The Tate of the Union: the implications of the American Health Care Act

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Last week, the Congressional Budget Office released its report on the House Republican health care plan, officially known as the American Health Care Act. The plan would eliminate Obamacare’s current requirements for all to be insured and would create a new system based on tax credits to incentivize Americans to purchase health insurance. The report concluded that the new plan would increase the number of uninsured Americans by 24 million by the year 2026, yet reduce health care premiums and the national deficit in the long term. Today, the proposed legislation to dismantle and replace President Obama’s Affordable Care Act has received widespread criticism from House Democrats and Republicans alike for its adverse implications for older and poorer Americans.

For many conservative supporters of the proposed legislation including President Trump, the reduction in federal spending is the new plan’s shining achievement. While the C.B.O.’s report confirms Republican claims that the new health care policy would help chip away at the national debt by reducing federal spending for programs like Planned Parenthood and Medicaid, this deficit reduction is negligible in the wake of the vast elimination of health care for millions of Americans.

The most egregious implications of the Republican health care plan are for those currently insured under Medicaid, the current health care program for low-income Americans. Under the Republican plan, the CBO predicts that 14 million fewer people would be covered by Medicaid. The new health care bill, combined with the recent Supreme Court ruling that states cannot be compelled to expand Medicaid offerings for its residents, will leave many Americans currently protected under the program without options and without insurance.

Although Republicans opposers of Obamacare denounce the health insurance mandates through tax penalties found in current health care law, their new plan would replace this system in a fairly similar way. In an illogical effort to encourage Americans to maintain their health care coverage, health insurance providers would be allowed to raise premiums by as much as 30 percent for those who have been without health insurance for more than two months.

In response to the CBO’s report, Democratic Representative John Yarmuth of Kentucky contends that bill would do much more than simple health care reform.

“It’s an ideological document with real and incredibly damaging consequences for American families,” said Yarmuth.

Of course, the Republican plan would not affect all Americans equally. Since health insurers would have free reign to charge older Americans higher premiums, the cost of coverage for those who need it most would skyrocket despite the new tax credits. Additionally, a more deregulated insurance market would create greater uncertainties for Americans with pre-existing medical conditions, those who will likely require medical care at some point in their lives. The C.B.O.’s report also confirmed that deductibles and various other out-of-pocket costs, which disproportionately affect poorer Americans, would be much greater for many consumers under the Republican plan.  

In a cruel twist for the older and lower-income Americans who voted Trump into office, the changes to health care in America under the American Health Care Act will likely have the greatest negative impact for them. The bill is scheduled for a vote in the House on Thursday, and no Democrats have pledged to support the legislation. While the president has described the plan as a “thing of beauty,” the realities for the millions of affected Americans will be ugly.

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