Tag Archives: American Health Care Act

NEJM: Senate Effort to Scale Back Health Care Coverage

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This is a concise summary on the potential effects of the U.S. Senate’s efforts to ‘repeal and replace’ Obamacare: from NEJM: Health, Wealth, and the U.S. Senate

Here’s an excerpt:

The Better Care Reconciliation Act (BCRA), as the U.S. Senate calls the health care bill released by a small working group of Republican senators last week, is not designed to lead to better care for Americans. Like the House bill that was passed in early May, the American Health Care Act (AHCA), it would actually do the opposite: reduce the number of people with health insurance by about 22 million, raise insurance costs for millions more, and give states the option to allow insurers to omit coverage for many critical health care services so that patients with costly illnesses, preexisting or otherwise, would be substantially underinsured and saddled with choking out-of-pocket payments — all with predictably devastating effects on the health and lives of Americans. What would get “better” under the BCRA is the tax bill faced by wealthy individuals, which would be reduced by hundreds of billions of dollars over the next decade — about $5,000 per year for families making over $200,000 per year and $50,000 or more for those making over $1 million, according to analysis of the AHCA, which included a similar set of tax provisions.1 We believe that that trade-off is not one to which we — physicians, patients, or American society — should be reconciled.

Related blog post: Five Reasons Why Medical Groups Oppose the Senate’s AHCA

St. Vitus Cathedral, Prague

 

Five Reasons Medical Groups Oppose the Senate’s AHCA

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Many analysts have described the American Health Care Act (AHCA) as essentially an 800 billion dollar tax cut which as a consequence eliminates health care coverage for more than 20 million.

Some of the reasons why almost all major medical groups oppose the repeal/replace effort of the Affordable Care Act are summarized from NBC News. In brief, they are the poor, the elderly, children, women, and those with preexisting conditions –all disadvantaged if the AHCA passes.

NBC News: Just About Every Major Medical Group Hates the GOP Healthcare

An excerpt -regarding children:

Medicaid covers 75 million people, including nearly 36 million children, according to data released Friday by the Center for Medicare and Medicaid Services..

“Senate leaders present their bill as providing states with flexibility. The reality is that it will put considerable pressure on states to limit their spending on health care, including for children,” said Dr. Matthew Davis, a professor of pediatrics and of medicine at Northwestern University Feinberg School of Medicine.

“The bill includes misleading ‘protections’ for children by proposing to exempt them from certain Medicaid cuts,” added Dr. Fernando Stein, president of the American Academy of Pediatrics.

“A ‘carve-out’ for children with ‘medically complex’ health issues does little to protect their coverage when the base program providing the coverage is stripped of its funding. Doing so forces states to chip away coverage in other ways, by not covering children living in poverty who do not have complex health conditions, or by scaling back the benefits that children and their families depend on,” Stein added.

Related blog posts:

What’s at Stake with “Repeal and Replace”

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Full Link from NEJM: The Mirage of Reform — Republicans’ Struggle to Dismantle Obamacare

Here’s an excerpt:

The [AHCA] bill distinguishes itself from the ACA largely by its commitment to regressive redistribution: it would give wealthier Americans more money (mainly through sizable tax cuts) while reducing government support to help low-income Americans afford insurance. Relative to the ACA, premium subsidies for the uninsured would decrease substantially, on average by 40% in 2020 and reaching 50% by 2026.1 Those cuts would fall heavily on lower-income people, with middle- and upper-income Americans receiving higher subsidies.1,3 The ACA’s subsidies to assist low-income persons with deductibles and copayments would be eliminated altogether. By 2026, for a person earning $26,500 a year and buying individual coverage, insurance plans’ actuarial value — which measures the share of costs that plans pay for covered services — would fall from 87% under the ACA to 65% under the GOP plan…

In addition to unified Democratic and significant Republican opposition in Congress and among governors, key stakeholders — including the American Medical Association, the American Hospital Association, and the seniors advocacy group AARP — oppose the bill. Furthermore, as its potential demise draws nearer, the popularity of the ACA, now part of the status quo, is growing. In the Republican imagination, Obamacare has been a disaster. The GOP’s problem is that in reality Obamacare has substantially expanded health coverage, with 20 million Americans gaining insurance. Rolling back the ACA means making insurance less affordable for low-income Americans, increasing the uninsured population, and taking vast funds away from states and medical providers. The GOP health plan neither fully repeals the ACA nor provides a compelling replacement. Instead, in my opinion, it offers only a mirage of reform.

Another analysis indicates significantly higher deductibles are likely under the GOP plan:

Link: Why dedcuctibles would increase under the GOP health plan