ALBANY - House Republicans' long-awaited plan to replace the Affordable Care Act led New York officials Tuesday to assess its impact on the state and its residents as Congress grapples with the bill's chances of passage.
Gov. Andrew Cuomo's office and state lawmakers have been bracing for changes to the health-care law commonly known as Obamacare, with an estimated $3.7 billion in federal funding for the state on the line.
The release of House Republicans' replacement plan late Monday gave them a glimpse of what could be to come, including a freeze on the Affordable Care Act's Medicaid-expansion program beginning in 2020.
State Comptroller Thomas DiNapoli said his office is still examining the bill and its effect, but his early review wasn't positive.
"This bill could reduce the number of insured New Yorkers and shift a larger share of the cost of the Medicaid program to the state," DiNapoli, the state's fiscal watchdog, said in a statement. "We're still sorting through the details, but it clearly could have a significant harmful impact on New York."
The House Republicans' plan, which President Donald Trump backed on Tuesday, would make significant changes to the health care law.
It would change Obamacare's subsidy system, instead switching to a series of tax credits for insurance buyers, with the credits adjusted by age rather than the cost of insurance premiums.
The House GOP plan would repeal penalties for not maintaining insurance coverage, while a provision allowing those age 26 and under to remain on their parents' plan would stay in place.
The system for reimbursing some state Medicaid costs would be changed, with the current open-ended match replaced with a stricter cap.
Assemblyman Richard Gottfried, the longtime chair of the state Assembly Health Committee, said the changes would "damage Medicaid and health insurance for working people."
“It will ruin people’s health, their family finances, health care providers’ stability and state budgets," said Gottfried, a Manhattan Democrat.
New York and other states took advantage of an Obamacare provision allowing them to expand access to Medicaid, with the federal government providing extra funding to help cover the costs.
And the large majority of New York's health-exchange enrollees are on Medicaid.
Under the House GOP's plan, that program would be frozen beginning in 2020. But the federal funding would continue for those who enrolled prior to 2020, as long as they still qualify.
"The eligibility rules and the funding do not change at all until 2020, and then even after that for people who are already enrolled," said Bill Hammond, director of health police for the Empire Center, an Albany-based think tank.
"So long as they stay in the coverage, their eligibility and the funding continues as is."
Rep. Tom Reed, R-Corning, Steuben County, said his goal has been to "make sure we have a bill that is fair to Americans across this nation."
He said the final bill -- which will go through the committee process in the coming weeks -- won't harm Medicaid recipients.
"We are also going to make sure that the folks in Medicaid, the folks that are struggling day to day, are not having their insurance coverage through Medicaid pulled out from underneath them," Reed said.
Kate Breslin, president & CEO of the Schuyler Center for Analysis and Advocacy, a think tank, said she's not convinced.
"We feel like this is kind of a sneak attack on Medicaid," Breslin said. "The proposal to cap Medicaid funding so it wouldn't be able to respond to the state and communities' needs, that's extremely concerning."
New York's U.S. senators, Democrats Kirsten Gillibrand and Charles Schumer, spoke out against the GOP plan, with Gillibrand saying it would "force middle class families and seniors to pay more money for less care."
"I will do everything I can to stop this assault on the health and economic security of middle class families and seniors," she said in a statement.