RICHMOND, Va. - Virginia millionaires could see an average tax cut of close to $40,000 a year if the American Health Care Act becomes law, according to a new analysis. Those tax cuts would be paid for in part by removing more than 500,000 Virginians from health-insurance rolls.
Alan Essig, executive director of the Institute on Taxation and Economic Policy, said Congressional Budget Office figures show the health bill that cleared the U.S. House is less about health policy than tax breaks for the top 3 percent of U.S. earners.
"The end result is 23 million people losing health-care coverage," he said. "The reason for that is to pay for $660 billion worth of tax cuts that overwhelmingly go to the wealthiest Americans."
Supporters of the AHCA have said cuts to Medicaid and reversing the program's expansion would reduce the federal deficit and lower health-care costs. The U.S. Senate has not yet made its version of the health bill public, but close observers say it closely resembles the House version.
The bill is opposed by the American Medical Association and American Nursing Association. Essig said the majority of Medicaid recipients that could be affected are older folks and people with disabilities, pregnant women and children. He warned that bankruptcies due to medical bills, which have decreased under Obamacare, could be back on the rise.
"Real people will end up losing their health-care coverage, and that will impact people's health, people's lives and people's bank books," he said. "We're going to be going back to where we were, which I don't think is where anyone wants to go."
Under the Affordable Care Act, low- and moderate-income Americans have been able to get coverage due in part to a tax on individuals making more than $200,000 a year, or $250,000 for couples filing jointly. Essig said insurance premiums for an average 64-year-old with an income of $27,000 would rise from $1,700 to more than $16,000 a year.
The analysis is online at americanprogressaction.org.
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Earlier this month, a new Arizona Public Service rate hike went into effect and one senior advocacy group said those on a fixed income may struggle to now pay their energy bills.
According to the utility, the average residential customer will see an expected bill increase of about 8%, which translates to about $10.50 a month. They said it is all in an effort to continue to provide Arizonans with reliable and resilient power and make "critical investments" in their system.
Aimee Cvancara, associate state director of AARP Arizona, contended the possible effects could be significant.
"Folks who are on a fixed income, whether that is a retirement income or even a working income with limited mobility, it is difficult to absorb a $10 to $12 cost in your monthly bill that was unanticipated," Cvancara pointed out. "Particularly because it's not the only increase that folks are seeing right now."
Cvancara emphasized consumers are feeling the weight of increased prices on everything, from groceries to gas, rent and now power. Arizona Public Service rooftop solar customers could also see an additional $2 to $3 a month on their bills but the Arizona Solar Energy Industries Association and Attorney General Kris Mayes are both demanding for a rehearing on the case with the Arizona Corporation Commission to challenge the rate hike.
Cvancara noted moving forward, a significant concern for Arizona consumers is going to be something called the system reliability benefit mechanism, which allows Arizona Public Service to recover costs between rate cases for new, utility-owned generation resources.
"This is a new thing for APS customers," Cvancara explained. "It is going to allow the utility to file for up to 3% rate increase and they can do that five times before they have to file for another rate increase."
Some ratepayers and environmental groups oppose the system reliability benefit mechanism, as they argued it will only raise rates and increase demand for fossil fuels. Cvancara said the Arizona Corporation Commission should always strive to balance investments for reliable energy versus the cost consumers will face.
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A 2023 study from the University of Nebraska Medical Center concluded the number of Nebraskans with a mental health or substance abuse disorder has probably increased over the pre-pandemic level of 20%. It also observed 88 of Nebraska's 93 counties have a shortage of behavioral health professionals.
Nonetheless, the state budget now awaiting Gov. Jim Pillen's signature cuts $15 million from the Division of Behavioral Health's funding for the state's six Behavioral Health Regions, which distribute those funds to providers. Many advocates believe the cut is based on an incorrect conclusion.
Annette Dubas, executive director of the Nebraska Association of Behavioral Health Organizations, said because $15 million remained in the budget for the Regions, it was concluded the money was not needed. In fact, she said much of it was for projects and proposals awaiting Department of Health and Human Services approval.
"The problem is not that it's not needed; there's a problem with getting it out the door and into services quickly," Dubas explained. "Because we know the demand is there. And if it's not being spent, let's figure out why. That's what we want the governor to sit down and talk to us about, so we can figure out where the holdups are."
The $15 million will be shifted to the Lincoln Regional Center for hiring nurses and other staff. Dubas questioned how realistic it is for the center to spend this amount of money on staffing, especially when the state is facing a nursing shortage of more than 5,000 by 2025. She also questioned what will happen to any money left unspent.
Dubas stressed the Division of Behavioral Health is not the only agency losing money through this budget process.
"This administration has gone into a lot of different funds, cash funds, etc., and kind of swept out money that they perceive is not being used or is not being spent, to use to help with their property tax relief," Dubas asserted.
The Pillen administration is paying Epiphany Associates from Utah $2.5 million annually for up to four years, to find savings of up to 25% across state agency budgets.
Chase Francl, CEO of the Mid-Plains Center for Behavioral Health, which receives about 40% of its funding from Region III, said cutting programs that save the state money cannot be considered cutting "waste."
"Mental health and substance use treatment really is a prevention service," Francl contended. "If we can get this right, then people are going back to work and maybe aren't ending up in corrections. And you start restricting here, you usually are just going to be creating a greater need for more costly services down the road."
Mid-Plains served 3,200 people in Grand Island, Kearney and Lincoln last year. Francl added they currently have about 60 people on a waitlist for therapy services.
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Congress just avoided a partial government shutdown by approving a budget through the end of September, but a new blueprint is renewing debate about a key safety net program and advocates in North Dakota and elsewhere are worried.
For the 2025 fiscal year, a House caucus of more than 170 Republican lawmakers has issued a proposed outline. It includes raising the retirement age for Social Security eligibility "to account for increases in life expectancy."
Nancy Altman, president of the advocacy group Social Security Works, said, like past suggestions from the caucus, it should be considered a non-starter, arguing it essentially amounts to a benefit cut.
"You never catch up," Altman asserted. "Even if you work till age 70, your benefit's going to be about 7% lower than it is under current law."
There was no specific higher age outlined, but AARP North Dakota has also sounded the alarm about the plan, urging its members to demand "no cuts." Social Security faces financial headwinds a decade from now, but Altman supports President Joe Biden's calls for raising payroll taxes on the wealthy to help ensure the program stays fully funded. His skeptics argued it would not be enough.
However, Altman and other advocates think it is a good first step. The GOP framework also calls for reducing benefits for higher earners. No income threshold was provided but Altman suspects it would still hurt a lot of people who are not exactly wealthy in their retirement.
"It's not what many people would think," Altman contended. "They're certainly not Jeff Bezos and Bill Gates, and the billionaire class."
She predicted the people targeted for cuts would be more aligned with the middle class. Republicans insist the changes would not cut or delay benefits for any senior currently in or near retirement. North Dakota's lone Congressman, Rep. Kelly Armstrong, R-N.D., is part of the caucus behind the proposal.
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