MPR News Staff

MPR News/90.1 FM

Senate Republicans’ plan for repealing and replacing Obamacare was in flux Thursday following an analysis that said 22 million people would lose their health insurance.

If the current version of the bill went to a vote, it would almost certainly fail. So, Sen. Majority Leader Mitch McConnell, R-Ky, is reportedly trying to revise the measure by week’s end.

It’s up in the air exactly what GOP senators could put to a vote, but here’s where things stand for Minnesota under the most-recent proposal.

Funding for Medicaid would be slashed

Medicaid provides health insurance to some 1.2 million Minnesotans who are low-income or have a disability. The Senate Republicans’ health care bill would cut funding for the program by $774 billion through 2026.

By that year, nonpartisan federal analysis says the Senate bill would have 22 million people lose their coverage.

It’s not clear how much federal Medicaid funding Minnesota would lose.

But some health advocates worry the Senate bill would lead to fewer Minnesotans being insured — or that the state would need to cut elsewhere to pay for Medicaid.

“The rollback of the Medicaid coverage is essentially going to land in the lap of Minnesota state government to figure out how we would continue to have those Minnesotans covered,” said Wendy Burt with the Minnesota Hospital Association.

Health advocates are worried about children

About 600,000 Minnesota kids are on Medicaid, accounting for about half the state’s enrollees.

There’s no way to tell how many of those kids would lose coverage under the Senate bill, but the fear is that when federal subsidies for Medicaid are cut, low-income people will bear the brunt of it.

States could choose to remove mandates for things like maternity or mental health care

Obamacare mandated that insurance companies cover a specific range of benefits. One argument for that requirement is that many of these services are preventive, which can reduce costs in the health care system overall.

The Senate bill, however, allows states to opt out of that requirement — and there’s no telling how Minnesota’s future administrations would act if they had that choice.

A few things would remain the same under the Senate bill

The Senate plan would allow kids as old as 26 to stay on their parent’s insurance plan.

It would also continue to prohibit insurance companies from increasing premiums or denying coverage based on preexisting conditions, though states would have some flexibility on this.

Chunk’s of Minnesota’s public health funding would be gone

The “Prevention and Public Health Fund,” which provided almost $14 million to Minnesota last year, would be no more under the Senate plan.

State Health Commissioner Ed Ehlinger urged the state’s congressional delegation to fight the bill. The fund at risk pays for programs like infectious disease prevention, diabetes research and work on childhood lead poisoning.

Some conservatives refer to the “Prevention and Public Health Fund” as a “slush fund.”

People on the individual market would pay higher premiums

Fewer than 5 percent of Minnesotans buy coverage on the individual market.

But for those who do, their premiums for the benchmark “silver” health plan would increase by 65 percent on average, according to a Kaiser Family Foundation analysis of the health care bill.

Kaiser says older and low-income enrollees would pay the biggest increases.

The analysis found that younger people would see more moderate increases and in some cases could actually see lower premiums with high-deductible coverage with lots of cost-sharing.

Tax credits for buying coverage would remain, but there’s a catch

You’d need to be at the lower end of the income scale to get the credits, and they’d cover skimpier plans under the Senate plan than they do with Obamacare.

Those changes, if adopted, wouldn’t kick for a few years, according to MNsure, which means the next round of open enrollment this fall wouldn’t be affected.

Reporting by Catharine Richert and Mark Zdechilk. Writing by Cody Nelson.