Recently in Washington, Republicans introduced a bill to repeal and replace ObamaCare.
In a nutshell, the American Health Care Act (AHCA) introduces market principles and limits government in the way most conservatives have wanted.
The Congressional Budget Office, which evaluates legislation for revenue gains and losses, is projecting the AHCA to reduce government spending by more than $1 trillion; however, the CBO report also shows the legislation reducing federal revenue by nearly the same amount.
Specifically, the AHCA sets forth tax reform through refundable credits for people purchasing individual insurance, which is good news for most families who want to keep more of their own money. On the other hand, Medicaid is set to take the hardest hit from the AHCA’s provisions.
Administered by the states, Medicaid federally assists families with limited resources to pay for their health care, and it has been the government’s second largest entitlement program since it was enacted under LBJ in 1965.
Effectively, the AHCA reduces Medicaid by about 25 percent over the next 10 years and shifts the open-ended traditional formula for the program to a block grant-funded system. CBO estimates that, in combination with its other provisions, the legislation could wipe out health care services for up to 24 million people.
This could ultimately result in families paying more for those without access to health care; for example, emergency rooms in the Texas are required to accept patients regardless of their ability to pay, and someone has to pay Doctor Piper.
U.S. Senate Republican Whip and real life Texas Ranger John Cornyn took to the Twitter to defend the proposed “Ryancare,” as the AHCA authored under U.S. House Speaker Paul Ryan has come to be known:
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The No. 2 Senate Republican was referring to projected and very real effects of ObamaCare, and he even took some shots at the CBO’s evaluation of the AHCA:
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The momentum to repeal and replace ObamaCare with the AHCA has further propelled Cornyn to the same page as his junior counterpart Ted Cruz, who said he believes the bill is not perfect, but “can be fixed.”
Cruz is up for reelection next year, so it makes sense he would play to the conservatives who want ObamaCare gone by any means, regardless of the impacts, especially the individual mandate and the employer requirements.
Where the AHCA’s proposed changes start to become a problem is for those states that chose to expand Medicaid eligibility under ObamaCare. Not surprisingly, Texas did not, but the Legislature must still build a budget, a majority of which calls for specific dollar amounts for state health care programs.
The latest Texas budget consisted of about $36 billion in federal funds for health care, but this significant portion, accounting for about 16 percent of the total $216 billion state budget, is not guaranteed this time around, and state finance committee members in both the House and Senate are working on a solution to abate the threats impending doom.
One proposed solution is for the governor to call a special session after adjournment of regular business in June, but no one wants to work longer than they have to, especially since so many Texans are facially opposed to anything federally mandated or even loosely affiliated with President Obama.
This is why state legislators are also suggesting use of special budget riders to direct spending to avoid any extra work. The riders would specify how funds should be spent on a percentage basis, ultimately to be restated in dollar amounts once/if Washington Republicans get themselves together and funding levels are finalized under the AHCA.
Nothing has been decided or finalized in either capital at this time, and passing the riders would be an unprecedented move for the modern Texas Legislature, but stranger things have happened, and ‘tis the season or unconventionality.