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CBO Confirms: When It Comes to ‘Better Care,’ GOP Senators Don’t Count Reproductive Care (Updated)

Christine Grimaldi

“By gutting Medicaid, repealing significant insurance protections, defunding Planned Parenthood, and expanding harmful abortion coverage restrictions, it would devastate women and families," said Debra Ness, president of the National Partnership for Women and Families.

UPDATE, June 27, 4:07 p.m.: Senate Majority Leader Mitch McConnell (R-KY) on Tuesday delayed a vote on the chamber’s Obamacare repeal bill until after the July 4 recess. CNN reported that McConnell “is open to changes” to the bill and will obtain a new Congressional Budget Office estimate to reflect those changes. The delay gives McConnell and the White House more time to shore up fledgling GOP support, but growing public opposition could put an end to the momentum.

Republicans in the U.S. Senate have proposed an alternative to the Affordable Care Act that they claim would result in “better care”—the so-called Better Care Reconciliation Act.

But their plan would result in 22 million more people uninsured than under Obamacare over ten years, starting with 15 million people without coverage by next year, according to a hotly anticipated Congressional Budget Office (CBO) score out Monday afternoon. In their bill, Senate Republicans doubled down on anti-choice provisions that will prevent Medicaid patients from accessing potentially life-saving care at Planned Parenthood affiliates, including cancer screenings, sexually transmitted infection testing, and contraceptive services. And people with private insurance will face abortion restrictions that their counterparts on Medicaid have long experienced under the discriminatory Hyde Amendment.

The consequences of the Senate bill mirror those of the U.S. House of Representatives’ American Health Care Act, which would leave 23 million more people than under Obamacare uninsured over the same ten-year period.
CBO determined that just like the House version, the Senate’s bill “defunds” Planned Parenthood, and only Planned Parenthood, at the expense of poor and rural people who disproportionately rely on the health-care organization. That finding could provide more justification for the Senate parliamentarian, the arbiter of the chamber’s rules and procedures, to rule that targeting Planned Parenthood alone represents a partisan vendetta and violates the fast-track process Republicans are using to pass repeal with only a simple majority.

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As the report notes:

To the extent that access to care would be reduced under this legislation, services that help women avoid becoming pregnant would be affected. The people most likely to experience reduced access to care would probably reside in areas without other health care clinics or medical practitioners who serve low-income populations. CBO projects that about 15 percent of those people would lose access to care.

Beyond reproductive health care, the ability of Medicaid patients to access any health-care services in general will suffer. The largest portion of the Senate bill’s $320.9 billion in savings over ten years would come from cuts to the joint federal and state program for people with low incomes; in fact, spending for Medicaid would decrease by $772 billion in that period. This represents a 26 percent decrease from under Obamacare. The House bill, by comparison, saves $119 billion—again, through Medicaid cuts that limit access to life-saving care.

CBO’s score of the “heartless” Senate repeal effort “offers no surprises,” Debra Ness, president of the National Partnership for Women and Families, said in a statement.

“By gutting Medicaid, repealing significant insurance protections, defunding Planned Parenthood, and expanding harmful abortion coverage restrictions, it would devastate women and families,” Ness continued.

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