GOP Plan to Scrap ACA, Medicaid, and Medicare Nightmare Scenario for Georgians

Release:  Friday, January 6, 2017

Atlanta, GA – Congressional Republicans are making moves in coordination with  members of the incoming Trump Administration—including Trump’s pick to head HHS, Representative Tom Price—to dismantle the Affordable Care Act. As a surprise to no one, Republicans are short on details, but that hasn’t stopped Georgia Republicans from announcing the formation of a “’repeal Obamacare’ task force to guide how Georgia responds to President-elect Donald Trump’s plans, saying the effort was one of their top priorities for the upcoming legislative session.”

The GOP has also indicated their intentions to privatize Medicare and cut state funds for Medicaid—a move that would disproportionately harm seniors, persons with disabilities, and low-income Georgians.

“Obamacare, Medicare, and Medicaid are proven to work and often mean the difference between life and death to millions of Georgians. Why are Republicans more eager to use our tax dollars for a ludicrous wall than they are to protect the wellbeing of the people? This plan to rip away Georgians’ healthcare will create utter chaos and the GOP would be wise to shift their attention to solving real issues.” – Rebecca DeHart, Executive Director

THE FACTS:
U.S. Department of Health & Human Services – Impact of the Affordable Care Act in Georgia

Employer Coverage: 5,240,000 people in Georgia are covered through employer-sponsored health plans. Since the ACA was enacted in 2010, this group has seen:

• An end to annual and lifetime limits: Before the ACA, 3,317,000 Georgians with employer or individual market coverage had a lifetime limit on their insurance policy. That meant their coverage could end exactly when they needed it most. The ACA prohibits annual and lifetime limits on policies, so all Georgians with employer plans now have coverage that’s there when they need it.
• Young adults covered until age 26: An estimated 74,000 young adults in Georgia have benefited from the ACA provision that allows kids to stay on their parents’ health insurance up to age 26.
• Free preventive care: Under the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no extra cost to consumers. This provision benefits 4,187,077 people in Georgia, most of whom have employer coverage.
• Slower premium growth: The average premium for Georgia families with employer coverage grew 5.7 percent per year from 2010-2015, compared with 7.0 percent over the previous decade. Assuming Georgia premiums grew in line with the national average in 2016, family premiums in Georgia are $1,800 lower today than if growth had matched the pre-ACA decade.
• Better value through the 80/20 rule: Because of the ACA, health insurance companies must spend at least 80 cents of each premium dollar on health care or care improvements, rather than administrative costs like salaries or marketing, or else give consumers a refund. Georgians with employer coverage have received $25,641,050 in insurance refunds since 2012.

Medicaid: 1,782,301 people in Georgia are covered by Medicaid or the Children’s Health Insurance Program, including 1,253,841 children and 137,671 seniors and people with disabilities covered by both Medicaid and Medicare. The ACA expanded Medicaid eligibility and strengthened the program for those already eligible.

• 389,000 Georgians could gain coverage: An estimated 389,000 Georgians could have health insurance today if Georgia expanded Medicaid under the ACA. Coverage improves access to care, financial security, and health; expansion would result in an estimated 44,000 more Georgians getting all needed care, 55,300 fewer Georgians struggling to pay medical bills, and 470 avoided deaths each year.
• Up to 159,000 Georgians with a mental illness or substance use disorder could get help: 159,000 Georgians, or an estimated 25 percent of those who could gain Medicaid coverage through expansion, have a mental illness or substance use disorder.
• Georgia could be saving millions in uncompensated care costs: Instead of spending $410 million on uncompensated care, which increases costs for everyone, Georgia could be getting $3 billion in federal support to provide low-income adults with much needed care.
• Children, people with disabilities, and seniors can more easily access Medicaid coverage: The ACA streamlined Medicaid eligibility processes, eliminating hurdles so that vulnerable Georgians could more easily access and maintain coverage.
• Georgia is helping seniors and people with disabilities live in the community: The ACA provided Georgia with a new option to help promote community integration through long-term services and supports, providing seniors and people with disabilities an alternative to institutional care.

Individual market: 478,016 people in Georgia have coverage through the Marketplace. Individual market coverage is dramatically better compared to before the ACA:

• No discrimination based on pre-existing conditions: Up to 4,323,897 people in Georgia have a pre-existing health condition. Before the ACA, these Georgians could have been denied coverage or charged an exorbitant price if they needed individual market coverage. Now, health insurance companies cannot refuse coverage or charge people more because of pre-existing conditions.
• Tax credits available to help pay for coverage: Before the ACA, only those with employer coverage generally got tax benefits to help pay for health insurance. Now, 427,353 moderate- and middle-income Georgians receive tax credits averaging $291 per month to help them get covered through HealthCare.gov.
• Women pay the same as men: Before the ACA, women were often charged more than men just because of their gender. That is now illegal thanks to the ACA, protecting roughly half the people of Georgia.
• Greater transparency and choice: Before the ACA, it was virtually impossible for consumers to effectively compare insurance plan prices and shop for the best value. Thanks to the ACA, consumers can now shop for coverage on a transparent market, choosing among 32 plans on average.

Medicare: 1,574,058 people in Georgia are covered by Medicare. The ACA strengthened the Medicare Trust Fund, extending its life by over a decade. In addition, Medicare enrollees have benefited from:

• Lower costs for prescription drugs: Because the ACA is closing the prescription drug donut hole, 141,609 Georgia seniors are saving $149 million on drugs in 2015, an average of $1,051 per beneficiary.
• Free preventive services: The ACA added coverage of an annual wellness visit and eliminated cost-sharing for recommended preventive services such as cancer screenings. In 2015, 751,478 Georgia seniors, or 73 percent of all Georgia seniors enrolled in Medicare Part B, took advantage of at least one free preventive service.
• Fewer hospital mistakes: The ACA introduced new incentives for hospitals to avoid preventable patient harms and avoidable readmissions. Hospital readmissions for Georgia Medicare beneficiaries dropped 7 percent between 2010 and 2015, which translates into 2,453 times Georgia Medicare beneficiaries avoided an unnecessary return to the hospital in 2015.
• More coordinated care: The ACA encouraged groups of doctors, hospitals, and other health care providers to come together to provide coordinated high-quality care to the Medicare patients they serve. 19 Accountable Care Organizations (ACOs) in Georgia now offer Medicare beneficiaries the opportunity to receive higher quality, more coordinated care.

Center on Budget and Policy Priorities – Impact of Affordable Care Act Repeal

1 million fewer people in Georgia would have health insurance in 2019 if the Affordable Care Act (ACA) is repealed, new Urban Institute estimates show. Republican policymakers plan to move quickly in January to repeal much of the health reform law without enacting a replacement.

Under Repeal, Georgia Would Lose $32.7 Billion in Federal Funding and Pay More in Uncompensated Care Costs

States would lose significant federal funds as marketplace subsidies and the Medicaid expansion end. Even states that didn’t expand Medicaid would see declines in federal spending as eligible people fall of the program. In Georgia, repeal means the loss of $1.8 billion in federal marketplace spending in 2019 and $20.5 billion between 2019 and 2028. Georgia would lose $953 million in federal Medicaid funding in 2019 and $12.2 billion between 2019 and 2028.

In addition, the growth in the number of uninsured residents would increase demand for uncompensated care by $1.1 trillion nationwide between 2019 and 2028. Assuming fixed federal spending on uncompensated care, state and local governments and health care providers would have to bear this cost.

Eliminating Marketplace Subsidies and Reducing Medicaid Enrollment Would Hit Low- and Moderate-Income Families

Moderate-income working families in Georgia would lose substantial financial assistance that is now available to help them pay their premiums and cost-sharing for insurance purchased in a marketplace. In 2016, Georgians who enrolled in marketplace coverage receive an average advance premium tax credit of $287, which covers 75% of the total monthly premium for comprehensive coverage.

In addition, nearly 220,900 more Georgia residents have enrolled in Medicaid since 2013 – coverage gains that likely would be lost due to the elimination of the Medicaid expansion for low-income adults.

Harmful Effects Would Be Felt Immediately

Repeal would destabilize the non-group insurance market beginning in 2017 as a combination of several factors — pending loss of subsidies, elimination of the requirement to buy insurance, and the requirement on insurers to sell to all purchasers — would cause prices to rise and the healthiest people to drop coverage. Nationwide, 4.3 million people would lose insurance right away, rising to 7.3 million by 2019.

###