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Hundreds of thousands could lose insurance in Georgia under GOP plan

An estimated 750,000 Georgians — many of them poor and older — could lose their health insurance under the GOP’s Obamacare replacement plan, a new analysis shows.

The data offers a first glimpse into how the GOP plan could fundamentally change access to health care in the Peach State. Georgia already has the third highest rate of uninsured in the nation.

GUIDE: Health care replacement in Georgia

MAP: Impact of replacement by Georgia county

Roughly 450,000 Georgia residents could lose their health insurance in the first year alone, according to Bill Custer, a health care expert at Georgia State University. Over the next decade, another 300,000 or so could lose coverage through Medicaid, the government health program for poor Americans that faces hundreds of billions of dollars in cuts nationally, Custer told The Atlanta Journal-Constitution.

Custer has tracked the effects of Barack Obama’s Affordable Care Act here from the law’s outset and is now analyzing the Republican effort to repeal and replace it.

Fundamentally, the GOP plan would hit lower-income, older Georgians who live in rural areas where health insurance premiums are higher the hardest, he said.

‘We’ve got to get this done’

The early Georgia estimates are based on a report released Monday by Congress’ nonpartisan scorekeeper, the Congressional Budget Office.

Nationally, the CBO found the Republican plan, called the “American Health Care Act,” could lead to 24 million Americans losing their health insurance by 2026. But the plan would also reduce the federal deficit by nearly $340 billion over that 10-year period in large part by reducing spending on Medicaid and on tax credits for people to help buy individual health insurance.

House Speaker Paul Ryan said in a statement that the report “confirms the American Health Care Act will lower premiums and improve access to quality, affordable care” and that it will provide massive tax relief, as well as reduce the federal deficit.

“Under Obamacare, we have seen how government-mandated coverage does not equal access to care, and now that law is collapsing,” he said. “Our plan is not about forcing people to buy expensive, one-size-fits all coverage.”

But consumer advocates argue the plan overwhelmingly favors the wealthy at the expense of the poor.

Beth Stephens, senior director for public policy and advocacy at Georgia Watch, was grim.

“We already have a really high rate of uninsured folks in our state. Any additional cut in that would be really harmful to Georgians,” she said.

Meanwhile, the CBO findings also stoked concerns among some Republicans, while others continue to support the plan.

Ryan faces an uphill battle in passing the plan, which has provoked stiff opposition from within his own ranks. Hard-line conservatives argue it doesn’t go far enough and that any replacement plan should repeal Obamacare in its entirety. Several moderate Republican senators from states that expanded and benefited from Medicaid expansion have also balked at the proposal.

President Donald Trump, who supports the plan, has been meeting with lawmakers to help bridge the conservative divide. Health and Human Services Secretary Tom Price, of Georgia, will make his pitch for the plan to America at 9 p.m. Wednesday during a CNN town hall.

On Tuesday afternoon, Sen. David Perdue, R-Georgia, met with Vice President Mike Pence and key Republican legislators behind closed doors to discuss “minor tweaks” to the plan.

“This is as much integration and coordination as I’ve seen since I’ve been in the Senate, and it’s very encouraging,” Perdue told reporters after the meeting. “I’d like to see it get done and the president sign it and go into law … (Obamacare) is collapsing right now. So we’ve got to get this done and tell the American people that we’re going to protect their coverage.”

The details matter

Ultimately, the number of Georgians who gain or lose coverage under the GOP plan will likely depend in large part on state leaders.

Under the plan, states would receive billions of dollars in federal funding each year to help stabilize the Obamacare insurance exchanges, but those dollars could be used in any number of ways.

For instance, the state could use the extra money to fund a “high-risk pool” for people with expensive chronic conditions, such as cancer. The plan could promote access to preventive care or help reduce co-pays and other out-of-pocket expenses for people.

IN-DEPTH: The faces of Obamacare in Georgia

MORE: Plan sets deadline to expand Medicaid

Secretary Price and Georgia can act together “creatively” to use the stabilization dollars to help Georgians, including the elderly, said Kelly McCutchen, president of the fiscally-conservative Georgia Public Policy Foundation.

“Once you’re able to pull back all the insurance regulations and mandates to lower the cost of premiums, I think you’ll see many more people able to afford insurance,” McCutchen said.

He also pointed out that using the national CBO data to calculate the impact on Georgia doesn’t necessarily take into account state-specific issues that could come into play. For instance, McCutchen said, poorer Georgians, especially those who didn’t get Medicaid coverage because the state did not expand, would get access to tax credits to help them buy coverage.

The GOP plan does open up financial help to a whole new set of people who didn’t qualify for Obamacare tax credits before. That’s because the credits — that would give people a flat sum between $2,000 to $4,000 to buy coverage — are based on age, not income.

Before, someone who made over roughly $50,000 was not eligible for any financial help.

Custer with Georgia State, however, said that for the people who make very little money that McCutchen is talking about, let’s say a 60-year-old making $20,000 a year, the tax credit they would get under the GOP plan is unlikely to go very far. The premiums would still be far too high for many to buy insurance.

What comes next?

The House Budget Committee is set to take up the GOP plan on Thursday, and it could head to the House floor for a full vote next week.

Conflict among conservatives has created yet another hurdle above and beyond already staunch opposition by Democrats.

“The Georgia State analysis and the CBO report corroborate each other, with both concluding that many Americans will lose access to health care under Trump Care,” said Rep. Hank Johnson, a Georgia Democrat. “Trump Care is not care at all. It’s callous and cold, and will result in the needless deaths of many people who will be forced to go without health care if this plan passes.”

Speaker Ryan will likely make changes to the plan to win over more Republicans. The Senate will also make its own changes to the bill.

It faces major opposition in the Senate with some lawmakers threatening the plan would be dead on arrival.

— Staff writers Tamar Hallerman and Ariel Hart contributed to this report.

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