For Seniors, Senate Health Care Bill Is Even Worse Than The House Version

The Senate health care bill released Thursday closely mirrors what the House narrowly approved in May. Some analysts called it a tempered version of the House bill which President Donald Trump called mean. But it nevertheless puts vulnerable seniors smack in its crosshairs, according to advocates for elderly people.

Actually, the Senate bill is even meaner than the House bill, Howard Bedlin, vice president for public policy and advocacy for the National Council on Aging , said in a phone interview.

Bedlin cited the Medicaid cuts and per-capita caps that would harm elderly people who rely on the program to pay for their long-term care. The Senate didnt stop the weakening of the Medicare Trust Fund that will result from the repeal of the payroll tax on wealthy Americans, nor did it change the so-called age tax that would dramatically increase out-of-pocket costs for older Americans in the form of higher premiums.

Over time, the Senate bill imposes even deeper cuts and caps on Medicaid than the House proposal, Bedlin said.

Here are a few reasons why the Senate measure is worse for seniors than what the House passed:

The Senate imposes deeper cuts to Medicaid, which pays for 65 percent of nursing home residents.

Medicare, the health care system for people 65 and older, does not pay for long-term nursing home stays. Most people enter a nursing home as a private-pay patient until they exhaust enough of their assets to qualify for Medicaid. For every $1 Medicaid spends on a poor child, it spends $5 for an elderly person in a nursing home.

Medicaid is the primary support for 65 percent of nursing home residents. It is literally the last resort for affording nursing homes, which easily can cost upward of $80,000 a year.

Under Obamacare, everyone who qualified for Medicaid of any age was guaranteed to get it. That would change under the GOPs plan. The House bill would let states decide who gets their health care needs met by Medicaid, and shrinks the total pot by a draconian $880 billion by 2026 .

The Senate bill follows that same course states would receive a lump sum per year, or a lump sum per enrollee, that would function as caps. But the Senate bill makes even deeper cuts to the program by tying federal spending to a slower growth index . The House measure tied it to medical inflation.

Under the House bill, the federal spending can increase only up to 4.7 percent each year (the Medical Consumer Price Index, plus 1 percent). Under the Senate bill, it can rise up to this same rate until 2025, when the capped growth rate drops forever to 2.4 percent (the Consumer Price Index), explained Bedlin.

The Senate bill also slows the introduction of these Medicaid cuts, pushing the deepest wounds to the elderly into the future. The changes wont fully kick in for seven years, which of course is long after the next Senate election. But make no mistake, said advocates for the elderly : When these changes to Medicaid fully kick in, they will pack a wallop.