Sen. David Perdue, R-Ga., was unhappy about the Senate's failure to pass a bill to repeal and replace the Affordable Care Act. He said one consequence was the effect for thousands of poor people in Georgia.
The data we found showed that he correctly stated that even with Obamacare, 300,000 Georgians below the poverty line can’t get insurance.
However, Perdue glosses over the fact that independent experts say the Republican replacement bills would not have solved this problem; in fact, they would have made it worse.
According to the Kaiser Family Foundation, 309,000 people in Georgia are in the "coverage gap" — a no-man's-land where their income puts them above current Medicaid eligibility but below the lower limit for premium tax credits for plans purchased on the ACA's online marketplaces.
The House and Senate bills would have addressed this, but only in a limited way.
“Both the House and Senate bill would have offered these individuals tax credits,” said Christine Eibner, a senior economist at the RAND Corp. But, Eibner said, the policies available would have such large deductibles that they’d either offer little protection from health care costs or scare off customers from buying a plan in the first place. The independent Congressional Budget Office estimated the deductible for a typical plan under the Senate bill would be $6,000, likely making it “unaffordable for a person with income under the poverty level,” Eibner said.
For the House bill, Eibner said, the CBO estimated that a low-income older person “could face net premiums in the range of $13,600 to $16,100, even after accounting the tax credits available.”
Such realities played into the CBO's conclusion that the Senate bill would leave 22 million fewer Americans insured by 2026 than current law and the House bill would see 23 million fewer insured.
As for Georgia, the Senate bill would have increased the number of uninsured Georgians by 376,000 in 2022, according to an analysis by the Urban Institute.
There's another problem: Georgia turned down expanding Georgia's eligibility for Medicaid under the Affordable Care Act. The state would have had to pick up about 10 percent of the bill, with the federal government paying about 90 percent.
The most recent analysis by the Urban Institute found Medicaid expansion in Georgia — which is still on the table — would reduce the number of uninsured Georgians by between 460,000 and 556,000 people in 2021.
In other words, the state could have covered even more low-income Georgians than Perdue’s 300,000 by expanding Medicaid under Obamacare. (And, as we noted above, it’s unlikely that the Republican bills would have covered those 300,000.)
“To blame the ACA for … Georgia’s decision not to expand Medicaid eligibility is a tremendous distortion,” said Urban Institute health policy specialist Linda Blumberg.
Our ruling
Perdue has a point: Even with Obamacare, 300,000 Georgians below the poverty line can’t get insurance. However, in the context of decrying the failure of the Republican bills to advance in Congress, this observation is misleading.
While the Senate and House bills would have offered tax credits to the poor, independent analysts agree those tax credits wouldn’t open the door to affordable insurance. In addition, the ACA’s Medicaid expansion could have covered even more than 300,000 low-income Georgians if it had not been rejected by Perdue’s fellow Republicans in Georgia.
We rate the statement Half True.
Because of the failure to pass a repeal bill, “Obamacare remains the law of the land … This means more than 300,000 Georgians below the poverty line will still not have access to the insurance Obamacare promised.”
— David Perdue on Friday, July 28th, 2017 in a statement
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