The Republican-controlled House of Representatives passed the American Health Care Act (AHCA) by two votes, even though it’s opposed by almost all stakeholder groups. The AHCA is supposed to lower the cost of insurance for younger and healthier Americans. It almost certainly won’t do that. What it’s guaranteed to do is rip health care away from 24 million Americans within a decade, causing irreparable harm and possibly about 24,000 more deaths a year.
While premiums are increasing (largely due to rising healthcare costs overall), they would have to jump more than 40 percent to approach where they would have been without the Affordable Care Act (ACA). Also, the increases primarily impact the 3 percent of Americans who buy full-price plans directly from the private market. So, why pass legislation of so little value, yet such grave consequences, for so many of us?
The answer? Two-thirds of the AHCA’s $765 billion in tax cuts would benefit the wealthiest among us. It also slashes $839 billion from Medicaid, a program providing health coverage to children, poor adults, and working families. Cutting a quarter of the program’s funding will force states to choose between covering fewer people, offering fewer benefits, or paying providers less. Sadly, it’s an easy target because enrollees often don’t have time to make their voice heard, generally don’t vote in big numbers and can’t afford to hire lobbyists.
What does this mean for Utahns? It means we could go back to the days when children couldn’t get the comprehensive care they needed to be healthy and active learners, when pregnant women couldn’t afford maternity care and when the 20-50 percent of non-elderly adults with a chronic condition were lucky to find coverage at all. It also means we could go back to the days when the 1 in 5 of us with a mental health condition had trouble getting the treatment needed to be productive members of our communities and when seniors and persons with disabilities had no choice but institutional care.
The AHCA allows insurers to charge individuals over 40 years of age 30 percent more, individuals who lose coverage for longer than two months 30 percent more and seniors up to $13,000 a year more than under the ACA. The bill also lets states decide whether to make insurers cover pre-existing conditions and essential health benefits. Knowing many won’t, it includes $108 billion to reduce out-of-pocket costs. Even so, it’s likely Utah could help offset costs for fewer than 40 percent of its estimated 29,000 residents with pre-existing conditions in the exchange.
AHCA supporters say not to worry because states know how to care for their residents better than the federal government. If this were true, millions of Americans wouldn’t have been without access to affordable, quality health care before the ACA. Leaving it up to the states means we’re likely to see a return to high-risk pools, even though they’re unaffordable for individuals and unsustainable for states. For example, Utah’s pre-ACA combined pool had a $5,000 deductible and a $1.5 million lifetime limit. No wonder it only attracted about 4,000 members and lost $80 million in its final year.
Despite the claims of Utah’s representatives, unaffordable coverage is denied coverage. The truth is, people who can’t afford insurance can’t afford care. People who can’t afford care go bankrupt or delay care. People who delay care get sicker or die. It’s why we’re calling on Sen. Hatch and Sen. Lee to protect the health of all Utahns and Americans by promoting the continued expansion of affordable coverage and quality care in negotiations with their colleagues.
Andrew Riggle is the Disability Law Center's public policy advocate.