Summary

Policy experts at Public Health – Seattle & King County determined House Speaker Paul Ryan's proposed replacement for the Affordable Care Act would endanger health care coverage for more than 200,000 county residents; increase out of pocket costs for low-income individuals; revoke coverage for mental health and substance-use disorder treatment; and erode the County’s ability to respond to disease outbreaks.

Story

King County embraced expanded health insurance and other reforms under the Affordable Care Act, and reduced the number of uninsured here by more than 50 percent since 2013. More than 200,000 people in King County acquired health coverage through the ACA. The number of uninsured working-age adults has dropped by 54 percent since 2013, to 7.7 percent, the lowest level ever recorded.

The proposal by House Republicans jeopardizes this progress and threatens widespread damage to the region’s health and economic well-being.

• The bill would sunset the Medicaid expansion, the source of coverage for more than 150,000 people in King County. As of 2020, federal funding for this coverage category would be significantly reduced.
• Coverage for 80,000 people in King County who purchase coverage through Washington Healthplanfinder would be jeopardized. Financial support based on need would be replaced by far less generous tax credits based primarily on age.
• Over time, coverage for nearly 400,000 of the lowest-income King County residents could also be endangered as Medicaid is turned into a block grant, with capped funding levels that would not keep up with rising costs, forcing cuts and reductions.

Insurance companies would no longer be required to cover mental health and substance use disorder treatment, maternity and preventive treatment. Currently, more than 12,000 King County residents depend on the Medicaid expansion to access to critical mental health and substance abuse treatment.

“We have waited anxiously for Congressional Republicans to offer their own health care legislation, and now that they finally have their proposal confirms our worst fears,” said King County Executive Dow Constantine. “The Trump/Ryan plan would take us backward -- taking away people's insurance, and reducing treatment options for people struggling with mental health and substance use. Our federal lawmakers must understand and be held accountable for the impact of their actions on the lives of people here in King County, and across the state and the nation.”

Other provisions of the Republican health care bill include:

• $4.5 million cut to local Planned Parenthood clinics, reducing access to contraceptives, cancer screenings, STD testing, and other critical family planning services.
• Elimination of the Public Health and Prevention Fund, which provides $14 million annually to Washington State for local health needs. King County relies on these funds to prevent disease outbreaks. The elimination will impact King County’s capacity to protect against emerging infections and diseases, or provide vaccines for outbreaks such as the mumps.

“This proposal is perilous to our health. We’re seeing more communicable disease outbreaks than ever and new health threats, but this proposal erodes our capacity to prevent and respond to these local challenges,” said Patty Hayes, Director for Public Health – Seattle & King County. “Their plan also comes up short by removing requirements for essential preventative services from health plans, like vaccines and screening tests, which help keep people healthy, catch problems early and keep people out of expensive hospital care.”

Relevant links

• Washington HealthPlanFinder
• News release: Joined by local providers and patients, Executive Constantine announces health care priorities as Congress debates rollback

Quotes

We have waited anxiously for Congressional Republicans to offer their own health care legislation, and now that they finally have their proposal confirms our worst fears. The Trump/Ryan plan would take us backward -- taking away people's insurance, and reducing treatment options for people struggling with mental health and substance use. Our federal lawmakers must understand and be held accountable for the impact of their actions on the lives of people here in King County, and across the state and the nation.

This proposal is perilous to our health. We’re seeing more communicable disease outbreaks than ever and new health threats, but this proposal erodes our capacity to prevent and respond to these local challenges. Their plan also comes up short by removing requirements for essential preventative services from health plans, like vaccines and screening tests, that help keep people healthy, catch problems early and keep people out of expensive hospital care.

For more information, contact:

Alex Fryer, Executive Office, 206-477-7966