Why Representative Thompson Should Vote No on the Health Care Bill

Marc Stier |

Rep. Glenn Thompson’s Background, Consequences for Constituents Are Reasons to Vote “No” on GOP Health Care Bill

Given his personal history in human services, and the demographic makeup of the 5th Congressional district, Congressman Glenn Thompson has long been an advocate for older Pennsylvanians – not just seniors but those in the 55 to 65 age bracket as well.

And that must make the upcoming vote on the Republican replacement of the ACA so difficult. As a loyal Republican, Thompson has reason to support it. But the bill is, in many ways, terrible for older Pennsylvanians, including many of his constituents in the 5th district. So the concerns of his district and his own history very much point in the other direction.

The threat to seniors and near-seniors come from a number of directions.

To begin with the threat to seniors: the per-capita cap  Medicaid expenditures will cost Pennsylvania $18 billion over ten years. This cut will force the state to reduce expenditures for long-term care under our medical assistance program. Nursing homes, like those Representative Thompson once managed, will see their reimbursements reduced. Many seniors will find themselves unable to secure affordable long-term care.

The problems for Pennsylvanians 50 to 65 begin with the Republican plan’s subsidies to purchase insurance on the health care exchanges, which are far inferior to those in in the ACA. According to Kaiser Foundation data, In the 16 counties of the 5th Congressional District, a 60 year old couple with an income of $40,000 would receive a subsidy that is $7,566 less under the GOP plan than under the ACA. A 60 year old couple with an income of $50,000 would receive $5,786 less. A 60 year old individual with an income of $30,000 would receive $3,095 less while one with an income of $40,000 would receive $1,495 less.

Revisions made to the Republican plan in late March added a $85 billion fund to lower premiums for people aged 50 to 64. There are rumors that members of Congress have been promised that this amount will be increased to $130 billion. But, there is still no guarantee that these funds will be appropriated. And rough estimates drawing on work by the Center for America Progress suggest that even $130 billion isn’t enough money to compensate for the reduction in subsidies. Indeed, even if we assume there are no other changes in the law, a $130 billion fund would only compensate for half of the subsidy reductions. And that fund can’t compensate at all for other changes in the health care law that increase insurance premiums for those 50 to 65.

The March Republican proposal called for two changes that will lead to higher costs for near-seniors. It raises the age rating ratio to 5:1, allowing the premiums charged to near-seniors to be five times those charged to younger, healthier people, instead of the ACA’s ratio of 3:1. And it abolishes the ACA’s rules on the minimum actuarial value of health insurance plans, which limit the costs of deductibles and co-pays. The result is that the health insurance plans under the GOP proposal will not only be subsidized at lower rates, but both premiums and out of pocket costs will be higher.

If this were not bad enough, the changes to the GOP plan in the MacArthur amendment allow states to opt-out of ACA regulations that were specifically designed to protect those in the 50 to 64 bracket. It allows states seek waviers for the rules that:

  • limit the costs of insurance premiums for older Americans to five times that of younger Americans. (The ACA sets this ratio as 3 to 1.)
  • prohibit insurance companies from charging people with pre-existing medical conditions more.
  • require insurance companies to provide essential benefits in all policies.

If Pennsylvania were to opt out of all three rules, near-seniors now protected by the ACA will face a health care disaster. If the age ratio limitation is eliminated, premiums for those in the 50 to 65 age range will shoot  up even more than predicted. If the prohibition on charging people with pre-existing conditions more is lifted, the burden of higher premiums will also fall on this age group. And if the essential benefits provision is lifted, insurance companies will again be allowed to offer people in this age group insurance that excludes their pre-existing conditions.

We expect that Representative Thompson is as concerned about these implications of the Republican health care plan as we are. And we urge you to contact his office to tell him that you share that concern and want him to put Republican unity aside and vote to support his constituents in the 5th district.