RACHEL MARTIN, HOST:
Dr. J. Mario Molina is worried. He's the CEO of Molina Healthcare. It's a company based in Long Beach, Calif., that provides health plans, including to those on Medicare and Medicaid. Now, as the Republicans' health care bill advances through Congress, some of his four-and-a-half million members are acting on the expectation they will soon lose their coverage.
J. MARIO MOLINA: There are anecdotes that patients who are coming in to see their doctors because they weren't sure what their coverage was going to be in 2017 or 2018 and they wanted to get done as - whatever needed to be done right now.
MARTIN: Under Obamacare, people get subsidies for health insurance based on income, including a million of Molina Healthcare's clients. The House Republican bill would replace those subsidies with tax credits based on age. Molina says that change would come at a great cost to his members. He spoke to our co-host Steve Inskeep.
MOLINA: It appears to me and to many others that the tax credits are not going to be sufficient to cover the premiums. And that means that people are going to have to pay more out-of-pocket for the same coverage they've been receiving.
STEVE INSKEEP, HOST:
Let me make sure I understand this because we're talking about subsidies of a couple thousand dollars a year for a younger person, up to 4,000 I think for older people. How does that compare to the price of a decent health insurance plan?
MOLINA: Well, let me give you an example. Right now, our silver plan, which is our most popular offering, costs about $4,300 a year. And a 40-year-old person would get a $3,000 tax credit, which means now they're going to have to come up with the other $1,300. Thirteen hundred dollars a year for an insurance premium may not be affordable for them.
INSKEEP: I'm just doing the math in my head. You're talking about an extra 90, a hundred dollars a month. That's like a grocery run for a lot of people. That's basically the amount of money we're talking about here.
MOLINA: It's a substantial amount of money. And it's a big increase from what they've been paying. Right now, our members with supplements from the federal government are paying about $20 a month.
INSKEEP: Now, another part of this is the Medicaid expansion. The House bill would roll that back. And we should explain that Medicaid is a health program for the poor. The Affordable Care Act expanded it so that states could choose to put more people on the rolls, people who were maybe a little bit further above the official poverty line but still not making very much money. That would be rolled back. How would that affect your customers?
MOLINA: Well, Medicaid pays for 50 percent of all the births in this country. About a third of the country's children are covered under Medicaid. And it also covers half of all the long-term care in the country. So it's a big program covering 72 million people.
INSKEEP: I just want to stop you for a second because my eyes are popping out of my head.
MOLINA: Sure.
INSKEEP: Did you just say Medicaid, the health care program for the poor, covers 50 percent of all the births in the United States?
MOLINA: That's correct. Medicaid covers about 50 percent of all births in the United States.
INSKEEP: I believe that House Republicans have said that rearranging Medicaid in this way will make it more efficient. Is it possible that they could be doing more with fewer dollars?
MOLINA: Well, I think we clearly need to make the system more efficient. But I don't know that you're going to be able to wring out those kinds of savings. And what it's really going to do is transfer the responsibility for funding Medicaid from the federal government and put more of a burden on the states. But when you shift more of the financial responsibility onto the states, how are they going to be able to do this? The two things that states really are responsible for funding are Medicaid and education. And if health care costs go up, where's the money going to come from? Are they going to raise taxes? Or are they going to take it away from education which will hurt public schools?
INSKEEP: So what does this mean for your business as a business?
MOLINA: Well, it means that people are going to be faced with lower subsidies and higher premiums in the marketplace. And I think it's going to mean big cuts to Medicaid. We estimate that 15 to 20 million people who got their coverage under the Affordable Care Act will eventually lose their insurance coverage.
INSKEEP: I want to be super clear on this. There have been rigorous studies that have found that millions of people would lose their health benefits under a plan somewhat like what the House Republicans have put out there. I haven't seen a study that says that everybody who gained under the Affordable Care Act would lose their insurance again. But you're telling me that's your working assumption, everybody who gained insurance in the last few years would lose it again eventually.
MOLINA: No. I'm not sure that everyone would lose. Right now, there are about 22 million people who are covered. But we think - and I've seen other people with similar reports - that 15 to 20 million people could lose their insurance coverage.
INSKEEP: OK. Would you have to totally change what your business does if this bill became law?
MOLINA: No, I don't think so. I think ironically what will happen is that states will look to us to help them with the remainder of their Medicaid population. And we might actually see more contracts and some growth in the short term. But I am worried about the long-term consequences to the safety net. Medicaid is the safety net. And when you damage that, people are going to fall through.
INSKEEP: Dr. Molina, thanks very much.
MOLINA: OK. Thank you Transcript provided by NPR, Copyright NPR.