The American Health Care Act: What do we have to lose?

The American Health Care Act: What do we have to lose?

The American Health Care Act: What do we have to lose?
March 21
23:51 2017

On March 6, Paul Ryan, the speaker of the house, released the long awaited plan to repeal and replace the Affordable Care Act, enacted under former President Barack Obama in 2010. The new legislation was released by House Republicans and presented as the American Health Care Act.

House Republicans want to put the bill up for a vote this Thursday. But the passing of the bill is uncertain. It has faced heavy criticism not only from across the aisle, but from within the GOP. There is much discontent from hard line conservatives, arguing that it looks very similar to the ACA, some even calling it Obamacare 2.0. Moderate Republicans are even reticent, realizing that it might really hurt their constituency.

Most of the criticism came after the nonpartisan Congressional Budget Office released a report that estimates the cost and coverage of the new legislation. Among the most alarming numbers are the effects on the federal budget, health insurance coverage and premiums.

The CBO presented the scorecard and found that the AHCA will reduce federal deficits by $337 billion over the 2017-2026 period. The largest savings will come from reductions in outlays for Medicaid and from the elimination of the ACA’s subsidies for non-group health insurance.

The reductions in insurance coverage between 2018 and 2026 stem in large part from changes to Medicaid program enrollment. Among the reasons given by the CBO is that some states would discontinue their expansion eligibility, states that are eligible for expansions would choose not to do so and that pre-enrolled spending in the program will be capped.

Therefore, subsidies allocated for the expansions that make it possible for more people to enroll in Medicaid will now be harshly reduced, making it less accessible for people to have health insurance.

It also estimated that in 2018, 14 million more people would be uninsured under the new legislation than under the ACA. More alarmingly, the number of uninsured people will jump to 21 million in 2020 and then to 24 million in 2026. In comparison, 52 million people would be uninsured against 28 million who would lack healthcare under ACA by 2026.

The new legislation will affect premiums, and this is among the most contentious part of the ACA. Premiums are what people really want to see change, but to the discontent of many, the new average premiums will increase before 2020, with a decrease starting in 2020 due to a decrease in enrollment.

The CBO further shows that changes in premiums relative to the ACA would differ significantly for people of different ages because of a change in age-rating rules. Under the new legislation, insurers would be allowed to charge five times more for substantially reducing premiums for young adults and substantially raising premiums for older people.

This is one of the provisions that has been most criticized and is of biggest conflict within the GOP. Remember that this is being presented as a budget bill, and cannot be filibustered by Democrats. They need 216 votes to pass the bill in the House, so House Republicans can’t afford to lose more than 21 votes.

In the hopes to secure more votes, Republican leaders released a set of changes Monday night, but none of the changes directly provide helpful tax credits for older Americans.

The AHCA, will also get rid of the individual mandate. But there will be a 30 percent surcharge on premiums for people who enroll, if they have been uninsured for more than 63 days within the past year. It will also repeal the surtax on certain high-income taxpayers’ net investment incomes.

Not surprisingly, the GOP proposed limits on Medicaid payments to Planned Parenthood. The provision will reduce federal spending on reproductive care for women, possibly causing many clinics to close.

One key thing to understand about the ACA is that the most unpopular parts of the law allow the parts that the public likes to be possible.

The ACA is by no means perfect, but by taking only parts of this law and producing a new set of rules and standards, it will dramatically affect the most disenfranchised parts of our society, the poor, the sick and the elderly.

Although this is an extremely politicized issue, it is real people and real lives that are affected in the end, regardless of party affiliation. After all the political discourse, it is going to be us, the people, who suffer the consequences of a system that is apparently created to treat healthcare as a luxury. In reality for many, access to healthcare is literally life or death.

Featured Illustration: Samuel Wiggins

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Gabriela Macias

Gabriela Macias

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