Gov. Scott prescribes health tax cuts; CBO says Senate uncovers 22M

U.S. Senate plan would leave 22 million without health coverage by 2026 compared to keeping the Affordable Care Act, the Congressional Budget Office said Monday, but Florida Gov. Rick Scott said he is heading to Washington this week to stick up for tax cuts.

“There seems to be a lot of people advocating for more government and higher costs in Washington and not a lot of people advocating on behalf of taxpayers,” Scott said.

The House and Senate GOP Obamacare replacement plans differ on a few points, but agree on the basics of one thing: a $1 trillion tax cut for corporations and high earners, including individuals making more than $200,000 a year, or $250,000 a year for couples. Those taxes were imposed to pay for the Affordable Care Act.

Scott’s office said it did not have figures handy for how many Floridians would benefit from the tax cut.

The median household income in Florida in 2015 was $49,426, according to Census data, down from $54,646 in 2007. About 4.1 percent of Florida households have been calculated to make more than $200,000 a year, though not all would be subject to the ACA’s investment and payroll taxes because couples pay them on income above $250,000.

About 90 percent of the benefit from repealing the taxes would go to the top 1 percent of U.S. earners, who make $700,000 or more, The Associated Press reported.

Billionaire Warren Buffett told CNBC in May his personal tax bill would be 17 percent lower, about $680,000 on his tax bill of a little less than $4 million.

GOP donor Sheldon Adelson could see his tax bill trimmed by about $43.5 million, Business Insider has reported, citing an analysis from the Center for American Progress Action Fund.

Scott would have saved about $246,000 on his 2013 tax return, Politico reported.

Scott, a former hospital company executive, does not take his $130,273 annual state salary. He said he wants to create jobs and cut taxes for everybody, citing 55 tax cuts for $6.5 billion in his tenure by April.

“I look forward to traveling to Washington to fight for Florida families and ensure there is a health-care proposal that dismantles the terrible, expensive mess of Obamacare,” Scott said in a statement Friday. “Let’s remember, costs have skyrocketed under Obamacare and we need a new healthcare policy that allows patients to have access to quality healthcare at an affordable price.”

Obamacare’s subsidies tied to income mean that about nine out of 10 of the roughly 1.5 million Floridians buying ACA marketplace plans pay an average premium of about $84 a month. Because the subsidies rise with rate increases, their out-of-pocket cost is likely to stay close to where it is, even though six insurers have filed for a rate increase averaging about 17 percent for ACA market plans in Florida in 2018. Customers without subsidies feel the full impact.

Immediate tax cuts retroactive to the start of 2017 would benefit those making $200,000 or more a year.

More broadly, the long-term direction of Medicaid, a critical focus of Obamacare replacement efforts, affects a deeper base of taxpayers who support the program through state and U.S. taxes.

Medicaid covers 4 million Floridians, including about half the childbirths, 70 percent of seniors in nursing homes and 41 percent of Palm Beach County’s children.

The focus should be on millions of people who will lose affordable coverage, advocacy groups said Monday.

“The CBO confirmed what every public interest, medical, hospital and patient group has been saying,” said Betsy Imholz, special projects director for Consumers Union, the policy and mobilization arm of Consumer Reports. “This bill would take insurance away from tens of millions, decimate Medicaid, cost consumers more in premiums and out-of-pocket costs, and leave the lucky few that can afford insurance with skimpy plans that aren’t required to cover basic care like emergency, maternity and prescription drug coverage.”

The Senate bill will “free the states” and “the marketplace to discover ever-better ways to deliver services,” Senate Majority Leader Mitch McConnell, R-Ky., tweeted Monday.

Florida Democratic U.S. Sen. Bill Nelson noted the CBO score was little different from the House’s: “22 million people. Is that the direction that we want to be going in?”

The Senate plan would reduce the deficit by $321 billion, more than the net savings in the House, largely through greater long-term cuts to Medicaid.

As U.S. Rep. Brian Mast, R-Palm City, has pointed out in town hall meetings, removing Obamacare’s tax penalty of $695 or more for not having health insurance would also represent a tax cut. That would provide a form of relief for those who do not want coverage, hope they won’t need it or want it but cannot afford it.

The decision by Florida’s GOP-led legislature not to expand Medicaid, to protect state taxpayers from having to pay a portion of those costs in later years, left about 800,000 residents unable to qualify for that program’s coverage. At the same time, many don’t qualify for government help on the ACA marketplace because the subsidy plan tied to income levels assumed states would expand Medicaid.

The Senate bill would cover slightly more people than the House plan, which would leave 23 million without coverage over 10 years compared to Obamacare, CBO said.

The Senate plan provides more subsidies to low-income people compared to the House bill, but at a reduced level compared to Obamacare, and makes deeper long-term cuts to Medicaid. Supporters say it protects people with pre-existing conditions, though patient advocates warned it could let insurers opt of certain essential benefits or reimpose annual and lifetime caps on benefits, posing a threat to people with illnesses that are costly to treat.

Though several GOP senators have said they can’t support it without changes, Senate leaders have said they hope to see the plan come to a vote as early as this week.

Scott said he is going to Washington this week on a schedule whose details will be announced later.

“I would like to thank Sen. Mitch McConnell and the Senate Republicans for working to eliminate the high taxes, fees and unreasonable mandates of Obamacare,” Scott said. “I also want to thank President Trump for his commitment to repeal and replace Obamacare.”

Scott said he plans to “meet with Congressional leaders to provide input on how we can make the bill better for Floridians.”

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