Your SHD Guide to Healthcare in 2017
The United States has long lagged behind the rest of the world in terms of universal healthcare, being one of the few developed countries without it. The Obama administration sought to change that through the passing of the Affordable Care Act (ACA). With this piece of legislation, the United States was set to join 58 other countries in providing universal health care to its citizens. However, the bill was not perfect; partisan pushback and resistance to elements like the individual mandate have now led to the creation of the Affordable Health Care Act (AHCA), Republicans’ proposed alternative. This new health care bill was significantly shorter and has been heavily criticized for being hastily drafted. After its passage through the House was widely regarded as the first major legislative win of the Trump administration, this bill poses a real threat to many high-risk communities across the U.S.
If the AHCA passes the Senate and becomes adopted into law, we can expect millions of citizens to lose their health insurance, particularly low income and elderly populations who often need health insurance the most.
Health care is complicated, and the past few years haven’t made it any easier. Here are some of the key facts surrounding the controversy of the AHCA.
The most popular part of the ACA, and therefore something that had to be included in the AHCA, was that insurance companies were prohibited from using a person’s pre-existing conditions to establish premiums. This was an incredibly important piece as the Department of Health and Human Services published a study reporting that 23-51% (61 million – 133 million people) have a pre-existing condition; this rate increases up to 84% for ages 55 – 64 (31 million people) who have at least one pre-existing condition.
This aspect of the ACA was balanced with the more unpopular part of the bill: the individual mandate, the requirement to have health insurance or pay a fine. In theory, costs could be spread among a community of people, so healthier people could help subsidize the costs for sicker people; the individual mandate would help that community grow and spread out the costs more.
Continuous coverage provision
In the struggle to retain the popular pieces of the ACA while replacing the undesirable parts, the AHCA established the continuous coverage provision. Rather than mandating people to have health insurance, this instead penalizes people for having lapses in health care coverage through an increase in insurance rates; for a year, rates rise 30 percent for any lapse longer than two months. Replacing mandating with incentivizing doesn’t seem like a huge change at first, which is why the bill first didn’t make it to the House floor.
The bill that was passed also included the MacArthur Amendment, a change that allows states to seek waivers for things like replacing the continuous coverage provision and allowing insurance companies for one year to consider a person’s health status in the individual market, or allowing the state to replace a federal essential benefits package with a lesser package of benefits. The MacArthur Amendment in collusion with the continuous coverage provision will likely disenfranchise millions who need it and could send the individual market into a death spiral.
What the future might hold
On paper, one would only be affected if they lived in a state with waivers, had a pre-existing condition, and had at least a two-month lapse in health coverage, a subset of people the bill has set aside a fund for. However, the Commonwealth Fund estimated that 30 million adults would have had a gap of at least 63 days in 2016 and the Congressional Budget Office (CBO) estimates that about one-sixth of the U.S. population live in states that could face this problem.
In addition to these communities, a prevailing theory is that the AHCA could potentially blow up insurance markets and leave people with preexisting conditions with enormous costs. The idea is that the healthier population would discover that insurance rates are lower if they were rated under their health condition as opposed to a part of the community pool, incentivizing inducing a lapse in coverage. This would cause community-rated plans to become filled with sicker and unhealthy people, raising the average costs in the community pool and entering a death spiral of increasing costs. Without an individual mandate to retain people in a community pool, health care will still be unaffordable and unattainable for many.
Give me your sick, your poor, your huddled masses yearning to breathe free.
We must hold them close, rather than pushing them aside. If the AHCA is adopted, it will disproportionately hurt low income and elderly communities. Do not stand idly by to allow these injustices to happen. Call your senator. Even if they are already against AHCA, call them, thank them, and tell them to keep fighting. Make sure your voice heard. Make sure we do all we can to keep people safe.
To find your senators and their contract information, refer to this website.
If you’re unsure about what to say, here are some sample scripts.
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