Americans need healthcare, not wealthcare.
Insurance exists to spread the risk across a large population. It works for homeowners, for auto owners, and for others. With car insurance, for example, the insurance company collects money from all automobile owners. Since relatively few people have an accident within a given month or year, they can afford to pay out to the few who do.
What would happen with auto insurance if a bunch of people said, “wait a minute, I didn’t have any accidents last year, so I’m not going to get insurance this year?” The system would fall apart.
Fortunately, they don’t have that option, because the states mandate that they carry a minimum amount of insurance.
Health insurance should work exactly the same way. Here are some points you need to know regarding Trumpcare aka AHCA.
The AHCA guts the federal Prevention and Public Health Fund that provides nearly one billion dollars to the CDC to respond to public health crises like Zika, Ebola and influenza. So when the next highly communicable disease or other crisis hits the US, millions could die.
In 1918, the Spanish Flu killed between 20 and 40 million people worldwide, including 675,000 Americans. Back then, the population of the US was just over 103 million. Today it’s over 376.5 million – you do the math!
The Individual Mandate
Eliminates the ACA’s individual mandate so that people would not have to pay a penalty if they went without insurance. The problem with this is that younger, healthier people would go without insurance. With a smaller pool of enrollees, companies will have to charge more to cover the older, sicker population that enrolls.
The Employer Mandate
Under the current law, large employers must make insurance available to their employees. The new law would no longer require it, potentially throwing many enrollees into the individual market.
One of the most popular parts of the ACA has been that nobody can be turned away or charged more because of pre-existing conditions. While the proposed new law claims to keep that feature, it doesn’t really.
If you’re receiving coverage for the first time, or if your coverage has lapsed, they can charge you a 30% penalty for a year.
Tax Credits and Subsidies
The ACA succeeded in enrolling millions of Americans who had not previously had health care coverage by providing subsidies to those earning less than $45,000 annually. The poorest Americans could also receive help to pay for deductibles and copayments.
Under the replacement law, subsidies will be based on age rather than income. This will adversely affect the poorest and oldest.
It also gives an advantage to wealthier Americans, who will be allowed to receive age-related subsidies if they earn up to $75,000. That cap will gradually increase over time to help those earning up to $215,000.
Shifts More Expense to Older Americans
The ACA caps premiums for the oldest enrollees at no more than 3 times what the young pay for coverage. The new law ups that to 5 times more. A 64-year-old with an income of $26,500 will pay $1700 a year currently. With the new law, he would pay a whopping $14,600 — an increase of 750%. (And, of course, he still has to pay copayments, deductibles, and out-of-pocket expenses for medicine.) Would you be able to live on less than $10,000 a year?
Gives Huge Tax Breaks to the Insurance Companies, Drug Companies, and the Wealthiest 2%
The wealthiest 1% of wage earners would get an average tax break of $33,000. The wealthiest 0.1% would average $197,000.
Additionally, insurance companies are currently allowed to only deduct $500,000 of Executive pay. That cap will be removed under the AHCA. Since executive pay starts at $10 million a year (yes, you read that right), that makes for a huge tax break.
When the ACA was enacted, a 3.8% tax was imposed on unearned investment income. The AHCA will remove that tax, giving a 3.8% tax break on unearned income to investors — in other words, the wealthiest.
Guts the Medicaid program
Under the ACA, Medicaid was expanded to cover more than 70 million people (although many states, including Florida rejected the expansion). This allowed an additional 11 million to become insured. Under the new plan, Medicaid would be changed to block grants. In other words, the Federal government would pay the states a fixed amount per enrollee. With states unable to make up the difference, they would reduce eligibility, or curtail benefits.
Because Republicans know they don’t have the 60 votes necessary to repeal the ACA, they’re using a budget process called Reconciliation, which requires only 51 votes. That’s why the CBO must score the legislation – this process requires a budgetary impact analysis.
The ACA requires that insurance policies cover 10 essential benefits. The AHCA would stop requiring Medicaid to cover these 10 essential benefits. They include
- outpatient care
- emergency services
- maternity and newborn care
- mental health services and addiction treatment
- prescription drugs
- rehabilitative services
- laboratory tests
- preventive services (including cancer screenings and vaccines)
- pediatric services
Completely ignoring the fact that Federal money already prohibits using taxpayer dollars for abortion, the new bill removes all funding from Planned Parenthood. Unfortunately, Planned Parenthood is often the only place where low-income women can receive a variety of health services, including:
- PAP tests
- Breast exams
- Testing and treatment for STDs
How You May Be Affected
The CBO (Congressional Budget Office) estimates that 24 million people will likely lose coverage, and many Central Florida residents could lose health care if this Act becomes law (listed here by Congressional District).
- District 6: 46,100 (Rep. DeSantis)
- District 7: 55,800 (Rep. Murphy)
- District 8: 43,700 (Rep. Posey)
- District 9: 68,00 (Rep. DeSoto)
- District 10: 52,600 (Rep. Demings)