For the past seven years, Republicans have repeatedly vowed to “repeal and replace” Obamacare. Although the party has always spoken vaguely on the subject, the GOP finally released a bill, the American Health Care Act (AHCA), to the public on March 6, 2017. Fortunately, after facing overwhelming opposition, President Donald Trump P’00 and Speaker of the House Paul Ryan decided to scrap the bill altogether on Friday, March 24th.
To put it lightly, since its introduction, the bill received less than enthusiastic support. Dubbed as “dead on arrival,” the AHCA was immediately disliked by bipartisan legislators. To liberals, the bill risked millions becoming uninsured; to conservatives, it was just too similar to the Affordable Care Act. Overall, it is easy to say that the AHCA was not the solution that America is looking for.
While the majority of the AHCA’s legislation would hurt the American people, it is necessary to mention that according to the Congressional Budget Office (CBO), it would result in a $150 billion reduction in deficits and a 10% decrease in premium costs compared to the ACA by 2026. Therefore, it would most likely be more cost-effective in the long run; however, its short term effects would result in major conflicts for many Americans.
By 2026, 52 million Americans would be uninsured under the AHCA, according to the CBO. In addition, premiums would be 15-20% more expensive by 2020. Both of these issues result from the removal of the tax penalty of the individual mandate. While the actual mandate is still included in the bill, those who forgo the AHCA will face no penalty, eliminating any incentive for younger, healthier people to sign up for insurance. Thus, the number of uninsured people will increase along with the cost of premiums.
A key component of the ACA is its subsidies, or tax credits, granted to individuals to help them pay for healthcare premiums. Under the ACA, the amount a person receives in credit is based on their income: anyone earning between 100 and 400% of the federal poverty line each year qualifies for a subsidy. Under the AHCA, tax credits would be based on age. Generally, the average 20-year-old needs medical care less frequently than a 70-year-old. Thus, the GOP bill would grant $2,000 a year to people under thirty years old, increasing by $500 every ten years until the age of sixty, when it would become $4,000 per year and remain that way indefinitely. Unlike Obamacare, these numbers would stay constant no matter the local cost of insurance, meaning that certain people would face much higher premiums than others, but would be granted the same amount of credit. In addition, insurers under the AHCA would be able to charge five times higher premiums to older individuals than younger people. Therefore, the tax credit system would most negatively impact those living in areas with high premiums, earning low incomes, or of an older age.
As expected, the AHCA includes legislation on women’s health and reproductive rights. The GOP plan would block federal funding of Planned Parenthood clinics for a full year, making it difficult for many women, especially those with lower incomes, to have access to contraception, prenatal care, and other services. Furthermore, women would no longer be able to apply tax credits to a plan that covers abortion services for individuals who are not in mortal danger due to the pregnancy or pregnant because of rape or incest. While Roe v. Wade is still intact, this bill guarantees that low-income women would have limited access to reproductive healthcare. Additionally, the AHCA does not require that all insurance plans provide the “ten essential benefits.” Under the AHCA, each state would be able to decide which services are mandatory to provide. One of these benefits is maternity care — a service that many conservatives argue is not a necessity. It is likely that the insurers under the AHCA would strip their plans down to the most minimal form.
While the AHCA’s disposal might possibly be the defining moment of Trump’s presidency so far, its cancellation does guarantee that Obamacare will remain in place for now. However, in order to eventually pass another bill, the Republicans will need more conservative support. Therefore, it is possible that their next proposed plan will be even more catastrophic for the American people than the AHCA. Hopefully, it will be a long time before that bill is passed.
