We interrupt our current series to bring you an analysis of the latest bill passed by the House of Representatives.
Today is a historic day. House Republicans voted to repeal Affordable Care Act (ACA).
Please note that this blog post is not a defense of the ACA, it is an evaluation of the House Republican bill.
What will this bill accomplish?
Let’s list the pros and cons:
1. It preserves the provision to allow children to remain on their parent’s health insurance until they reach the age of 26.
1. It will drastically reduce the subsidies provided to help lower-middle class and lower income workers purchase insurance.
2. Reduce Medicaid Expansion: I want to highlight a little known fact about Medicaid. There are provisions in Medicaid that have a significant impact on children with disabilities. Medicaid helps school districts pay for special education services and equipment. This monetary aid helps pay for physical therapists and feeding tubes. Children are also given vision and hearing screenings through Medicaid. The new law cuts Medicaid by $880 billion over the next ten years. A survey was taken in January of this year of nearly 1,000 school districts, 70% said they use money from Medicaid to pay the salaries of health care professionals who assist special education students. What provision in the Republican Health Care Bill will offset these costs?
3. As many as 24 million people will either loose or elect to give up their health insurance.
4. The bill will effectively end the ban on discriminating on those with pre-existing conditions by subjecting sick people to higher costs.
5. The bill will place the sickest people in high risk pools. We have seen on this blog that this measure doesn’t work. High risk pools were tried in 36 states. Premiums in high risk pools were 150 to 200% higher than the rest of the market.
6. State’s Costs: According to TIME magazine , “in 2011, net losses for 25 state high-risk pools were over $1.2 billion for just 225,000 nationwide enrollees.”
7. Long Wait Times for Care: We also pointed out there are long waiting lists for patients. Some even died while waiting. People will die. Some 27% of people in the individual market had preexisting conditions that barred them from being covered before the ACA was enacted.
8. Employer Based Health Insurance: Don’t think you’re shielded from the bill’s negative effects because you have employer based health insurance. The Affordable Care Act allows large employers to choose which state insurance regulations they want to abide by. The ACA preserved consistency across states by imposing 10 “essential health benefits” that all health plans must provide. These essential benefits include:
• Ambulatory patient services (outpatient care you get without being admitted to a hospital
• Emergency services
• Hospitalization (like surgery and overnight stays)
• Pregnancy, maternity, and newborn care (both before and after birth)
• Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
• Prescription drugs
• Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)
The Republican bill allows entire states to get waivers from regulations like the essential health benefit requirement. This means a large employer can choose to abide by the regulations of a wavier state and fail to provide the aforementioned benefits.
If this is not enough, the bill will significantly help the rich by:
1. Eliminating the Medicare Surtax on Wages
2. Scraping the Medicare tax on investments
3. Establish more generous tax-advantaged accounts for health expenses
4. Give people who earn up to $215,000 ($290,000 if married) help for paying for insurance
Republicans were able to sway doubting members of their party by providing $8 billion to high risk pools. They need to add $192 billion in order for high risk pools to have a chance to work. Here is the killer caveat: States that have waivers to opt out of protections under Obamacare are not required to set up high risk pools!
The Republican Party is not a pro-life party. It is a party that prizes profit over death. Trump voters will suffer and perhaps die because of Donald Trump and his 217 House co-conspirators. This bill will leave dead bodies and underserved special education children in its wake.