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Update on Senate Health Reform Bill and AMA Polling Results



The American Medical Association(AMA) released the results of seven public opinion polls of registered voters in states that will be pivotal in determining the outcome of pending health reform legislation in the Senate (Alaska, Arkansas, Colorado, Nevada, Ohio, Tennessee, and West Virginia). Six of the seven polls were conducted by Public Opinion Strategies, which is the firm that conducts polls for the Wall Street Journal and NBC News. The West Virginia poll was conducted by Jan van Lohuizen.   

Voters expressed substantial opposition to key elements of the House passed legislation, as well as to ideas that have been discussed in the Senate.  The most consistent finding is broad support for the Medicaid program, which voters do not want to see cut.  While there is significant support for making it easier to sell insurance across state lines, voters hold little enthusiasm for catastrophic or other plans with high cost sharing.  

Here is a national press release and a slide deck that summarize the poll findings.

Also attached is a revised summary of the Senate version of the health system reform legislation, known as the Better Care Reconciliation Act of 2017, or BCRA (H.R. 1628).  The most significant change made to the bill is a new section 206 that is intended to stabilize the individual insurance market by providing an incentive for healthy individuals to maintain coverage.  As an alternative to the individual mandate, the new section would impose a six-month waiting period when purchasing insurance for individuals whose coverage lapsed for 63 days or more during the previous 12 months.

Finally, the Congressional Budget Office released its estimate of the spending and coverage impact of BCRA as revised on June 26.  Among the key findings:

  • The number of uninsured would increase by 22 million in 2026 relative to current law, for a total of 49 million.
  • In 2018, about 15 million more people would be uninsured, primarily due to elimination of the individual mandate.
  • Average premiums would increase in the nongroup market prior to 2020 compared to current law; after that, premiums are projected to be relatively lower, largely due to the reduced actuarial value of the benchmark plans, which will cover a smaller share of health care services than under current law.  CBO estimates that fewer low-income people will purchase plans starting in 2020, despite being eligible for premium tax credits, due to higher deductibles and copayments.
  • The deficit would be reduced by $321 billion, largely due reductions in Medicaid spending (-$772 billion) and changes in the Affordable Care Act’s low-income subsidies (-408 billion), offset by repealed or modified tax provisions ($541 billion) and reduced collection of penalty payments ($210 billion).

The Senate still plans on voting on the legislation this week, with floor debate beginning as early as tomorrow.  Other refinements to the legislation may still be made to help secure sufficient votes for passage.

Source: American Medical Association



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