Affordable Care Act Replaced By ??

"We're going to have insurance for everybody"— the current inhabitant of the Oval Office, Washington Post interview, Jan.15 2017

The administration in the White House is racing to get the Affordable Care Act (ACA) repealed and replaced by end of April.   More than a few Republicans in Congress are not in favor of the plan being pushed at the American people.  Many demonstrations in town hall meetings have erupted from people who don’t want to see the ACA scrapped for something inferior and have their health care coverage put at risk.  Why rush?  Get it right.  Other countries have done it well with national health care systems that are derided by some as “socialism”

The Congressional Budget Office (CBO), a nonpartisan agency that provides budget and economic information to Congress, released a report a few days ago on the Republican-backed American Health Care Act (AHCA, we’re full of acronyms here).  The report, among other things, estimated that if the bill becomes law, 14 million more people will be uninsured next year. That number was estimated to rise to 24 million fewer people having insurance in 2026.

Some people would voluntarily drop their coverage because the bill repeals the mandate requiring people to buy insurance.  Others would choose to not have insurance in response to higher premiums.  The coverage losses would be "disproportionately larger among older people with lower income," according to the CBO.  Those people would face higher premiums under the House Republicans’ bill and less federal aid to pay for them.

Health insurance premiums would initially rise 15% to 20% than under current law but would eventually decrease, ending up 10% lower than ACA's projected prices by 2026.  Costs wouldn't go down for everyone, though, and the worst affected by the proposed plan would be one of the most vulnerable groups: older patients.

The CBO projects average 21 year olds could expect a 20-25% decrease in their premiums, but in sharp contrast 64 year olds would see their premiums increase 20-25%. This is because of a change in the law that would allow insurers to charge older customers more than they can under the ACA.

That’s not all that’s worse for those older patients.  Most people who get individual insurance through ACA receive subsidies and older customers would get less help under the House plan. The bill would give people a fixed amount of help, unlike how ACA subsidies rise according to the patient’s income and the price of insurance.

For 64 year olds making $26,500 a year, the effects would be almost catastrophic. They would pay, on average, $1,700 total for health insurance under ACA in 2026, but $14,600 under the House bill.   On the other end, some higher-income seniors and younger customers would pay less for insurance than they do now.  In the example given by the CBO, that 64 year old under the proposed AHCA would receive the same tax credit of $4,900 to contribute to insurance costs as a 64 year old earning $68,200.  Under the current plan, the $26,500 earner receives a tax credit of $13,600.  That’s an $8,700 difference. The current plan provides no credit to the $68,200 earner.   

In the speech announcing his run for president, the guy who now rides in Air Force One said that he would "save Medicare, Medicaid and Social Security without cuts" and bragged on Twitter that he was the first Republican contender to make that pledge.  But the CBO found that he would break his promise significantly.  ACA expanded Medicaid to cover approx. 11 million more people, but the House bill would reduce Medicaid spending by $880 billion by 2026, at which point it would spend a full 25% less than under current law.

I know, that was a lot of numbers.  Many people stand to have their lives seriously altered by those numbers.  The ACA needs improvement.  Replacing it with something worse would not be an improvement; it would be a deterioration which would adversely affect people who could not afford it.

~ Exile in Medford, Oregon