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Vice President Mike Pence encourages Senate to 'repeal and replace' ACA in latest interview

Posted at 11:33 AM, Jul 21, 2017
and last updated 2017-07-23 19:16:15-04

CINCINNATI -- Vice President Mike Pence encouraged the Senate to "repeal and replace" the Affordable Care Act in an interview in Ohio Friday evening. 

Pence spoke from Washington to WCPO about the Republican party's mission to repeal the Affordable Care Act -- commonly known as Obamacare -- and the latest roadblocks that have plagued the Senate's proposed health care bills. 

"It's in the hands of the Senate now and we have to see the Senate being willing to step up," Pence said.

The vice president also said that Senate Democrats "have refused to lift a finger" to change a law. He called on senators to "do their job."

Pence claimed the bill would help combat the opiate abuse epidemic, saying that "help is on the way." However, the Associated Press has reported that the bill would cut opioid funding and could hit hard in states deeply affected by the addiction crisis.

According to Pence, one of the reasons to repeal and replace the Affordable Care Act is that premiums have risen "by more than 75 percent in Ohio." However, the Washington Post reported that the report cited by Pence does not take into account tax credits, which have protected most people from premium hikes.

After learning the Senate GOP's latest bill did not have the votes, Pence said Tuesday that he and President Donald Trump stand behind a new plan to repeal the health care plan now and replace it later.

"The Senate should vote to repeal now and replace later or return to the legislation carefully created in the House and the Senate. But either way, inaction is not an option," Pence said. "Congress needs to step up, Congress needs to do their job and Congress needs to do their job now."

The House passed its version of an Obamacare repeal bill in May. That legislation would leave 23 million fewer Americans with health insurance by 2026 than under the Affordable Care Act, according to the nonpartisan Congressional Budget Office. 

Breakdown of Senate GOP's repeal and replace bill

Senate Majority Leader Mitch McConnell has said the Senate bill does not have the support to pass, but it is worth explaining how that bill could affect healthcare for millions of Americans. 

The largest savings in that Senate bill would come from reducing federal spending on Medicaid, which would decline by 26 percent by 2026, compared to current law. Like the House plan, the Senate's version would end enhanced funding for Medicaid expansion, though at a slower pace, while overhauling the entire Medicaid program.

Federal spending on Medicaid would be reduced by $772 billion over the next 10 years, compared to current funding levels. Some 15 million fewer Americans would be covered by Medicaid in 2026 -- a deeper cut than under the House bill.

Also, senators would eliminate the mandates that require nearly all Americans to have coverage and companies with more than 50 workers to provide health benefits.

And it would jettison Obamacare's taxes on the wealthy, insurers and others. These provisions, along with some others in the bill, would increase deficits by a net $541 billion, the CBO found. The costliest among them: the repeal of the 3.8 percent net investment tax on rich Americans, which would reduce revenue by $172.2 billion.

However, the Senate bill would maintain much of Obamacare's subsidy structure to help people pay for individual coverage, but make it less generous, particularly for older enrollees. The federal government would spend $424 billion less on these subsidies under the Senate bill, compared to under Obamacare.

And senators would keep more of Obamacare's insurance regulations than the House legislation, while allowing insurers to charge more to older policyholders.

The Senate version also provides funds to stabilize the Obamacare market over the next few years, including money for a key set of subsidies for insurers.

CBO found that premiums would likely rise next year and the year after under the Senate bill, but would fall after that. In 2020, the average premium for the benchmark plan would be about 30 percent lower than under current law, mainly because those policies would cover fewer benefits -- and come with much higher deductibles -- and because insurers would receive federal funds designed to lower rates.

By 2026, average premiums would be about 20 percent lower. The decrease would be less than in 2020 mainly because of a reduction in the federal stabilization funding.

Older and lower-income enrollees would be hit harder by the GOP plan, the CBO analysis found. A 64-year-old with an income of $56,800 would pay $6,800 for a silver plan under current law. But that consumer would pay $20,500 for such a plan under the Senate bill.

A person making $26,500 would pay more for coverage under the Senate law at ages 21, 40 and 64.

Who would pay less? A 21-year-old and a 40-year-old earning $56,800 a year.

Also, CBO found that those with annual incomes below the poverty line in states that didn't expand Medicaid would get hefty subsidies under the Senate plan, unlike under Obamacare. They would only have to pay a few hundred dollars a year for coverage. However, experts say it would be unlikely that these folks would buy coverage since the deductibles would be thousands of dollars a year.

Overall, enrollees in the individual market would have to pay a lot more for health care services, particularly in states that seek waivers from Obamacare's insurance regulations. The federal subsidies would be pegged to plans that only pick up 58% of costs, on average, roughly comparable to an Obamacare bronze plan. This year, bronze plans have deductibles of about $6,000.

But Obamacare's subsidies are tied to silver plans, which cover about 70% of costs and have deductibles of about $3,600 this year.

The individual market would be stable in most areas of the country under the Senate plan, the CBO projected. The legislation's premium subsidies and stabilization funds would help keep rates low enough to attract healthy enrollees.

In analyzing the House bill, the CBO estimated that the market would be stable under current law, but could break down in states that seek extensive waivers from Obamacare rules.

A total of 49 million people would be uninsured in 2026 under the Senate bill, compared with 28 million who would lack coverage under current law. This would reverse years of coverage gains under Obamacare.

The Associated Press and CNN contributed to this report.