Tuesday, March 7, 2017

TrumpCare Isn't Care

I am thrilled that the GOP finally (after 6 years) revealed their ACA (i.e. Obamacare) replacement. Unfortunately, it’s a huge step in the wrong direction for four reasons:

1) One of the main ways that the ACA increased insurance coverage was by expanding the Medicaid program to cover millions more of low-income Americans.
  • The ACA opened the program up to anyone below 138 percent of the poverty line (about $15,000 for an individual) in the 31 states that opted to participate.
  • But the new Republican bill will phase out this expansion by 2020, forcing millions to lose healthcare. 
2) One of the main ways that the ACA reduced the burden placed on taxpayers to pay for someone else’s healthcare was by imposing an individual mandate (requiring everyone to buy healthcare or pay a fee).
  • This mandate is essential to healthcare reform because it balances out the risk pool for insurance companies. It puts the young, old, sick and healthy into the same risk pool. After all, you need both healthy and sick people to sign-up for healthcare to balance the insurance market and lower costs in the long-term. 
  • This new bill, however, does not require those who free-ride the system to pay a fee. Instead, it requires those who don’t maintain “continuous coverage” to pay a hefty fine when they want to reenter the insurance market.
  • This places a significant disadvantage to those who need healthcare the most. In fact, people with chronic conditions and disabilities are more likely to have breaks in employment and gaps in coverage as a result of their conditions. With this new bill, these people are at a much greater risk of having insurers increase their premiums. 
  • At the same time, the removal of the mandate could discourage healthy people from getting healthcare until they’re sick. This, in turn, will increase costs for the rest of us. 
3) The ACA currently restricts how much insurers can charge their elder enrollees.
  • Under the ACA, insurers can only charge their older customers three times as much as their youngest. 
  • This new bill removes this important regulation, thus allowing insurers to increase premiums for their older customers. 
4) Under the ACA, tax credits are provided to those who need healthcare but may be unable to afford the current premium prices.
  • These tax credits are based on income, with those who earn less getting more help. In fact, thanks to these tax credits, nearly 80% of those who either sign up for the first time in the marketplace or change plans in the marketplace will only end up paying between $50-$100 a month for insurance. 
  • This new bill, however, would offer tax credits based mostly on age. As such, a significant disadvantage is placed on younger, healthier Americans who are needed in the insurers risk pool. It will also not cover the new high premiums that older Americans will now be charged (see point 3). And it will unfairly benefit the wealthiest among us, while shifting costs to those who are sicker and lower-income.
Please call your member of Congress and ask them to vote against this new bill. 

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