So the GOP healthcare bill has only just passed the house and frankly it’s given us more questions than answers but one thing is for sure – people will die. It’s not to suggest that Paul Ryan is leading a double life and may actually be a serial killer who specifically stalks the elderly and those with pre-existing conditions (although we can’t rule that out) but more that the policies contained in the AHCA bill are both monstrous and dangerous for those who rely on our healthcare system the most.
So while the bill now goes to the Senate and will almost certainly face major revisions, here’s the groups of Americans who find themselves in the most peril in the aftermath of the Republican healthcare bill.
1. Seniors, especially those who rely on Medicaid.
Based on the current draft of the bill, the law would now operate on a policy called “per capita cap” for Medicaid. This particular policy approach is shit for pretty much everyone currently on the program.
As it stands, the federal government (yes, the same one that most right-leaning seniors hate) matches the amount of money that states spend on Medicaid at a set rate. The more poor the state, the more money the federal government gives. Under the new bill, in 2020 the government would simply give a flat sum per eligible individual in each state. The problem with this kind of policy is that it fails to scale over time and essentially results in a cut to Medicaid overall. While we don’t know the exact amount lost over time it’s currently estimated to be tens of billions over ten years.
What compounds all of these problems is that the adjusted sums don’t keep up well with the cost of the senior population either. The difference is cost between a 60-year old and an 85-year old is obviously quite significant taken as a whole demographic but the new bill does not dramatically scale the sums matched to compensate. This means that states with more seniors will see rates climb and accelerate over time.
2. Anyone with a pre-existing condition.
This group you’ve almost certainly already heard about on Facebook or Twitter. Pre-existing conditions were one of the crowning achievements of Obamacare. No longer could insurance companies just deny people coverage or care based on arbitrary (and often inaccurate) qualifiers related to “pre-existing conditions”.
In the new Republican bill the “MacArthur Amendment” allows states to waive the “community rating” provision that Obamacare created. This provision essentially requires that insurance providers regulate their prices within a fixed margin and can’t increase premiums on sick people. This is a huge sticking point because it essentially means that anyone with a “pre-existing condition” will see their premiums rise at an unfathomable rate akin to the wild west days before Obamacare.
How much would this impact your average individual? Well, that depends on what your pre-existing condition is and who your provider is. However, the list of what classifies as a pre-existing condition and what the increase in premiums could be is extensive. Congestive heart failure? That’ll be a surcharge increase of 459%. Autism? That’ll be 135%. Good old fashioned asthma? 106% increase.
Needless to say, the provisions regarding pre-existing conditions were one of the most popular parts of Obamacare across all Americans and it’s debatable if this amendment will actually survive the senate or not given how incredibly unpopular it is.
3. The poor.
The GOP never misses a chance to shit on the poor and this new bill is absolutely no exception. While the AHCA does still offer tax credits for the purchase of insurance it doesn’t scale to better compensate lower income households. This means that as you approach the “dead zone” (literally) between not making enough money to afford health insurance and making too much money to qualify for Medicaid you’ll find that the credits you receive are essentially worthless as they were never designed to help you and were built for a household in a different income bracket entirely.
This means that under the new bill, the most vulnerable and struggling families – those that are trying to claw their way up and make ends meet but are still “too well off” to fully qualify for assistance will be trapped and forced to go uninsured.
4. Anyone who has a lapse in their coverage.
Speaking of people who can’t afford insurance or who fall onto a line where maybe it’s just barely out of reach – the new penalty. While the new bill no longer has a mandate that requires Americans to be insured it does penalize anyone who isn’t. This penalty goes into effect for anyone who has a lapse in coverage longer than 63 days and allows insurance providers to charge an additional 30% of whatever the premium they would otherwise pay would be.
Where this becomes particularly cruel is that it essentially penalizes those who are already struggling to afford insurance. Whereas Obamacare penalized those without insurance in the form of a tax that would then be turned around to further help those on Obamacare this new bill simply allows insurance providers to reap more money from low-income or vulnerable Americans by just jacking up their prices on anyone who may have a lapse in coverage.
So if you’re an individual who can barely afford insurance and your situation causes you to lapse your coverage for 63 days or more then you may find that your insurance has now gone from “almost” to “impossible” as the price climbs 30% higher.
5. Anyone with a chronic condition.
Prior to Obamacare, one trick that insurance providers used to avoid paying too much for any particularly patient was to impose as “lifetime limit”. This meant that if a single person ultimately required X amount of money spent on their care over their lifetime the provider could simply cap them out and kick them off.
Most Americans would never hit their lifetime limit but for anyone with a chronic condition or one that requires many surgeries and longterm care, this practice could ultimately mean bankruptcy or a death sentence. Children with chronic conditions or those who require a series of surgeries at a young age could be looking at hitting this limit within only a few years and forced into an unthinkable situation.
Under the new Republican bill, lifetime limits will again be on the table for insurance providers to enforce and for those families dealing with a chronic condition, this change is both terrifying and devastating.
6. Literally, everyone.
Let’s not pull any punches here. If you’re a healthy, young American with dependable coverage, the Republican healthcare bill will most likely not change your life in a significant way other than perhaps increasing your premiums a bit. However, all of us are destined to age, get sick and need care sooner or later. This bill weakens our national coverage, sentences our most vulnerable citizens to uncertainty, worse care, and perhaps even death. As a nation, we gain nothing by diving headlong into legislation not made for the people but built simply to be a vessel of destruction to fulfill a promise the GOP made to be rid of Obamacare.