Would the American Health Care Act Benefit Patients?

Posted March 19, 2017

"What my plan is is that I wanna take care of everybody".

It appears that Republican leaders in the House were right on when they said replacing Obamacare with Trumpcare would give Americans real choices. "Seniors are concerned about losses and cuts in services", she said. "And there needs to be some adjustments to relieve some of that cost shift to the states and to make sure that we don't go back to where we were before - which was we just had our emergency room filled with those who didn't have any coverage". "The people making new laws, why don't they seem to consider the human factor in this?" The Republican plan would up that from 3-to-1 to 5-to-1.

This week, the Congressional Budget Office released its cost estimate of the House Republicans' American Health Care Act. You may remember that when pushing the Affordable Care Act through Congress, then-Speaker Nancy Pelosi famously said they had to "pass the bill so you can find out what is in it".

While I have heard some stories from people who feel like they have better coverage under the ACA, I have heard many more stories from my constituents who are struggling under this failed law. Their plan is fatally flawed by the fact that health insurers have little to no control over the myriad parts and systems of health care.

The Republican plan, which is supported by President Donald Trump, calls for getting rid of the higher match in 2020 for new enrollees who are eligible under the expanded standards. "It would definitely be a resource constraint, and Medicaid is already a big expense for states".

The uninsurance rate will increase among the poor and nonpoor alike. Under the proposed changes, that person would pay $14,600, more than eight times more. Premiums are driven up by as much as 30 percent. They said without Obamacare, they wouldn't be here. But now, high deductibles attached to marketplace plans have become unaffordable for some, he said. All plans must contain broad, generous coverage, including maternity care, mental health coverage, drug abuse coverage and pediatric dental coverage - even for those with no children.

"Listen, I wasn't in Congress when Obamacare passed and I've always said we need to get to work fixing it, but this thing is so awful it frankly isn't worthy of being called a health care bill". By that year, 14 million fewer people would have Medicaid coverage, and program spending would be about 25 percent lower than what's now projected. Those people have incomes at or less than 133 percent of the federal poverty level, or about $2,349 a month for a family of three in New Jersey. The Medicaid expansion, which has extended care to hundreds of thousands of people in OR alone, is eviscerated.

About 82,587 people in The Press' coverage area would be at risk of losing some coverage if a rollback occurred, according to February enrollment numbers from the state Department of Medical Assistance and Health Services. Everyone would be well advised to familiarize themselves with the provisions of this bill. Medicaid covers the cost of long-term care for over 60 percent of nursing home patients. While the landmark legislation has increased access, benefited hospitals, providers and insurance companies, and it has certainly increased the number of Americans insured, it has done nothing to contain costs. Lisa Neeley, an elder law attorney in MA, says it's a hard conversation to have with her clients. "There's the issue of, don't exclude people because of pre-existing conditions, so we have to provide guaranteed coverage".

The report also notes that although average premiums would increase prior to 2020 and decrease starting in 2020, older people will pay "substantially more" (because they consume more medical care). The individual mandate requirement sought to enforce healthy people to pay in to help subsidize the sick. Lower-income people can't afford to pay the full cost of a decent insurance policy. But Ron Caplan, Stockton University associate professor of public health, said as of now, he does not see any exemptions to that surcharge even for people who may suddenly lose their jobs.

"We're going to have a free market, and you buy what you want to buy", Ryan explained.