Republicans in the House of Representatives released their replacement for the Affordable Care Act (ACA) this Monday, and it is a doozy.
One of the biggest criticisms people laid down on the Affordable Care Act was that it simply wasn’t affordable. These claims seem to be justified considering that health care costs have continued to rise after the law’s implementation (albeit at a slower rate).
Republicans are making no such promises of affordability in their healthcare bill, simply calling it the American Health Care Act (AHCA). Let’s jump right into it.
Premiums are going to keep getting higher
The most significant cost-reducing measures in the ACA are premium subsidies for low and middle-income Americans (anyone making under 400% of the poverty line). This means that if you are a worker earning less than $47,520 or a family of four earning less than $97,200, the government will pay for a portion of your monthly insurance premium. These subsidies scale with income, so poorer Americans get more of their premium covered than richer ones. The median household income for Alabama in 2015 was $44,765, so over half of all Alabamians are currently eligible for these subsidies in the private marketplace.
The AHCA gets rid of these subsidies, and replaces them with tax credits. With the subsidy, you have the option to apply it to your premium every month and pay the reduced price. With the tax credits, you’ll be paying full price for your premium every month, and then you can get some of that back in tax credits. This means low-income families who rely on the subsidies will have to give up their health care because they can’t afford to pay the high cost premiums in the first place.
On top of that, the tax credits don’t target lower-income Americans nor do they scale with income like the subsidies do. Instead, tax credits are offered at flat rates to Americans making below $75,000 (or $150,000 for couples). So the healthy 20-year-old who makes $70k with a $800 premium and the 20-year-old with an expensive medical condition who makes $15k with a $3000 premium will both get the same tax credit.
The credits do scale with age, so older Americans will receive larger tax credits than younger Americans. Older folks tend to require more healthcare than younger ones, and insurance companies usually try to profit on that by spiking their premiums.
But if you thought Congress was going to lower healthcare costs for older Americans, you were sorely mistaken. The tax credits under the AHCA are much smaller for older and lower-income Americans than the subsidies which they currently receive under the ACA. Obamacare currently limits insurers from charging older Americans no more than three times as much as they do younger Americans, and the new bill increases that limit to five times more.
Where do we go from here?
Overall, older, sicker, and working class Americans are going to be paying much more for their healthcare, and many of them are going to be priced out and will lose coverage altogether. For those who can continue to afford health insurance if this bill is passed, their insurance will be covering much less.
The GOP snuck defunding Planned Parenthood into the bill as well by preventing women on Medicaid from going to any healthcare provider who also provides abortion services. This means women on Medicaid won’t be able to get contraception, cancer screenings, and STI tests from any Planned Parenthood clinics if this bill goes through. This is all without even talking about discrimination against plans which cover abortion, the extensive cuts to Medicaid, the continuing coverage fee, and much more that’s in the bill.
The Republicans have been criticizing the ACA for years now because of its failure to provide Americans with affordable healthcare, and now they released a bill that worsens the situation by making healthcare more expensive for all of us, just to give major tax cuts to the rich. Now is the time to resist, to be outraged, and to do whatever it takes to not only stop this right-wing onslaught on the lives of innocent Americans, but also to work towards a political future where universal healthcare in the United States is a reality.
Dannial Budhwani is a writer currently based in Birmingham. His work has appeared in WBHM 90.3 and The Auburn Plainsman.