disabilities, and $87 million on children with disabilities.

Sixty-four percent of Vermonters living in nursing homes were covered through Medicaid in 2015, according to the Kaiser Family Foundation, and 62 percent of nursing home beds across the country are paid for through Medicaid.

“I don’t think people realize how many people who need a very high level of care either get that care through nursing homes and they’re paid for by Medicaid,” Paquin said. “If an elder exhausts all of their personal resources over time and is left without help, then they’re in that (nursing home) system.”

He said people with developmental disabilities are almost certainly using Medicaid, and people who develop disabilities later in life often use both Medicaid and Medicare. He said working people with disabilities are often low-income and may have become eligible for Medicaid.

Additionally, he said a lot of middle-class working people develop long-term care needs after they retire, and because nursing home beds are so expensive, they often turn to Medicaid after spending through their savings.

“Once you’ve exhausted your savings, then Medicaid is your safety net, and unfortunately we’re living in a time when a lot of people” go into retirement without significant savings and without a pension, Paquin said.

“Where does that lead long term?” he asked. “Worse health care leads to shorter life expectancy.”

Roger Allbee, the CEO of Grace Cottage Hospital in Townshend, said the Medicaid cuts would also hit his small community hospital, which he said is already losing $2 million a year treating Medicaid patients, because the reimbursements are so low.

“It’s absolutely devastating what they’re doing,” Allbee said. “It would be hard for a rural health care center like ours, which serves 14 communities, to even exist in the future under their plan. It’s devastating, absolutely devastating.”

The U.S. Census Bureau recently ranked Vermont as the third-oldest state in the country. Allbee said his hospital needs to exist to provide health care in rural communities and to run programs that help senior citizens get transportation to the hospital.

“If you sit in a rural health care setting today, and you look at what’s proposed, the question you have to ask is, ‘How can services even be provided in the future?’” Allbee said.

Allbee worked for the late Sen. Jim Jeffords, a Vermont Republican, on agriculture issues several years ago. He said the current process in Washington, D.C., does not reflect the type of work members did back then.

“What we’re seeing coming out of Washington is not good policy,” he said. “It seems to be based on politics and not what’s good for our citizens.”

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