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Greenstein: Congress Should Build on the Affordable Care Act’s Success, Not Reverse Our Progress

Fri, 24 Mar 2017 21:38:57 +0000

Today’s outcome allows the nation to continue its historic progress of the last seven years under the Affordable Care Act.

In Case You Missed It...

Fri, 24 Mar 2017 19:24:55 +0000

This week at CBPP, we focused on health care, the federal budget and taxes, and food assistance.

House GOP Bill Could Deprive Millions of Mental Health and Opioid Addiction Treatment

Fri, 24 Mar 2017 18:34:52 +0000

We explained earlier today why a Republican leadership plan to add $15 billion for behavioral health treatment and maternity coverage and newborn care to the House health bill would do little to offset the enormous damage that the underlying bill would do to millions who would lose these important categories of care.

Here, more specifically, are four ways that the House bill would harm people with mental health and substance use disorders: 

Population’s Aging Would Deepen House Health Bill’s Medicaid Cuts for States

Fri, 24 Mar 2017 18:27:46 +0000

Due to the proposal in the House Republican health bill to convert Medicaid to a per capita cap or block grant, the aging of baby boomers would likely exacerbate the federal Medicaid spending cuts over the long run.

Pre-ACA Health Insurance Market Isn’t Worth Returning To

Fri, 24 Mar 2017 17:47:11 +0000

I’ve already explained that if the pending House bill to repeal the Affordable Care Act (ACA) becomes law, plans that people buy on their own will be far skimpier — as bad as, or worse than, before the ACA.

GOP’s Health Agenda Would Undercut Their Vow to Let States Set Essential Health Benefits

Fri, 24 Mar 2017 16:44:18 +0000

Republicans argue that repealing the ten “essential health benefits” that the Affordable Care Act (ACA) requires every health plan to cover would simply allow states to make their own choices about what benefits to require.

House Republican Health Plan Would Increase Premiums

Fri, 24 Mar 2017 15:59:58 +0000

Speaker Paul Ryan says the House Republican health bill would lower premiums by 10 percent, but that’s highly misleading.  It doesn’t mean that the price of your insurance plan would be lower, as Ryan implies.  In fact, people who wanted to keep the insurance plan that they have would face premium increases averaging 13 percent, according to a Brookings I

States Have Requested Waivers from SNAP’s Time Limit in High Unemployment Areas for the Past Two Decades

Fri, 24 Mar 2017 14:32:26 +0000

The Supplemental Nutrition Assistance Program (SNAP) limits most working-age adults not raising minor children to three months of food assistance out of every 36 months unless they are working at least 20 hours a week or otherwise exempt. This law allows states to seek temporary waivers from the time limit for higher-unemployment areas. Every state but Delaware has sought a waiver at some point.

Don't Be Fooled: $15 Billion More for House GOP Health Bill’s Stability Fund Will Undo Little of Bill’s Harm on Mental Illness and Substance Use Disorders

Fri, 24 Mar 2017 13:50:22 +0000

No one should fall for it — a one-time $15 billion investment with little direction on how to spend the funds wouldn’t come close to offsetting the enormous damage that the underlying House bill would do to millions of people who would lose these important categories of care.

Waivers Add Key State Flexibility to SNAP’s Three-Month Time Limit

Thu, 23 Mar 2017 22:45:22 +0000

One of the harshest rules in the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps) limits unemployed individuals aged 18 to 50 not living with children to three months of SNAP benefits in any 36-month period when they aren’t employed or in a work or training program for at least 20 hours a week.[1]  Under the rule, implemented as part of the 1996 welfare law, states are not obligated to offer all individuals a work or training program slot, and most do not.  SNAP recipients’ benefits are cut off afte

History Shows Ending Essential Health Benefits Would Likely Promote Fraud, Abuse

Thu, 23 Mar 2017 20:03:02 +0000

We’ve explained that eliminating the Affordable Care Act’s (ACA) minimum benefit standards (“Essential Health Benefits,” or EHB) for individual and small-group market plans, as House Republican leaders are reportedly considering, would likely leave many people with pre-existing conditions unable to find coverage at any price, cause women to be charged mo

Alaskans Could Suffer the Most Harm Under the House Republican Health Plan

Thu, 23 Mar 2017 18:54:51 +0000

The House Republican health care plan would impose on Alaska the nation’s largest cut in premium tax credits, a five-fold increase in state costs for new enrollees if Alaska wanted to maintain its Medicaid expansion, and the elimination of key health benefits for Alaska Natives.  While the plan would seriously harm all states, Alaska would face a “perfect storm” of detrimental effects that would gut its Medicaid program, destabilize its individual health insurance market, and widen disparities in health coverage.  In short, Alaskans would likely lose more under the House plan than residents

If “Essential Health Benefits” Standards Are Repealed, Health Plans Would Cover Little

Thu, 23 Mar 2017 16:29:56 +0000

The White House and House Republican leaders are reportedly negotiating with House Freedom Caucus members to eliminate federal minimum benefit (“Essential Health Benefits”) standards for individual and small-group market plans as part of the House health bill.  That would leave many people with pre-existing conditions unable to find the coverage they need at any price, much less an affordable one; result in women being charged more than men; and expose many people with h

Lowering the Medical Expense Deduction Threshold Would Do Little to Help Taxpayers Facing High Premiums

Wed, 22 Mar 2017 17:19:05 +0000

This change would do little to help those most in need of assistance affording health coverage, and provide a tax cut to those who need it least.

House Republican Health Plan Would Shift Medicaid Costs to States

Wed, 22 Mar 2017 16:54:50 +0000

The House Republican health plan would shift hundreds of billions of dollars in Medicaid costs to states over the next decade, new data from the Urban Institute show. These fact sheets provide state-by-state data on how much more states would have to spend to maintain their Medicaid programs (including the Medicaid expansion).

House GOP Health Bill Still Cuts Tax Credits, Raises Costs by Thousands of Dollars for Millions of People

Wed, 22 Mar 2017 15:13:08 +0000

The updated House Republican legislation to repeal the Affordable Care Act raises total out-of-pocket health costs by an average of $3,600 in 2020 for people who buy health insurance through the ACA marketplaces.

Commentary: The House Republican Health Bill – A Test for Members

Wed, 22 Mar 2017 02:13:12 +0000

When House GOP leaders unveiled their legislation to repeal the Affordable Care Act (ACA), House Republicans faced a fundamental question: would they insist on changes to make the bill fairer for the tens of millions of low- and moderate-income people across America who would be treated harshly under it?

Updated House ACA Repeal Bill Deepens Damaging Medicaid Cuts for Low-Income Individuals and Families

Tue, 21 Mar 2017 20:54:18 +0000

The updated House Republican plan to repeal the Affordable Care Act takes an already damaging plan and makes it even more harmful.

Interactive Map: Cost-Sharing Subsidies at Risk Under House GOP Health Bill

Tue, 21 Mar 2017 19:52:54 +0000

While drastically cutting the Affordable Care Act’s (ACA) premium tax credits, the House Republican health bill also eliminates the other, lesser-known marketplace subsidies — cost-sharing reductions (CSRs) — that reduce deductibles, co-payments, and other out-of-pocket costs for more than 6 million marketplace enrollees. Our new interactive map shows what’s at stake in the 39 states whose residents enroll through the federal platform.

House GOP’s Proposed “Fix” for Health Bill Prioritizes Tax Cuts for Richest

Tue, 21 Mar 2017 18:21:42 +0000

In their updated health bill, House Republicans are doubling down on their plan to cut taxes for high-income households while cutting health insurance for mostly low- and moderate-income households — speeding up tax cuts for the very richest people so they take effect in 2017, rather than 2018.

False Claims That the Medicaid Expansion Is Causing Waiting Lists

Mon, 20 Mar 2017 21:07:43 +0000

Pushing for huge Medicaid cuts, including ending the Affordable Care Act’s Medicaid expansion for low-income adults and imposing a per capita cap, some congressional Republicans continue to claim falsely that the Medicaid expansion is squeezing out funding for other Medicaid beneficiaries. Most recently, Senator Ted Cruz and Rep.

House GOP Health Plan Would Accelerate Depletion of Medicare Trust Fund by Four Years

Mon, 20 Mar 2017 20:22:36 +0000

The House bill to repeal the Affordable Care Act (ACA) would move up the Medicare’s Hospital Insurance (HI) trust fund’s depletion from 2028 to 2024 (see graph). Repealing a payroll tax on high earners would advance the depletion date by three years, as we previously reported. Additional Medicare payments to hospitals that serve many uninsured payments would advance it one more year, we now estimate.

States Estimating Large Medicaid Cost Shifts, Coverage Losses Under House GOP Plan

Mon, 20 Mar 2017 19:58:22 +0000

The Republican health plan that the House plans to consider on Thursday would force states to spend billions more to maintain their Medicaid programs (including the Affordable Care Act’s Medicaid expansion to low-income adults) or, far likelier, cut hundreds of thousands of low-income residents off Medicaid, most of whom would end up uninsured, according to projections by a growing number of state policymakers and independent researchers.

Three Resources Highlight House GOP Health Plan’s Big Tax Cuts for the Rich

Mon, 20 Mar 2017 19:00:41 +0000

The House GOP health plan would repeal, starting in 2018, two Medicare taxes in the Affordable Care Act (ACA) that fall only on high-income filers: the additional Hospital Insurance payroll tax on high earners and the Medicare tax on unearned income. These tax cuts together would cost $275 billion over ten years, according to the Joint Committee on Taxation, and they’re raising increased concerns even within Republican circles.

Table: Potential Impact of Selected Trump Budget Proposals in 2018, by State

Mon, 20 Mar 2017 18:22:01 +0000

State Vouchers Cut Public Housing Funding Cut CDBG Funding Cut HOME Funding Cut
Alabama  -2,783 -$57,522,695 -$40,510,462

Tax Credit Changes Under Discussion Won’t Close House Health Bill’s Massive Affordability Gaps

Mon, 20 Mar 2017 16:05:28 +0000

The options under discussion wouldn’t come close to closing the House bill’s massive affordability gaps.

Commentary: Ryan Makes It Clear That Cutting Medicaid to Pay for the Health Bill’s Tax Cuts for the Wealthy Enables Deeper Corporate Tax Cuts in Tax Legislation to Follow

Mon, 20 Mar 2017 15:07:34 +0000

Passing these tax cuts now as part of a health package allows the GOP to offset their cost through cuts to health care spending.

In Case You Missed It…

Fri, 17 Mar 2017 19:39:22 +0000

This week at CBPP, we focused on health care, the federal budget and taxes, housing, state budgets and taxes, Social Security, food assistance, and the economy.

Also Missing from Trump’s Skinny Budget: $18 Billion in 2017 Cuts

Fri, 17 Mar 2017 17:25:08 +0000

There’s an $18 billion hole in President Trump’s “skinny” budget:  it calls on Congress to cut this year’s funding for non-defense discretionary programs by $18 billion but gives no hint about which programs the President wants to cut.

Trump Budget Slashes State and Local Grants at Tough Time for States

Fri, 17 Mar 2017 15:04:13 +0000

President Trump’s new budget would push huge additional costs to states at a time when most of them lack the revenue to pay for current services.  Low-income families would be particularly hard hit, as the budget eliminates or deeply cuts funding for a wide array of state programs and services that help these families overcome hard times and rise into the middle class. 

African Americans Have Much to Lose Under House GOP Health Plan

Fri, 17 Mar 2017 14:58:01 +0000

Running for President, President Trump asked African Americans, “What do you have to lose by trying something new like Trump?”  As it turns out, one answer is health insurance.

Trump Budget Will Increase Homelessness, End Federal Role in Community Development

Thu, 16 Mar 2017 20:21:50 +0000

President Trump’s fiscal year 2018 budget for the Department of Housing and Urban Development (HUD) proposes deep cuts in every state in rental assistance for families and other aid for the nation’s poorest urban and rural communities, which would increase homelessness and other hardship across the country.

SNAP Marks Four Years of Falling Caseloads

Thu, 16 Mar 2017 19:20:34 +0000

The number of SNAP (formerly food stamps) recipients is now below 43 million -- a decline of almost 5 million people (or 10 percent) since the December 2012 peak -- new Agriculture Department data for December 2016 show.

New Mexico Wisely Rescinds Call for Constitutional Convention

Thu, 16 Mar 2017 17:10:00 +0000

New Mexico lawmakers yesterday rescinded the state’s resolutions of decades ago calling for a national convention to amend the U.S. Constitution. That’s important because other states – misled by arguments from the American Legislative Exchange Council (ALEC) and other groups – are calling for a convention, which would put at risk the cherished rights and freedoms that the Constitution provides and deepen the country’s wide divisions.

Trump Budget Harms Those He Promised to Help

Thu, 16 Mar 2017 15:19:45 +0000

President Trump’s new budget proposal would do severe damage to an array of investments that help many of the very people that President Trump has said would be his priority.

Trump’s “Skinny” Budget Omits Most of the Budget

Thu, 16 Mar 2017 11:49:49 +0000

President Trump released his so-called “skinny” budget today, and it contains substantially less detail than “skinny” budgets of the last five administrations going back to Ronald Reagan.

Medicaid Offers Access to Needed Care; House GOP Health Bill Would Undermine It

Wed, 15 Mar 2017 19:46:48 +0000

Promoting the House Republican health proposal that massively cuts federal Medicaid spending, top Administration officials continue to insist that fewer providers are willing to serve Medicaid patients. Studies, however, show that Medicaid beneficiaries have comparable access to care to people with commercial insurance. Moreover, the House proposal would make providers less willing to accept new Medicaid patients because it would likely force states to cut payments to doctors and other providers, threatening access to care for millions of children, seniors, and parents.

For House GOP Health Bill, Deficit Reduction and Coverage Loss for Millions Go Together

Wed, 15 Mar 2017 19:33:09 +0000

The White House and Republican congressional leaders seem conflicted about whether to praise or criticize the Congressional Budget Office’s (CBO) analysis of the House bill to repeal the Affordable Care Act (ACA).

House Republican Plan Needs $100 Billion Fund to Maintain Individual Insurance Market

Wed, 15 Mar 2017 18:09:02 +0000

The House Republican health care bill would destabilize the individual insurance market, raising premiums and reducing insurer participation. To address that problem, the bill provides a $100 billion “stability fund” to help insurers and finance other state initiatives. That’s a major reason why the Congressional Budget Office (CBO) predicts the individual market would generally be stable under the House bill.

Commentary: No, the House GOP Health Bill Won’t Protect Medicaid Beneficiaries

Wed, 15 Mar 2017 17:46:17 +0000

The bill effectively ends the Medicaid expansion, freezing out millions of people who would have gotten coverage and causing current enrollees benefitting from the expansion to lose their coverage as well.

Trump Skinny Budget Will Be Short on Details, But Troubling Fiscal Agenda Is Emerging

Wed, 15 Mar 2017 14:56:37 +0000

The President’s emerging fiscal agenda features large increases in defense funding that are offset by cuts in a range of critical domestic priorities.

Little-Noticed Medicaid Changes in House Plan Would Worsen Coverage for Children, Seniors, and People with Disabilities and Increase Uncompensated Care

Wed, 15 Mar 2017 14:41:55 +0000

The AHCA would make little noticed changes to Medicaid that would significantly affect coverage and financial security for over 70 million low-income Americans.

Cassidy-Collins Proposal Would Weaken ACA’s Coverage and Consumer Protections

Tue, 14 Mar 2017 20:46:26 +0000

Senators Bill Cassidy and Susan Collins say their legislation to replace the Affordable Care Act (ACA) would allow people who like the coverage they have to keep it and states that support the ACA to maintain it.  In reality, however, their bill would almost certainly take health insurance and access to care away from many millions who now rely on ACA health coverage, especially those with low incomes and pre-existing health conditions.

House Republican Health Plan Would Weaken Medicare

Tue, 14 Mar 2017 19:13:06 +0000

The House bill to repeal the Affordable Care Act (ACA) wouldn’t just cause 24 million people to become uninsured, as the Congressional Budget Office (CBO) reports; it also would weaken Medicare by repealing a payroll tax on high earners that supports Medicare’s Hospital Insurance (HI) trust fund (see figure) and by increasing Medicare spending for the uninsured.

Trump Plans Big Federal Workforce Cuts, But Workforce Already at Record Lows, Undermining Basic Services

Tue, 14 Mar 2017 18:39:38 +0000

President Trump plans to propose large cuts in the number of federal employees, news reports suggest, even though federal employment already equals its lowest level ever recorded (both as a

Trump Budget Continues Multi-Year Assault on IRS Funding Despite Mnuchin’s Call for More Resources

Tue, 14 Mar 2017 17:29:18 +0000

The Internal Revenue Service (IRS) budget has been cut by 18 percent since 2010, after adjusting for inflation, and the agency has lost roughly 13,000 employees — around 14 percent of its workforce.  These cuts have harmed customer service, frustrated honest taxpayers, and undermined critical enforcement efforts to combat tax avoidance and growing identity theft.  Treasury Secretary Steven Mnuchin, whose department includes the IRS, appears to understand that these cuts are misguided, stating at his confirmation hearing:

President Trump’s Health Promises Don’t Match Facts, CBO Report Shows

Tue, 14 Mar 2017 17:23:17 +0000

President Trump promised to replace the Affordable Care Act (ACA) with, as he said a few weeks ago, “a very competitive plan” under which “costs will come down [and] health care will go up very substantially. People will like it a lot.” But such promises don’t match the facts.

Cuts Weakening Social Security Administration Services

Tue, 14 Mar 2017 16:54:01 +0000

Years of Social Security Administration (SSA) funding cuts have hampered the agency’s ability to serve the American people, but President Trump and Congress can begin to address the problem when they turn to funding the government for the rest of fiscal year 2017 and for 2018. 

CBO: Millions Would Pay More for Less Under House GOP Health Plan

Tue, 14 Mar 2017 01:55:28 +0000

Along with reducing health coverage by 24 million, the House Republican bill to repeal the Affordable Care Act would make coverage less available and less affordable for virtually all age and income groups.

CBO: 24 Million People Would Lose Coverage Under House Republican Health Plan

Mon, 13 Mar 2017 21:54:43 +0000

The House Republican health plan to repeal much of the Affordable Care Act and radically restructure Medicaid would cause 24 million people to lose coverage by 2026 and drive $880 billion in federal Medicaid cuts over the next ten years.