House Republicans this week finally revealed their long promised plan to repeal the Affordable Care Act, also known as Obamacare. The draft, which has earned the moniker of Trumpcare, does offer some insight into how Republicans plan to change health care access for a least 20 million Americans.
The price tag of the measure known as the American Health Care Act is still up in the air. Not even Congress has any idea how much will it cost to repeal and replace Obamacare. What we do know is that it would eliminate the Obamacare Medicaid expansion, which covered more than 11 million low-income people.
House Democratic Minority Leader Nancy Pelosi said in an interview with CBS This Morning, that this new proposal would force tens of millions of Americans to pay more for less coverage, and push many out of care. A considerable number who stand to lose could be people of color.
Here’s what we know about the proposed plan as it now stands:
Say Goodbye to the Individual Mandate: Part of the deal with the ACA is that everybody had to be enrolled in an active plan to cut costs. This part of the plan, known as the individual mandate is one of the red flags that had Republicans fighting ACA.
The new plan does not directly repeal the individual mandate by law, but it proposes to roll back the tax penalties that go with not joining a plan and paying premiums. If there are no penalties, there is no mandate. Without healthy participants who do not have any pre-existing conditions, the system would collapse under the weight of care for those with chronic illness.
You Might Get Some Tax Credits but Maybe Not: If it sounds sketchy, it is. There is a possible provision in the plan for a tax credit that would not kick in until 2020. The credit would replace the insurance subsidy currently offered by the ACA to make premiums affordable. The new plan could mean a $2,000 credit for individuals under the age of 30, and $4,000 for individuals who are age 60 and older. There is also a possible $14,000 credit per family. The Kaiser Family Foundation has published a chart comparing tax credits under the ACA in 2020 compared to the tax credits proposed by the new American Care Act proposed on March 6, 2017. Follow the money.
Older People Could Pay Five Times as Much for Coverage: It is true that under the ACA, older customers pay approximately three times as much for their premiums as younger customers. The Republican plan opens up the door for insurers to charge the elderly five times as much as younger customers. AARP has suggested that this could add thousands of dollars to premiums that those who are in their 50s and 60s already pay.
If You Are Covered Under Your Employer’s Plan: Don’t breathe a sigh of relief if you get your health care coverage through your job. You too can expect to see changes in your plan that will either cost you more money or could cause you to be dropped from the plan. Currently there are 150 million individuals who are covered in some way by the insurance offered through their jobs. Look to take a big hit on your premiums if this plan is passed.
While deductibles are on the rise, overall premiums on plans have remained fairly stable over the past few years. One of the options is to tax medical benefits as if they were income. What does it mean to your bottom line? It would be like taking a pay cut because your tax bill would go up.
There are some tax credits on the table for younger people who participate in the new, proposed plan. If those credits are approved, it would create a loophole where younger people can just skip their employer’s plans and buy coverage. But it could also make dropping the health care coverage benefit look attractive to some employers.
Pre-Existing Conditions: One of the big worries on both sides of the aisle is the idea that people might lose coverage because of pre-existing conditions. But the House proposal maintains coverage for people living with pre-existing conditions. However, if they fail to stay enrolled in a plan and need to re-enroll, they could see an estimated 30 percent surcharge on the cost of their premium, each and every year. The key, no matter what kind of policy people select, would be to keep payments current, especially customers have pre-existing conditions.
Planned Parenthood Patients Could be Big Losers: While there is no surprise that the Trump administration was going to make good on the promise to defund Planned Parenthood, the proposed legislation calls for a yearlong ban on any federal funding to the organization for a year. It also calls for a ban on any federal funding for any health care organization that provides funding for abortion services. It should be noted that Planned Parenthood does not use any federal funding to provide abortions.
This has a major impact of women, especially women of color. Note the fine print—you could be a client for pre-natal services, to manage your diabetes, or to get a mammogram, but the health care center does either perform abortions or provides funding for off-site services. According to the new proposal, Medicaid users cannot receive services at health care centers that fund abortions.
Planned Parenthood receives $500 million in federal funding including Medicaid and Title X. Planned Parenthood President Cecile Richards said in a formal statement that the organization would reject the proposal.
“The defunding of Planned Parenthood would block millions of people from accessing birth control, cancer screenings and preventative care,” Richards says.
Do you think the measure will pass the Senate or are things just heating up? Sound off in comments.
Andrea King Collier is a multimedia health journalist based in Michigan. She is also the author of Still With Me… A Daughter’s Journey of Love and Loss, and the Black Woman’s Guide to Black Men’s Health.