NYAPRS Note: The U.S. Senate's version of the American Health Care Act would cost New York's Medicaid program billions of dollars over the next decade, putting Albany in the position of having to choose between raising taxes or cutting services and programs for hundreds of thousands. The bill, which is certain to change before coming to a vote, would also upend New York's individual health insurance market, likely saddling many with higher deductibles and more expensive premiums.
WHAT YOU NEED TO KNOW:
— The state's Essential Plan, which enrolls nearly 700,000 New Yorkers in low-cost health insurance plans, likely would not survive because it relies on federal funding that would disappear.
— The Senate bill includes an amendment sponsored by Reps. John Faso and Chris Collins that would effectively prohibit the state from using county taxes to pay for the Medicaid program. That is expected to shift roughly $2.3 billion from county budgets to the state budget, and though it may ease the property tax burden in upstate New York, it will do nothing to ease the budget woes facing Albany in 2019.
— The more severe Medicaid cuts would hit between 2020 and 2024, according to the Senate bill, which phases out the enhanced federal match states such as New York received from the federal government because of Obamacare. In its place, there would be a per-capita cap assigned to each state. The per-capita cap would be based on what a state spent between 2014 and 2017, but high-cost states such as New York would see their per capita reduced by the secretary of Health and Human Services by as much as 2 percent.
— Shoppers on the individual insurance market would see the value of their subsidies decrease.
The Senate's version is also worse for New York hospitals compared to the House version, according to the Greater New York Hospital Association, which pointed out that the House bill repeals the cuts to the Disproportionate Share Hospital program for Medicaid expansion states in 2020. The Senate does not, costing hospitals billions of dollars.
"It's every bit as bad as the House bill. In some ways, it's even worse," Senate Minority Leader Chuck Schumer said Thursday on the floor of the Senate. "The president said the Senate bill needed heart. The way this bill cuts health care is heartless. The president said the House bill was mean. The Senate bill may be meaner."