The Republican Budget Risks Americans' Health

May 14, 2015

The Republican conference agreement on the budget repeals the Affordable Care Act (ACA), block-grants Medicaid, voucherizes Medicare, and puts public health at risk – all in the name of deficit reduction while refusing to cut a single special-interest tax break to reduce the deficit.

Takes away insurance from more than 16 million Americans – The budget repeals the ACA, despite the law's success in covering 16.4 million uninsured people and reducing the uninsured rate to the lowest level on record. The budget eliminates premium tax credits, reverses Medicaid expansions in 29 states and DC, kicks millions of young adults off their parents' plans, and allows insurers to deny coverage or charge higher premiums due to pre-existing conditions.

Harms children, seniors, and people with disabilities – The budget block-grants Medicaid and slashes funding by about $0.5 trillion over ten years. Block-granting undermines the safety net for 70 million Americans, including more than one in three children. The plan endangers seniors and people with disabilities who rely on Medicaid for long-term services like nursing home care. A Congressional Budget Office (CBO) analysis of this type of plan indicates that states may limit eligibility for Medicaid, scale back benefits, cut payment rates, or increase out-of-pocket costs.

Shifts health care costs onto current retirees The budget increases seniors' costs by repealing the ACA's Medicare benefit improvements, such as a provision that reduces prescription drug costs for millions of seniors. If Republicans had succeeded at one of their several attempts to repeal the law, nearly 5.1 million seniors and people with disabilities in Medicare would have paid an additional $4.8 billion – or an average of $941 per beneficiary – for their drugs in 2014.

Ends the Medicare guarantee for future retirees – The budget makes it the policy of the House to endorse a plan to shift the risks of growing health care costs onto seniors by converting Medicare into a program in which future enrollees receive a fixed premium-support payment (or voucher) toward the purchase of a private health plan or traditional Medicare. CBO analyses show that the only way these plans can ensure significant long-term federal Medicare savings is by markedly increasing costs to Medicare beneficiaries.

Disinvests in America's health and safety – The budget maintains sequester-level funding caps for 2016, cutting non-defense discretionary funding by $37.3 billion below the comparable President's request. If Republicans were to spread this cut proportionately based on their allocations for each appropriations bill, promising medical research and public health programs will be suspended. The Administration estimates that relative to the President's request for 2016, the Republican budget could mean 1,400 fewer National Institutes of Health grants.