The new Anti-Affordable Health Care Act has now been unveiled in the House of Representatives. It is called the American Health Care Act, and it is not pretty.
Under the guise of “returning” authority over health care to consumers and states, many changes to the Affordable Care Act simply take us backward to the problems we had prior to ACA.
For young people in the peak of health not a lot will change other than they can now drop health care coverage totally since it would no longer be mandated.
Healthy people of any age will potentially leave the insurance pool, gambling that they won’t need insurance at all. That puts more people with existing health care needs to be covered, raising the overall outflow of insurance payments. In turn that outlay for your care – considered to be costs to insurance companies - will shove up the premium and other expenses on you, the insured.
To “relieve” insurance corporations from the burden of caring for a less healthy population, especially those with pre-existing conditions that still must be offered coverage, Congress will permit the return of significant “risk rates”. These set higher costs for covering not just illnesses but conditions such as age. The older you get (a good thing yes?) the more you may be charged. You may be charged more if you are in poor health or have a pre-existing condition.
Subsidies will continue for now. They will no longer be linked to income, however, but will be flat rates also based on age.
The monthly subsidies are now set at 1/12 of $2000 per year for those up to age 30, escalating to 1/12 of an annual $4000 allotment for those aged 60. What is masked in this flat rate assistance is the variable cost of premiums in different states and, more important, the fact that those aged 60 will now pay 5 times what those in their 20s pay but the assistance remains only double for older citizens. It is not uncommon for premiums for those aged 60 to be close to $1000 or more per month while the subsidy would be $333.
That is a huge gap between help and hardship. Younger people with pre-existing conditions receiving lower subsidies per month will also find their premiums much higher than those of their healthy peers since those with pre-existing conditions may be charged three times more.
One of the pre-Affordable Care Act problems for the very ill who had chronic or life-threatening problems was the existence of annual and lifetime caps on expenditures for health care coverage. Those are again permitted.
Employer tax credits for providing health insurance will be eliminated.
Health Savings Accounts will receive disproportionate tax credit help. Those with little to now discretionary income cannot save to create an HSA in the first place. For the working poor, enrolling in a ‘catastrophic’ plan with very high deductibles (50% or more would be the patient’s financial burden) would be highly encouraged. The lower income supports for deductibles would be eliminated.
Preventive care that has no extra charge will be eliminated.
Overall evaluation of the costs to individuals and families is staggering. Per David Cutler, Professor of Applied Economics at Harvard University, health care under this proposed bill will cost families an additional $2243, those 55-64 will pay an additional $7604. For those below 250% of the federal poverty level, the bill will rise an additional $6228.
One Representative summed up the health care choices for the working poor as a difference between their choosing an expensive iPhone and health care. The problem is, health care is not a commodity, and most iPhones can be had for $100, not $6000-plus. This plan returns the working poor to a choice among rent, food, insurance.
Medicaid will be another problem for states. It will be transferred as a block grant meaning a flat sum not based on need or use or caseload. What has, in California, been transformative for homeless single adults, will now possibly be means tested, work related (a problem for those with disabilities), or capped so new enrollees would not be able to join. Those on Medicaid now will be eligible until 2020 in states that expanded the program in 2013. After 2020, the federal supports are not clear, the program at grave risk, with no alternative specified as part of the to-be-amended Social Security Act.
Those states not participating in Medicaid expansion will still not be part of that program. The very poor, disabled, elderly, blind, and otherwise uninsured poor will still have no access to care.
For those who opt out of private health coverage since it’s no longer mandated, there will be no tax penalty to cover the possible cost of emergency services. However, should insurance be needed in the future, there will be a new ‘penalty’ for non-coverage that will be equal to 30 percent of premiums for 12 months.
There will be tax cuts in the new plan, eliminating taxes on insurance companies, on pharmaceutical and medical device manufacturers, and the “Cadillac Tax” on high-cost health employer-provided health plans. In part to cover the tax breaks, there is a proposed diversion – some say raid – of $346 billion from the Medicare Trust Fund. (Source-socialsecurityworks.org)
Finally, the bill defunds Planned Parenthood, a major source of health access for men and women without local providers, insurance, or public clinics. PP provides an enormous array of services not just reproductive, and its defunding harms the poorest of the poor yet again.
TIME AGAIN TO RAISE YOUR VOICE!
It is no doubt clear California Church IMPACT is horrified. We, along with hundreds of thousands of you, fought for the Affordable Care Act through early 2010. The faith community across America was very important in securing the passage of ACA, and we need to be present in opposition to these setbacks.
The Congressional Budget Office has not yet scored the bill – and passing it without a word of its public cost impacts is horrifying – but we already see that millions will lose their coverage through unaffordability and others will experience skyrocketing increases in their family outlays.
This is unacceptable!
The promises of those opposed to ACA were to ‘repeal and replace’. Repeal is clear. Replacement is not. This bill takes us back to the days of great harm to people whose only fault was not being rich. With employer mandates and tax credits removed, more people will be uninsured, not fewer.
RAISE YOUR VOICE!
Please contact the House immediately. Some votes on parts of this law are coming up in the next few days!
Please let them know you support continuation and improvement of the Affordable Care Act not this bill, not this way, not this tactic, not this time. We want real health care and real affordability, not promises that the “market” will somehow push prices down when it never has and never will.
Call Congress via the Switchboard at 202-224-3121 to connect with your Representative and tell your member of Congress that you will not accept this assault on Americans’ health care.
Time is of the essence. Please call tomorrow morning – your “Faithful Five Minute” call per day has never been more important!