Immediate threats to healthcare coverage

October 11, 2017


Despite the best efforts of many of the House and Senate Republicans, the effort to repeal/replace the ACA (“Obamacare”) that would have decimated federal Medicaid funding has failed — not once, but twice. However, the House has just passed a draft budget that is yet another threat to this critical healthcare funding.

  • The $4.1 trillion budget proposes cuts of $1 trillion to Medicaid over the next decade[1]
  • Nearly 70 million Americans – over 20 percent of the population – were enrolled in Medicaid as of July 2017[2]

Children’s health insurance funding

CHIP – Funding for the Children’s Health Insurance Plan funding expired at the end of September when Congress failed to reauthorize the program. The program has long been bipartisan with little debate; yet, Congress has yet to find a legislative vehicle through which to reauthorize funding.

  • 9 million lower- and middle-income American children are covered under CHIP
  • 11 states will run out of CHIP funding by the end of 2017 if the program is not reauthorized
  • New York will run out of CHIP funding in February or March of 2018
  • In New York, nearly 700,000 children were enrolled in CHIP in 2016

Safety net hospitals

DSH – The Disproportionate Share Hospital program provides much-needed funding to safety-net hospitals to subsidize the costs they incur for providing healthcare to low-income or uninsured patients. Now, the Centers for Medicare and Medicaid (CMS) is threatening to cut the funding by $43 billion over the next eight years.

  • DSH cuts would result in a loss of $1.1 billion in funding for New York State hospitals over the next 18 months
  • New York City’s public health system, Health + Hospitals – which serves 1.2 million patients – would lose $380 billion in funding
  • Congress has yet to provide a way to postpone these funding cuts to DSH

Coverage for low-income Americans

CSRs – Cost-sharing reduction payments are payments made by the federal government to health insurers to offset the cost of covering lower-income Americans. Without them, insurers may raise premiums, or exit the marketplace altogether. The Trump Administration is making these payments on a month-by-month basis, with no guarantee that the payments will continue — throwing the insurance market into chaos.

  • Health insurers have already cited the uncertainty of CSR payments as a reason to raise premiums[3]
  • If CSR payments were halted, federal deficits would increase by $6 billion in 2018 to $26 billion in 2026[4]
  • 6 million Americans who benefit from these CSRs would be affected[5]