Head Smacker: Buy my $1 health insurance! How to make a very bad bill worse


April 21, 2017

We’ve seen reports that House Republicans are continuing to work on changes to their bill to repeal the Affordable Care Act. For some of the most right wing members who opposed the bill, their excuse was that it wouldn’t reduce premiums enough. So a possible amendment has been talked about, drafted by Representatives Mark Meadows and Tom MacArthur, which would allow states to reduce costs for some by gutting requirements that key services be covered (such as inpatient or outpatient care, prescription drugs, mental health or substance use disorder treatment, and maternity care). That is, you can pay little and get pretty much nothing. The amendment would also let states gut protections for people with pre-existing conditions. States could waive what are called “community rating requirements,” which under the Affordable Care Act prevent insurance companies from charging people more based on their medical history. Under the MacArthur-Meadows amendment, states wishing to waive these requirements can do so if they create or join a federal high risk pool. This is a real head-smacker. High risk pools were a feature of the bad old days before the Affordable Care Act. They failed because they put people with expensive health conditions into a separate pool, requiring tremendous subsidies to make the insurance come close to being affordable. They weren’t affordable. That’s why, right after the Affordable Care Act took effect, the number of non-elderly people with pre-existing conditions who had no health insurance declined by 3.6 million. That includes 1.1 million with hypertension and 1.2 million with asthma or chronic lung disease.

It’s hard to see what’s attractive about this new proposal. It makes a very bad bill even worse, by placing people at the mercy of state governments to determine whether there is anything of value left in their health insurance benefits, and whether they will have to pay much more if they are among the up to 130 million non-elderly adults in the U.S. with pre-existing conditions. And states will be hard-pressed to preserve the current law’s protections, because the repeal bill would slash subsidies that now make insurance affordable for people who actually need to use it.

But amendments like these are apparently appealing to members of Congress who just want to say they’re making health insurance cheaper, at least for the people who aren’t sick. Or pregnant.

When the House tried to take up the previous very bad repeal bill (the American Health Care Act), they had to pull it because there weren’t enough votes. It didn’t have enough votes because of the outpouring of opposition. The time for that is not over. When Congress returns from its recess next week, they will be looking at a bill that will still cause 24 million people to lose insurance by 2026, and that will cut Medicaid by more than $800 billion. Oh – and that will still hand tax cuts averaging over $50,000 per year to millionaires. It’s still a Head Smacker. But hey – buy my $1 insurance and I’ll send you 2 aspirin!

Or, we can make sure members of Congress know that we don’t want them to gut the Affordable Care Act and put coverage out of reach for millions. We can make the opposition just as loud and strong this time as it was when they had to pull the previous bill. Use the #ProtectOurCare hotline and call 1-866-426-2631 (English) or 1-877-736-7831 (Spanish), or email your representative today.

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