Last week, we reported reviving the GOP health care bill would mean more uninsured, costlier coverage in North Carolina. On Friday unfortunately, Republicans in Congress reportedly reached agreement on an amendment that would eliminate key Affordable Care Act (ACA) protections for people with pre-existing health conditions. Under the amendment, states could end some of these protections at will, and end others provided that they created or participated in a federal high-risk pool. Overall, it is clear the American Health Care Act (AHCA) is not fixable. Most Americans already know that almost every piece of the bill would cause people to lose coverage, make coverage less affordable or less comprehensive, or cut taxes for high-income people.
Below are key points related to this amendment, according to the Center on Budget and Policy Priorities.
The amendment takes us back in time
The reported Meadows-MacArthur amendment to the American Health Care Act (AHCA) would allow states to request waivers of key pre-existing conditions protections. This would effectively restore pre-ACA law with respect to these protections, making an already severely flawed bill even worse. The amendment would allow:
- Insurers to once again discriminate against people based on their medical history.
- Women would again be charged more than men for coverage. While proponents claim that the deal preserves the ACA’s ban on gender discrimination, eliminating Essential Health Benefit requirements means that women would have to pay more for plans that included maternity coverage.
- Plans would likely be able to impose annual and lifetime limits on coverage — including for people who get health coverage through their jobs.
Before the ACA, 105 million people with private health insurance — the large majority of whom had employer plans — had policies that imposed lifetime limits on coverage. Waivers of Essential Health Benefit requirements could mean returning to a time when millions of people with health coverage were one major illness away from medical bankruptcy.
AHCA’s Underlying Flaws Remain
The reported amendment makes no changes to the underlying bill. Under the AHCA:
- 24 million more people would be uninsured by 2026 — meaning 1 of every 10 non-elderly Americans who have health insurance coverage under current law would lose it under the AHCA. This would eliminate all of the coverage gains made under the ACA.
- Medicaid would be cut by $839 billion over ten years. The bill would effectively end Medicaid expansion and radically restructure the entire Medicaid program by converting it to a per capita cap or block grant. Under the House bill, 14 million fewer people will be enrolled in Medicaid by 2026.
- People who currently purchase coverage through the ACA marketplaces would see large increases in their premiums and deductibles, and other out-of-pocket costs. Total out-of-pocket costs (premiums, deductibles, copays, and coinsurance) would increase by an average of $3,600 for current HealthCare.gov marketplace consumers, with larger increases for older and lower-income consumers and consumers in high-cost states.
- High-income people would receive billions of dollars in tax cuts, averaging over $50,000 per year for people with incomes exceeding $1 million.