Last week, the Republican Senate released a dreadful response to the House Republicans failed attempt to repeal & replace Obamacare.

Their response was the Better Care Reconciliation Act (BCRA) — which had far less to do with healthcare than it did tax cuts for the wealthy — and promoted nothing short of disaster for individuals throughout the country who are dependent on Medicaid.
Prior to the nonpartisan Congressional Budget Office’s estimates that 22 million more people would be uninsured in 2026 under this new bill, the outcry against this legislation was enormous — and for good reason.

The BCRA is not a solution to our health care challenges – and here’s why:

It phases out Medicaid.

Beyond the information you can see in our chart to the left, the BCRA takes an axe to the safety net provided to low income earners through Medicaid by phasing it out in 2021.

Under the Affordable Care Act (ACA), millions of low income Americans were able to receive coverage. Under the senate’s plan, millions stand to lose it. Also, the generous funding provided by the federal government to states that entered Medicaid expansion will begin to decrease around this time. New states will not be able to enter into the expansion and other states that were early adopters of it may be forced to drop out.

Smaller Subsidies for Less Generous Plans + Higher Deductibles

Under the ACA, individuals who earned less than 400% of the federal poverty line were eligible for assistance. The new bill raises this bar to 350%, which means that fewer people will be eligible for help.

The Affordable Care Act ensured that individuals living under the 400% threshold would not spend more then 9.7% of their individual income on insurance. Under the Senate’s plan, a 60 year old who earns $35,640 (300% of the federal poverty line) would spend 16.2% of their income.

This effort would ultimately lead to less generous insurance at a higher cost which may mean more co-pays and higher deductibles.

Then there’s the replacement of the individual mandate — which was one of the most controversial parts of the Affordable Care Act. Through their proposal, the Republican Senate opted to do away with the mandate (which was designed to keep premiums low) and replaced it with a six-month waiting period for anyone who has gone without insurance for over 63 days. So, should you get sick after not maintaining your health insurance, you will not be able to enroll in a new plan until six months passes from the day you file for new coverage.

But guess what doesn’t wait in a penalty box? A disease. So this punitive measure will likely cost lives.

Lastly, this plan focuses heavily on tax cuts for the wealthy. The Senate bill contains many of the tax breaks that were included in an earlier person of the health bill passed by the House. That bill included an estimated $33 billion in tax breaks from the 400 highest income earners — which nearly amounts to the federal costs of Medicaid expansion in Arkansas, Nevada, West Virginia, and Alaska combined.

Impact on Arkansas

Earlier today, Arkansas Advocates for Children & Families outlined ten reasons why the Senate health reform bill is dangerous for Arkansas.

We’d like to highlight some of their points:

  • The bill will strain the state budget. The proposed cuts to the Medicaid program will only shift costs to the state. Recent estimates show that in Arkansas we would lose $300 billion dollars over the next decade.* This cost shift would create a large hole in the state budget, since Medicaid dollars account for over 64 percent of federal dollars in the Arkansas budget. We would have to raise taxes, cover fewer children and families, pay for fewer services, or cut payments to health care providers.
  • The bill ends the Arkansas Works program. Over 300,000 adults are enrolled in the state’s Arkansas Works program, which is the state’s Medicaid expansion program for individuals earning low incomes. The program is funded with Medicaid expansion dollars, which would eventually end, resulting in tens of thousands of Arkansans losing coverage, access to care, and financial security.
  • The bill endangers rural hospitals, health providers, and families. Children and families in largely rural states, like Arkansas, will be more at risk of losing coverage than families in urban areas. Over 60 percent of children in rural Arkansas rely on Medicaid to provide a consistent source of health coverage, and half of adults enrolled in Arkansas Works live in rural areas. Rural hospitals will also bear the financial burden of these proposed cuts because they are more likely to serve more low-income, elderly, and chronically ill Arkansans.

The people of Arkansas deserve better than this.

So, where are we now?

As of today, there will note be a vote on this bill before the July 4th holiday — but this doesn’t mean we stop responding.
Senator Tom Cotton and Senator John Boozman need to hear from you.

Call them. E-mail them.

Do not let your voice go unheard. The time has come for these two men to choose between D.C. politics and what’s best for the people they serve.

Senator John Boozman

(202) 224-2353 (D.C.)
(479) 751-0879 (Springdale)

Senator Tom Cotton

(202) 224-4843 (D.C.)
(501) 372-7153 (Little Rock)