After waging Holy War against Affordable Care Act (ACA or Obamacare) for almost an entire decade, Congressional Republicans have finally unveiled their long-anticipated healthcare replacement plan. The House of Representatives are set to vote on the bill, dubbed the American Health Care Act (AHCA), this Thursday.
The bill was expected to pass strictly along party lines, but some members from the fiscally conservative House Freedom Caucus have recently expressed their opposition against it, casting its future in doubt. Rep. Mark Meadows (R-NC), leader of the Freedom Caucus, explained that the bill is unlikely to gain enough support from members of the caucus to pass the House. These members feel that the AHCA does not go far enough to repeal some of the most costly provisions of the ACA, such as the expansion of Medicaid services at the state level.
The House Freedom Caucus still opposes the GOP replacement bill in its current form.
— House Freedom Caucus (@freedomcaucus) March 17, 2017
Even if the bill were to squeak pass the House, it is practically dead on arrival in the Senate. On Friday, Sen. Dean Heller (R-NV) joined Sen. Susan Collins (R-ME) and Sen. Rand Paul (R-KY) and became the third GOP Senator to announce that they would vote against the AHCA. These three Republicans will likely kill the bill as it stands by joining the 46 Democrats and 2 Independent Senators voting against it.
Republican governors of four states (Arkansas, Michigan, Nevada, and Ohio) have also voiced concern against the bill in a joint letter to Senate Majority Leader Mitch McConnell (R-KY) and Speaker of the House Paul Ryan (R-WI). This group of governors, which included former presidential candidate John Kasich (R-OH), is worried that the Medicaid cuts will harm their states’ low-income residents the most.
These concerns are all bolstered with projections by the nonpartisan Congressional Budget Office (CBO), which paint a bleak outlook for the bill’s impact. The CBO estimates that 14 million Americans would lose health insurance within a year after the AHCA’s implementation, with the number surging to 24 million by 2026. The Trump administration wasted almost no time blasting the CBO’s report. Press Secretary Sean Spicer questioned the agency’s track record while Health and Human Services Secretary Tom Price downplayed the report by saying the CBO has “been woefully underperforming when it comes to evaluating health systems.”
Despite the massive loss of coverage, the AHCA ultimately fulfills the goal of budget hawks like Paul Ryan, however, as it would reduce the federal deficit by a hefty $337 billion. The bill does so by countering $883 billion in tax breaks with $1.2 trillion in rigorous reductions in healthcare spending. The cuts would largely affect subsidies for low-income people while the tax breaks would mostly benefit business owners as well as healthcare, drug, and insurance companies.
The American Health Care Act–dubbed Trumpcare by some, Ryancare by others–is unlikely to live up to President Donald Trump’s campaign promises to protect Medicaid, increase market competition, lower premiums, and expand coverage and access to “everybody”. Trump has taken notice of this and has provided measured support for the GOP bill. Though President Trump declared that “Obamacare is dead” and that he is “100 percent” in support of the GOP replacement plan, he has been reluctant to openly brand the AHCA as Trumpcare–which is a bit strange considering Trump has made his fortune in large part by putting his name on other people’s products.
Upon realizing that the AHCA would detrimentally affect Trump voters more than any other group, however, it makes sense why Trump would keep his distance from it and shift the blame elsewhere. According to data recently gathered by the Kaiser Family Foundation and the Cooperative Congressional Election Study (CCES), the AHCA would give older and rural Americans smaller tax credits and would impose higher premiums on them than the ACA currently does. The ten states that would be most affected by the AHCA all voted for Donald Trump during the campaign, with residents in these states losing an average of nearly $5,000 in healthcare subsidies.
Under the AHCA, premiums would increase from 15 to 20 percent the first two years after its roll out, but would fall afterwards due to less regulation and more younger, healthier people signing up. However, this also means that older Americans living near the federal poverty line could see a 75-fold increase in their health insurance premiums. These financially insecure seniors, many who live solely on fixed incomes, would be paying substantially more for substantially less coverage. This has prompted the American Association of Retired Persons (AARP), the nation’s largest special interest group, to come out against the AHCA in its current from. In their statement, the AARP blasted the “dramatic financial toll [the AHCA will have] on low- and moderate-income older Americans” along with the bill’s proposed changes to Medicaid and also the tax breaks for insurance companies and drug makers.
Despite the fact that our country spends substantially more on healthcare than any other country, we have one of the lowest returns-on-investment. According to the Center for Disease Control (CDC), “life expectancy and health outcomes are generally worse for Americans than for citizens of other developed nations in North America and Europe.” Eight of our nation’s ten leading causes of death are largely preventable through adequate healthcare and screenings. Yet rather than providing accessible, affordable, and quality healthcare to their constituents, congressional Republicans and the Trump Administration seem more fixated on beefing up our border security and expanding our already-bloated military. Our nation’s vitality and prosperity cannot be secured in this manner, however. If we truly want to put “America First”, then our government must invest in the well-being and health of its citizens rather than burning tax money on trifling illusions of power and grandeur.