Tag Archives: insurance

Death by 1,000 cuts: How Republicans can still alter your health coverage

The Affordable Care Act’s worst enemies are now in charge of the vast range of health coverage it created. They’re also discussing changes that could affect a wider net of employment-based policies and Medicare coverage for seniors.

Republicans failed last month in their first attempt to repeal and replace the ACA. But President Donald Trump vows the effort will continue. Even if Congress does nothing, Trump has suggested he might sit by and “let Obamacare explode.”

Health insurance for the 20 million who benefited from the ACA’s expanded coverage is especially at risk. But they’re not the only ones potentially affected. Here’s how what’s going on in Washington might touch you.

A 3-year-old lawsuit threatens many plans. A suit by the Republican-led House challenges some subsidies supporting private plans sold to individuals and families through the ACA’s online marketplaces, also called exchanges. It has already gained one court victory. By many accounts, it would wreck the market if successful, stranding up to 12 million without coverage.

“It’s the single-biggest problem facing the exchanges,” said Rachel Sachs, a health law professor at Washington University in St. Louis. “That would make insurers not only exit tomorrow but also not want to offer plans in 2018.”

The litigation involves lesser-known ACA subsidies that reduce out-of-pocket costs such as copayments and deductibles for lower-income consumers. These are different from the law’s income-linked tax credits, which help pay for premiums.

Filed in 2014, when Barack Obama was president, the suit could backfire by politically harming the Republicans now in charge. House leaders have delayed the litigation and said they won’t drop the lawsuit but will continue the subsidies while it gets considered. The administration has not said how it plans to handle the lawsuit.

Policy confusion undermines coverage.

Even if Congress doesn’t repeal the ACA, the continuing battle makes insurance companies think twice about offering marketplace policies for next year. The less clarity carriers have about subsidies and whether the administration will promote 2018 enrollment, the likelier they are to bail or jack up premiums to cover themselves.

Preserving the subsidies, which limit out-of-pocket costs for lower-income consumers, “is essential,” said Kevin Lewis, CEO of Community Health Options, a nonprofit Maine insurer. “Markets don’t like uncertainty. The ‘sword of Damocles’ hanging over our collective heads is unsettling, to say the least.”

Democrats say Republicans are sabotaging Obamacare.

Shortly after taking power, Trump officials yanked advertising designed to maximize enrollment in marketplace plans just before a Jan. 31 deadline. It was partly restored after an outcry.

Then the administration said it would scrap an Obama-regime plan of rejecting tax returns from individuals who decline to say whether they had health insurance — weakening the requirement to be covered.

Trump aide Kellyanne Conway suggested in January the administration might entirely stop enforcing that requirement — the part of the law most hated by Republicans. If officials persist with that message, plans could attract even fewer of the young and healthy members whose premiums are needed to support the ill. That would cause more rising premiums and insurer exits.

“More mischief can be done,” said Dr. Peter Kongstvedt, a health industry consultant and senior faculty member at George Mason University. “It is absolutely possible that some markets will end up with no carriers unless a combination of state and federal government act to preserve the market” with taxpayer money.

Trump officials will move to roll back ACA coverage even if Congress doesn’t repeal.

Tom Price, secretary of the Department of Health and Human Services, has signaled his intent to reverse parts of the ACA through regulation even if Congress doesn’t repeal the law.

For example, Price couldn’t unilaterally eliminate coverage for birth control or maternity care, both of which many Republicans object to on moral grounds or because of cost. But birth control might no longer be free as a preventive benefit. Maybe the administration would let states limit the number of prenatal visits in maternity coverage. Perhaps more employers could gain religious exemption from providing birth control.

Medicaid coverage for low-income people could shrink.

Obamacare’s coverage expansion included government Medicaid coverage for folks with lower incomes. Thirty-one states and the District of Columbia expanded Medicaid to most adults with incomes below about $16,000 for singles and $28,000 for a family of three — although eligibility varies.

Republicans want to reduce the growth of Medicaid spending and give more control over the program to states. Discussions for a Medicaid overhaul focus on replacing ACA provisions with fixed, less-generous federal grants to states.

But even if the ACA survives, it’s likely the administration will give states more say in who gets Medicaid coverage and how much. Many Republicans favor work requirements for Medicaid recipients and raising out-of-pocket payments for patients.

Under the failed House replacement bill, the American Health Care Act, 9 million people in those states would have lost Medicaid coverage in 2020, estimated the nonpartisan Congressional Budget Office.

At the same time, however, Republican support for the ACA’s Medicaid expansion is growing, which might mean overall cutbacks would be less severe or Medicaid coverage could increase among the 19 states that didn’t expand the program under the ACA.

Some Republicans want to overhaul Medicare for seniors.

House Speaker Paul Ryan wants to restrain Medicare growth by giving members fixed, “premium support” payments to buy plans and possibly raise the age of eligibility. Both could lead to less coverage or greater out-of-pocket expense.

But the proposal wasn’t part of the Republicans’ replacement bill. Changing Medicare likely would trigger loud objections from AARP and other powerful lobbies. And Trump doesn’t seem inclined to back a change.

“I don’t think … Trump wants to meddle with Medicare or Social Security,” White House chief of staff Reince Priebus said in January.

Job-based coverage could become less generous.

Although ditching Obamacare would end the requirement for large employers to offer health insurance, most companies would keep their plans as a way to attract workers, analysts say.

But that coverage could become less generous. The ACA limits employer-plan members’ annual out-of-pocket cost and also prohibits caps on annual and lifetime benefits. At the same time, it prohibits waiting periods for covering a new worker’s preexisting illness.

Any replacement law signed by Trump might not include those protections.

Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.

ACLU files suit in Wisconsin over denial of coverage for transgender state employees

Wisconsin’s state university system and insurance board were sued on April 7. The claim from the national ACLU, ACLU of Wisconsin and volunteer attorneys from the law firm Hawks Quindel says the state refuses to provide gender-affirming health insurance coverage to employees who are transgender.

The suit was filed on behalf of Alina Boyden, a graduate student at the University of Wisconsin-Madison, and Shannon Andrews, a cancer researcher at the University of Wisconsin Medical School.

“The state continues to deny our clients coverage for medically necessary treatment simply because they are transgender, in violation of Title VII of the Civil Rights Act and the Equal Protection Clause of the Fourteenth Amendment,” stated John Knight, of the ACLU’s national Lesbian, Gay, Bisexual, Transgender and HIV Project. “All that transgender people like Alina and Shannon are asking for is to be treated like everyone else, and that includes respect and coverage for the health care you need.”

The Group Insurance Board approved coverage for such medically necessary care in July 2016, but under pressure from the state attorney general, voted in closed session to rescind these essential benefits in December.

The clients are two transgender state employees who filed challenges to the exclusion with the federal Equal Employment Opportunity Commission, and are now seeking relief in federal court.

“Many people can relate to paying into an insurance plan only to be told that the treatment they need is not covered,” Andrews stated.  “But when the reason you are denied coverage is because of who you are, it is even more painful. And it’s clearly discrimination.”

“Too many transgender people continue to face discrimination in all facets of life, including health care access, and so I felt compelled to stand up and try to do something about it,” said Boyden.

“The state should not be playing games with its transgender employees’ essential medical needs,” said Chris Ott, ACLU of Wisconsin executive director. “It has cruelly backtracked on its promise to provide access to care that the medical community agrees is necessary. Most people would hate to have the government make health care decisions for them. Our clients have experienced both, and it needs to stop.”

The legal team for the plaintiffs includes Larry Dupuis of the ACLU of Wisconsin, John Knight of the ACLU’s LGBT & HIV Project and Nick Fairweather and Mike Godbe of the law firm Hawks Quindel.

On the web

The complaint is online here.

National Day of Action for universal health care to take place April 8

As members of Congress return to their home districts for the spring recess, they will be greeted by a broad coalition of doctors, nurses, students and patients demanding “Improved Medicare For All,” a single-payer health plan that covers all Americans.

On April 8, participants in 43 cities — from New Hampshire to Hawaii and including Wisconsin — will hold marches, rallies, congressional office visits and “die-ins,” highlighting the urgent need for a national health program.

The  Day of Action was sparked by a renewed interest across the political spectrum in a single-payer, universal health program.

Participants will ask their representatives to sign on to H.R. 676, the Expanded and Improved Medicare for All Act.

Researchers estimate that replacing the Affordable Care Act with a streamlined, publicly financed single-payer health system like H.R. 676 would yield about $500 billion annually in administrative savings, enough to provide immediate coverage to the 26 million Americans who are currently uninsured, saving nearly 21,000 lives in year one.

The savings would also be sufficient to eliminate all copays and deductibles for those already insured. H.R. 676 currently has 90 co-sponsors, 21 of which signed on in the last two weeks.

In addition, U.S. Sen Bernie Sanders of Vermont has announced plans to introduce a single-payer health bill in the U.S. Senate.

“Republican attempts to strip millions of Americans of their health insurance have backfired,” said Dr. Carol Paris, a retired psychiatrist based in Nashville, Tennessee, and president of Physicians for a National Health Program, one of the groups participating in the April 8 Day of Action. “With the swift defeat of the GOP bill, a grassroots movement toward a universal, single-payer health program is growing. Now is the time.”

National Nurses United, which is also participating in the Day of Action, feels the same sense of urgency. “Nurses will never stop fighting until health care is guaranteed as a human right, not just as a privilege,” said the group’s co-president Deborah Burger, RN. “Nurses will be out in several states on April 8, calling for Medicare for all, canvassing for the single-payer bill we sponsored in California, SB 562, and making sure our elected officials hear the collective voice of the people, saying we want health care, not health insurance.”

Participating labor groups are fully on board with this message.

“To put it simply, health care is a damn human right,” said Cory Aaron, a member of the Brotherhood of Maintenance of Way Employees Division of the Teamsters union who was born in Jasper, Alabama, and now works for the BNSF Railroad near St. Louis. “Everyone should have the health care they need and we are only going to get it by standing together. That’s why my family and I are going to the action on Saturday.”

The Day of Action is coordinated by the Campaign for Guaranteed Healthcare, which includes Healthcare-NOW, Physicians for a National Health Program, Students for a National Health Program, National Nurses United, Progressive Democrats of America, Labor Campaign for Single Payer Healthcare, Our Revolution, the Brotherhood of Maintenance of Way Employees (Teamsters), American Student Medical Association (AMSA) and White Coats for Black Lives.

Detailed information and local contacts for each of the 43 participating cities can be found here here:

Berkeley, CA
Orange County, CA
Los Angeles, CA
Idyllwild, CA
Riverside, CA
West Covina, CA
Boulder, CO
Denver, CO
Washington, DC
Fort Lauderdale, FL
Jacksonville, FL
Naples, FL
St. Petersburg, FL
Tampa, FL
The Villages, FL (Central FL)
West Palm Beach, FL
Atlanta, GA
Honolulu, HI
Elgin, IL
Louisville, KY
Frederick, MD
Boston, MA
Pittsfield, MA
Minneapolis, MN
St. Louis, MO
Kansas City, MO
Las Vegas, NV
Concord, NH
Albuquerque, NM
New York, NY
Charlotte, NC
Greensboro, NC
Cleveland, OH
Dayton, OH
Toledo, OH
Roseburg, OR
Corvallis, OR
Philadelphia, PA
Memphis, TN
Austin, TX
Virginia Beach, VA
Seattle, WA
Fond du Lac, WI

‘We just pulled it’ Trump says after no vote on GOP health care plan

GOP House leaders pulled their health care bill from consideration on March 24 due to a shortage of votes despite desperate lobbying by the White House and its allies, dealing a big blow to President Donald Trump.

Republican leadership had planned a vote on the measure after Trump cut off negotiations with Republicans who had balked at the plan and issued an ultimatum to vote on Friday, win or lose.

Republican moderates as well as the most conservative lawmakers objected to the legislation. But the White House and House leaders were unable to come up with a plan that satisfied both moderates and conservatives.

Trump told the Washington Post: “We just pulled it.”

Amid a chaotic scramble for votes, House Speaker Paul Ryan, R-Wis., who has championed the bill, met with Trump at the White House before the measure was pulled from the House floor after hours of debate.

Trump told the Post the health care bill would not be coming up again in the near future and that he wanted to see if Democrats who uniformly objected to the Republican plan would come to him to work on health care legislation, a Washington Post reporter said on MSNBC.

For now, Barack Obama’s signature domestic policy achievement, the 2010 Affordable Care Act — known as Obamacare — will remain in place despite seven years of Republican promises to dismantle it.

Repealing and replacing Obamacare was a top campaign promise by Trump in the 2016 presidential election, as well as by most Republican candidates, “from dog-catcher on up,” as White House spokesman Sean Spicer put it during a briefing on Friday.

The House failure to pass the measure called into question Trump’s ability to get other key parts of his agenda, including tax cuts and a boost in infrastructure spending, through a Congress controlled by his own party.

Trump already has been stymied by federal courts that blocked his discriminatory executive actions barring entry into the United States of people from several Muslim-majority nations.

Now members of his own party worry the defeat on the health care legislation could cripple his presidency just two months after the billionaire real estate mogul took office.

In a blow to the bill’s prospects, House Appropriations Committee Chairman Rodney Frelinghuysen announced his opposition, expressing concern about reductions in coverage under the Medicaid insurance program for the poor and the retraction of “essential” health benefits that insurers must cover.

“We need to get this right for all Americans,” Frelinghuysen said.

Progressive groups overwhelmingly opposed the health care plan as offered by Ryan and the amendments intended to appease even more conservative members of his party.

House Speaker Paul Ryan departs following a meeting with President Trump at the White House. REUTERS/Carlos Barria

Move to dump essential benefits could strand chronically ill

A last-minute attempt by conservative Republicans to dump standards for health benefits in plans sold to individuals would probably lower the average consumer’s upfront insurance costs, such as premiums and deductibles, said experts on both sides of the debate to repeal and replace the Affordable Care Act.

But, they add, it will likely also induce insurers to offer much skimpier plans, potentially excluding the gravely ill, and putting consumers at greater financial risk if they need care.

For example, a woman who had elected not to have maternity coverage could face financial ruin from an unintended pregnancy. A healthy young man who didn’t buy drug coverage could be bankrupted if diagnosed with cancer requiring expensive prescription medicine. Someone needing emergency treatment at a non-network hospital might not be covered.

What might be desirable for business would leave patients vulnerable.

“What you don’t want if you’re an insurer is only sick people buying whatever product you have,” said Christopher Koller, president of the Milbank Memorial Fund and a former Rhode Island insurance commissioner. “So the way to get healthy people is to offer cheaper products designed for the healthy people.”

Such a change could give carriers wide room to do that by eliminating or shrinking “essential health benefits” including hospitalization, prescription drugs, mental health treatment and lab services from plan requirements — especially if state regulators don’t step in to fill the void, analysts said.

As part of the push by House GOP leaders to gain more support for their plan, they amended the bill Thursday  to allow states to decide, starting next year, what if any benefits  insurers must provide on the individual market, rather than requiring health plans to include the law’s essential health benefits, according to House Ways and Means Chairman Kevin Brady (R-Texas).

The Affordable Care Act requires companies selling coverage to individuals and families through online marketplaces to offer 10 essential benefits, which also include maternity, wellness and preventive services — plus emergency room treatment at all hospitals. Small-group plans offered by many small employers also must carry such benefits.

Conservative House Republicans want to exclude the rule from any replacement, arguing it drives up cost and stifles consumer choice.

On Thursday, President Donald Trump agreed after meeting with members of the conservative Freedom Caucus to leave it out of the measure under consideration, said White House Press Secretary Sean Spicer. “Part of the reason that premiums have spiked out of control is because under Obamacare, there were these mandated services that had to be included,” Spicer told reporters.

Pushed by Trump, House Republican leaders agreed late Thursday to a Friday vote on the bill but were still trying to line up support.

“Tomorrow we will show the American people that we will repeal and replace this broken law because it’s collapsing and it’s failing families,” said House Speaker Paul Ryan, R-Wis. “And tomorrow we’re proceeding.” When asked if he had the votes, Ryan didn’t answer and walked briskly away from the press corps.

But axing essential benefits could bring back the pre-ACA days when insurers avoided expensive patients by excluding services they needed, said Gary Claxton, a vice president and insurance expert at the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)

“They’re not going to offer benefits that attract people with chronic illness if they can help it,”said Claxton, whose collection of old insurance policies shows what the market looked like before.

One Aetna plan didn’t cover most mental health or addiction services — important to moderate Republicans as well as Democrats concerned about fighting the opioid crisis. Another Aetna plan didn’t cover any mental health treatment. A HealthNet plan didn’t cover outpatient rehabilitative services.

Before the ACA most individual plans didn’t include maternity coverage, either.

The House replacement bill could make individual coverage for the chronically ill even more scarce than a few years ago because it retains an ACA rule that forces plans to accept members with preexisting illness, analysts said.

Before President Barack Obama’s health overhaul, insurers could reject sick applicants or charge them higher premiums.

Lacking that ability under a Republican law but newly able to shrink benefits, insurers might be more tempted than ever to avoid covering expensive conditions. That way the sickest consumers wouldn’t even bother to apply.

“You could see even worse holes in the insurance package” than before the ACA, said Sabrina Corlette, a research professor at the Center on Health Insurance Reforms at Georgetown University. “If we’re going into a world where a carrier is going to have to accept all comers and they can’t charge them based on their health status, the benefit design becomes a much bigger deal” in how insurers keep the sick out of their plans, she said.

Michael Cannon, an analyst at the libertarian Cato Institute and a longtime Obamacare opponent, also believes dumping essential benefits while forcing insurers to accept all applicants at one “community” price would weaken coverage for chronically ill people.

“Getting rid of the essential health benefits in a community-rated market would cause coverage for the sick to get even worse than it is under current law,” he said. Republicans “are shooting themselves in the foot if they the offer this proposal.”

Cannon favors full repeal of the ACA, allowing insurers to charge higher premiums for more expensive patients and helping consumers pay for plans with tax-favored health savings accounts.

In an absence of federal requirements for benefits, existing state standards would become more important. Some states might move to upgrade required benefits in line with the ACA rules but others probably won’t, according to analysts.

“You’re going to have a lot of insurers in states trying to understand what existing laws they have in place,” Koller said. “It’s going to be really critical to see how quickly the states react. There are going to be some states that will not.”

Mary Agnes Carey and Phil Galewitz contributed to this story.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation. This is published here under a Creative Commons license.

American Medical Association urges defeat of House health care bill

Citing projections that millions of people would lose coverage if the American Health Care Act were to become law, the American Medical Association urged members of Congress to oppose the amended legislation.

The AMA, in a press statement, said it would continue working with Congress to increase the number of Americans with quality, affordable health insurance, but the bill, as currently drafted, pushes policy in the wrong direction.

The AMA is nation’s largest physician group.

“Health insurance coverage is critically important,” the AMA stated in a letter to House members. “Without it, millions of American families could be just one serious illness or accident away from losing their home, business, or life savings.

“The AMA has long supported the availability of advanceable and refundable tax credits, inversely related to income, as a means to assist individuals and families to purchase health insurance.  The credits proposed under the AHCA are significantly less generous for those with the greatest need than provided under current law.  The reduced purchasing power with the AHCA tax credits will put insurance coverage out of reach for millions of Americans.”

The letter continued: “We also remain deeply concerned with the reduction of federal support for the Medicaid program and the resulting significant loss of coverage.  Medicaid expansion has provided access to critical services, including mental health and substance abuse treatment, for millions.  Not only will the AHCA force many states to roll back coverage to these millions of previously ineligible individuals, but the significant reduction in federal support for the program will inevitably have serious implications for all Medicaid beneficiaries, including the elderly, disabled, children, and pregnant women, as well.”

The letter concluded: “We continue to stand ready to work with Congress on proposals that will increase the number of Americans with quality, affordable health insurance coverage but, for the reasons cited above, urge members to oppose the American Health Care Act.”

Last week, the AMA launched a new website, patientsbeforepolitics.org, aimed at encouraging physicians and patients to join the effort to increase access to affordable, meaningful coverage for all Americans.

The interactive site provides the information on health care legislation moving through Congress, as well as the AMA’s efforts to help “shape the future of U.S. health care.”

In January, the AMA released its health system reform objectives — primary among them that people who currently have insurance should not become uninsured — and shared them with members of Congress.

Mayo Clinic faces questions over CEO’s ‘prioritized’ patients remark

Mayo Clinic is facing questions from the state of Minnesota after its CEO told employees that if patient conditions are equal, its hospitals should prioritize privately insured patients over those under government-subsidized programs such as Medicaid.

John Noseworthy’s comments were made late last year in a videotaped speech to staff but surfaced only this week after a transcript of his speech was obtained by the Star Tribune newspaper.

The Mayo Clinic has verified the transcript is accurate.

Noseworthy said in a statement that medical need will always be the top factor in scheduling an appointment.

“In an internal discussion I used the word ‘prioritized’ and I regret this has caused concerns that Mayo Clinic will not serve patients with government insurance. Nothing could be further from the truth,” he said, adding that the hospital is committed to serving patients with government insurance.

“Changing demographics, aging of Americans and budgetary pressures at state and federal government pose challenges to the fiscal sustainability in healthcare today,” he said. “While these discussions are uncomfortable, they are critical for us to be able to meet the needs of all of our patients.”

Minnesota Department of Human Services Commissioner Emily Piper said she was surprised and concerned by Noseworthy’s earlier comments and has questions about what they really mean and how Noseworthy’s directive would be carried out.

The department is looking into whether there are possible violations of civil and human rights laws.

The agency also is reviewing its contracts with Mayo Clinic to ensure the hospital is meeting its obligations to serve patients in public programs.

Last year, Noseworthy told staff that when Mayo Clinic has expertise that can’t be found elsewhere, it will always take patients, regardless of how they are paying for care.

“We’re asking. if the patient has commercial insurance, or they’re Medicaid or Medicare patients and they’re equal, that we prioritize the commercial insured patients enough so . we can be financially strong at the end of the year to continue to advance our mission,” Noseworthy said in the transcript.

Mayo Clinic spokeswoman Duska Anastasijevic said the speech stressed the need to increase privately insured patients, but not at the expense of government insured patients.

Mayo Clinic said about half of the services it provides go toward those enrolled in government programs. The clinic said it provided $629.7 million in care to people in need in 2016, including $546.4 million that wasn’t covered by Medicaid or other programs for the uninsured or underinsured.

The statement said that as Mayo’s percentage of publicly funded patients has grown, to now roughly 50 percent, the health system is working to increase commercially insured patients.

“To fund its research and education mission, Mayo needs to support its commercial insurance patient numbers in order to continue to subsidize the care of patients whose insurance does not cover the cost of their care,” the statement said.

Piper said Noseworthy’s statements do not reflect routine hospital practices and she found them to be troubling.

As Human Services commissioner, Piper is focused on ensuring access to health care for those enrolled in public programs. She said providers have to follow the law and uphold agreements to provide such care. She said that in her view, nothing that is happening with the health care law on the federal level changes those requirements.

“Health insurance coverage for health insurance coverage’s sake is not the end goal,” she said. “It’s access _ that’s what’s important.”

Anastasijevic said Minnesota Medicaid patients are and will continue to be scheduled the same as patients with commercial insurance.

WalletHub: Milwaukee in top 10 cities most affected by ‘Trumpcare’

Source: WalletHub

With the average health-insurance premium estimated to rise 15-20 percent in the next two years and federal tax credits expected to decrease under the recently proposed American Health Care Act, the personal-finance website WalletHub conducted an in-depth analysis of cities most affected by the GOP health plan, which it referred to as “TrumpCare.”

To gauge the impact of the Republican-proposed health plan on people who buy their own insurance, WalletHub’s analysts compared 457 U.S. cities based on the differences in premium subsidies that the average household would receive under “Obamacare” and “Trumpcare.”

The impact on Milwaukee:
 

  • Average Obamacare Premium Subsidy: $5,707
  • Average Trumpcare Premium Subsidy: $5,000
  • Subsidy Difference: -$707
  • Milwaukee ranks 78th most affected overall and 10th most affected among large cities.

On the web

https://wallethub.com/edu/cities-most-affected-by-trumpcare/33588/

Spring storm: Activists gathered outside Ryan’s Racine office to protest health care plan

About 250 people from Illinois and Wisconsin assembled outside House Speaker Paul Ryan’s office in Racine March 14 to demand he drop his health care repeal plan.

The demonstration took place days after the Congressional Budget Office’s analysis showed the House GOP health plan would cause 24 million Americans to lose their health coverage.

People from Fair Economy Illinois and the Jane Addams Senior Caucus joined with members of Citizen Action of Wisconsin — all People’s Action organizations — and with SEIU Healthcare Wisconsin and the Wisconsin Alliance for Retired Americans.

Protesters marched from Racine’s Monument Square on Main Street to Ryan’s office with cans of dog and cat food — the kind of lunch organizers say some seniors will have  if House Republicans pass their health plan is passed.

Outside the speaker’s office, people shared stories and fears of living without health insurance.

Reggie Griffin, of Chicago, is in his 70s and works as a home caregiver. He said he would be devastated by the defunding of Medicare because of chronic health conditions. “I want to live a life of dignity,” Griffin said, according to a news release from organizers of the protest. “There are some members of Congress, like Speaker Paul Ryan, who think I don’t deserve to live with dignity.”

“This is a huge test for our democracy, because the Republican repeal can’t survive once the people understand it’s true implications,” said Robert Kraig, executive director for Citizen Action of Wisconsin.

“This attack on seniors and families will devastate Midwest communities. It is irresponsible and ruthless,” added Anna Marin, manager of civic engagement for the Jane Addams Senior Caucus.

One of the speakers at yesterday’s action, Tammy Wolfgram, is a small business owner from Hartland.

Before the passage of the Affordable Care Act, Wolfgram, her husband and her daughter could not find any health insurance company that would sell them coverage because all three had pre-existing conditions.

She said they struggled to afford costly insurance with high deductibles on Wisconsin’s high-risk pool.

“If ACA is repealed, I don’t know what we will do,” Wolfgram said.

A report by the Congressional Budget Office released this week shows 14 million people will lose their insurance coverage by next year and 24 million by 2026.

“Anyone who believed GOP promises that people would still have health insurance under the Republican repeal plan now know that they were lied to; they are going to be left out in the cold,” said LeeAnn Hall, co-director of People’s Action and executive committee member of Health Care for America Now.

Deciphering CBO’s estimates on the Republicans’ health bill

The Congressional Budget Office is out with its estimate of what effects the Republican health bill, “The American Health Care Act,” would have on the nation’s health care system and how much it would cost the federal government.

The GOP plan is designed to partially repeal and replace the Affordable Care Act passed during the Obama administration.

Here are some of the CBO highlights:

• $337 billion reduction in the deficit. That’s CBO’s estimate over the next decade, taking into account both decreased government spending in the form of less help to individuals to purchase insurance and lower payments to states for the Medicaid program. It also includes decreased revenue from the repeal of the taxes imposed by the ACA to pay for the new benefits.

• 24 million more people without insurance in a decade. The federal budget experts estimate that people will lose insurance and that the drop will kick in quickly. In 2018, they say 14 million more people would join the ranks of the uninsured. It would reach the 24 million by 2026, when “an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.”

• 15 percent of Planned Parenthood clinic patients would “lose access to care.” These patients generally live in areas without other sources of medical care for low-income people. The Republican bill would cut out Medicaid funding for Planned Parenthood for a year.

• 15 to 20 percent increase in 2018 premiums, but relief would follow. Monthly costs for insurance would go up at first, due to the elimination of the requirement for most people to have insurance or else pay a tax penalty. After 2018, CBO estimates that average premiums would actually drop by 10 percent by 2026 compared to current law. That is because the lower prices for younger people would encourage more to sign up. By contrast, the law would “substantially [raise] premiums for older people.”

• 95 percent of people who are getting Medicaid through the health law’s expansion would lose that enhanced federal funding. The CBO estimates that only 5 percent of enrollees in the expansion program would remain eligible for the higher federal payments by 2024, since the bill would phase out those payments to states as patients cycle in and out of eligibility.

• 14 million fewer Medicaid enrollees by 2026. That’s 17 percent fewer than projected under current law. The projection includes people who are currently eligible and would lose coverage, as well as people who might have become eligible if more states, as expected, expanded coverage under the ACA. CBO projects that is unlikely to happen now.

• $880 billion drop in federal Medicaid spending over the decade. That comes primarily by imposing, for the first time, a cap on federal contributions to the program for those with low incomes.

Published under a Creative Commons license. Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.