Republican Health Care Plan

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Republicans in Congress have released their plan to replace the Affordable Care Act. Swapna Reddy, a professor at Arizona State University’s School for the Science of Health Care Delivery, College of Health Solutions, will give us the highlights.

TED: GOOD EVENING AND WELCOME TO "ARIZONA HORIZON." I'M TED SIMONS. REPUBLICANS TODAY RELEASED A PLAN TO FORMALLY REPEAL THE AFFORDABLE CARE ACT AND REPLACE IT WITH A DIFFERENT HEALTH CARE PLAN. HERE IS SWAPNA REDDY. GOOD TO SEE YOU AGAIN.

SWAPNA REDDY: THANKS FOR HAVING ME.

TED: IS THIS A BIG CHANGE? IS IT OBAMACARE LIGHT? I'M HEARING PEOPLE SAYING BOTH?

SWAPNA REDDY: WELL, IT'S A A LITTLE BIT OF BOTH AND IT KIND OF DEPENDS ON THE POPULATION THAT YOU'RE SPEAKING OUT. IT'S THE AMERICAN HEALTH CARE ACT, AHCA. IN MANY WAYS, IT'S NOT THAT MUCH OF A REPEAL OF THE AFFORDABLE CARE ACT. THE AFFORDABLE CARE ACT HAS TEN TITLES AND ALL BUT THREE HAVE BEEN LEFT UP TOUCHED VIRTUALLY. WHAT IT IS A REALLY BIG CHANGE FOR IS OUR MEDICAID PROGRAM AND PROGRAMS THAT AFFECT LOW INCOME INDIVIDUALS.

TED: I'LL GET TO THAT IN A SECOND BECAUSE THAT'S A BIG DEAL HERE IN ARIZONA. CAN STAY ON PARENTS' UNTIL 26, CAN'T DENY PREEXISTING PROVISIONS.

SWAPNA REDDY: THEY'RE POPULAR PROVISIONS AND MOST AMERICANS LIKE THEM. THE AHCA HAS KEPT THEM IN.

TED: NOW, MEDICAID. MEDICAID EXPANSION IN ARIZONA WAS A BIG FIGHT. WE GOT IT DONE, AT LEAST THE STATE GOT IT DONE. HOW ARE WE AFFECTED BY THIS?

SWAPNA REDDY: WE HAVE AROUND 400,000 PEOPLE IN ARIZONA THAT HAVE GAINED MEDICAID COVERAGE THROUGH THE EXPANSION. ACCORDING TO THIS NEW AHCA BILL, WE WOULD REALLY BE CHANGING OUR NATIONAL MEDICAID SYSTEM FROM AN ENTITLEMENT PROGRAM TO MORE OF A PER CAPITA PROGRAM. IT DRASTICALLY SHIFTS THE WAY WE LOOK AT MEDICAID AND THE SAFETY NET.

TED: WE DON'T GET THAT BLANKET SUM ANYMORE. WE GET MONEY PER HOW MANY ENROLLEES.

SWAPNA REDDY: AND DOESN'T NECESSARILY COVER EVERYBODY THAT'S CURRENTLY COVERED IN MEDICAID ANYMORE, EITHER. THE OTHER THING THAT'S IMPORTANT TO KNOW IS IN 2020, STATES WILL NOT CONTINUE TO EXPAND THEIR MEDICAID PROGRAM. FOLKS ALREADY ON MEDICAID THROUGH THE EXPANSION -- THROUGH THEIR STATE EXPANSION CAN CONTINUE ON IF THEY CONTINUE TO BE ELIGIBLE.

TED: BUT 2020 IS A DIVIDING LINE. AND A GROWING STATE LIKE ARIZONA, MORE PEOPLE ARE GOING TO COME IN HERE. NO CHANCE OF THEM GETTING FEDERAL ASSISTANCE.

SWAPNA REDDY: THERE'S A MAJOR ROLLBACK IN FEDERAL ASSISTANCE FOR THE MEDICAID PROGRAM.

TED: WHAT DOES THAT MEAN FOR THE STATE? WHAT ARE THE OPTIONS?

SWAPNA REDDY: WE'RE STILL FIGURING IT OUT. ONE THING THAT'S REALLY IMPORTANT TO KNOW ABOUT THE BILL, CONGRESSIONAL BUDGET OFFICE IS IN CHARGE OF RATING BILLS. SO WE DON'T REALLY HAVE A DEFINITIVE ANSWER ON HOW MANY PEOPLE ARE GOING TO LOSE COVERAGE OR GAIN COVERAGE OR IF IT'S A SAVINGS OR IS GOING TO COST THE COUNTRY MONEY. THE HOUSE IS PLANNING ON STARTING TO MARKUP THE BILLS TOMORROW. THERE'S ALSO $100 MILLION THAT THE BILL HAS PLANNED TO GIVE OUT TO STATES TO USE AS THEY CHOOSE TO COVER HIGH-NEED POPULATIONS OR COVER KIND OF GAPS IN CARE. IT'S REALLY UP TO THE STATES HOW THEY USE THAT. WE'LL HOPEFULLY LEARN A LITTLE BIT MORE ABOUT THAT.

TED: WITH THAT BLOCK FUNDING AND THE PER CAPITA OF FUNDING TOGETHER, COULD THAT HANDLE WHAT ACCESS DOES NOW?

SWAPNA REDDY: IT'S HARD TO SAY. WE DON'T KNOW HOW THE PER CAPITA FUND SOMETHING ACTUALLY CALCULATED. WE HAVE A PARTICULARLY HIGH NEED POPULATION HERE IN ARIZONA. WE HAD LOTS OF UNINSURED PEOPLE IN ARIZONA BEFORE THE ACA. SO TONS JUMPED ON THE ROLES THAT NEEDED CARE. UNTIL WE HAVE A BETTER SENSE OF HOW IT'S GOING TO BE CALCULATED AND HOW MUCH MONEY WE WOULD ACTUALLY RECEIVE AND HOW WE COULD USE THOSE FUNDS, IT'S HARD TO SAY IF IT WOULD BE A BOON FOR ARIZONA.

TED: NO MORE TAX INCREASES ON THE WEALTHY?

SWAPNA REDDY: NO, THE WEALTHY ARE ACTUALLY GOING TO FARE QUITE WELL. IT'S NOT PARTICULARLY GENEROUS TO LOW INCOME INDIVIDUALS. AND PROBABLY WILL MAKE MARKETPLACE AFFORDABILITY MUCH MORE OF A CHALLENGE FOR LOW INCOME INDIVIDUALS. PRETTY FAIR TO MIDDLE INCOME AMERICANS AND QUITE GENEROUS TO HIGHER INCOME AMERICANS.

TED: NO MORE MANDATORY INSURANCE. HOW DOES THIS THING WORK?

SWAPNA REDDY: GOOD QUESTION. BUT, YES, THE ACA MANDATE WAS SOMETHING FAIRLY UNPOPULAR WITH THE AMERICAN PUBLIC. IT WAS SOMETHING THAT PRESIDENT TRUMP RAN HEAVILY ON REPEALING. THERE WILL NO LONGER BE A MANDATE. BUT IN ORDER TO HOPEFULLY STABILIZE THE INSURANCE MARKET, THE AHCA HAS PROPOSED CONTINUOUS COVERAGE AS A PROVISION. BASICALLY IF INDIVIDUALS DO NOT MAINTAIN COVERAGE FOR ABOUT A TWO-MONTH PERIOD, THEY'LL SEE A 30% INCREASE IN THEIR PREMIUM.

TED: INCENTIVE IS TO GET IN AND STAY IN AND DON'T BE JUMPING AROUND.

SWAPNA REDDY: ABSOLUTELY.

TED: I'M SURE WE'LL HEAR MUCH MORE ABOUT THIS. THANKS FOR JOINING US.

SWAPNA REDDY: THANK YOU.

Swapna Reddy; professor at Arizona State University's School for the Science of Health Care Delivery, College of Health Solutions

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