As we’re sure you’ve heard, the US House of Representatives’ second version of the American Health Care Act (AHCA) – the Republican replacement for the Affordable Care Act (ACA), better known as Obamacare – was passed by just four votes last night. Should this bill make it to the point wherein it’s the law of the land, there will be huge economic and political ramifications – but, most importantly, it will have a huge effect on the health of tens of millions of American citizens.
Academics, medical professionals, scientific researchers, hospitals, nurses, doctors, and even insurers have come out in a strong display of unity against the bill, as have the Democratic Party and a 3-1 majority of the American public. One editorial called it an “abomination,” adding “if there has been a piece of legislation in our lifetimes that boiled over with as much malice and indifference to human suffering, I can’t recall what it might have been.”
So what’s in this bill, and is it really as draconian and spiteful as the outcry seems to suggest? Let’s take a look.
A Redistribution of Wealth
The AHCA was shot down by the House a few weeks back after various moderates and conservative GOP lawmakers were unhappy with the content of the bill – it was either not extreme enough, or too extreme.
Now, with amendments to paradoxically make both sides happy, it barely squeezed through, but it was rushed through the House so quickly that it wasn’t even properly costed, and many GOP voters that opted to support the bill admitted they haven’t actually read it. It will soon be presented to the Senate, whose Republicans members have already said that they will scrap the AHCA and write their own version of it – so who knows what will make it into the final copy and what won’t.
Medical experts have been taking a close look at the AHCA in its current form, and there’s already a consensus that it will have dire consequences.
“We are deeply concerned that the AHCA would result in millions of Americans losing their current health insurance coverage,” a letter from the American Medical Association, addressed to Paul Ryan, reads.
“Although the MacArthur Amendment [a late-stage addition to the AHCA] states that the ban on preexisting conditions remains intact, this assurance may be illusory,” it adds. “Health status underwriting could effectively make coverage completely unaffordable to people with preexisting conditions.”
Here are some of the headlines from various analyses:
- It will cut $880 billion from Medicaid, a social health program designed to support those on low incomes. This means that by 2020, 8 million people relying on it for mental health treatments, and 10.4 million counting on it to help with their substance abuse problems, will lose coverage.
- At the same time, ACA-era tax increases on the wealthiest Americans would be erased, which would amount to an $883 billion tax cut.
- 24 million more people would be uninsured by 2026.
- Those who are healthy and are earning high wages will benefit from this bill, but older people in poor health will see their premiums rise considerably.
- Despite what the GOP leadership have said, the extremely popular ACA provision – that people with pre-existing conditions will not lose their health insurance – simply isn’t true, and millions will lose out as a result of this bill becoming law.
Let’s focus on that final point for now, as it’s likely to be the most controversial. Before the ACA became law, insurance companies could charge people a lot more for their insurance, or deny it to them outright, if they had a long-running medical issue of some kind. Now, it’s illegal to do so, but the AHCA wants to insidiously reverse that. Here’s a selection of just a few pre-existing conditions, at least one of which almost a third of adults under the age of 65 have:
- Breast Cancer
- Coronary Heart Disease
- A form of paralysis
- A transplanted organ
- Psychological disorders
- Sexual assault
- A cesarean section
- Victim of domestic violence
- Being pregnant
As has been rightly pointed out by many, many of these pre-existing conditions are those experienced by women, so the bill is inherently and ludicrously misogynistic.
It’s extremely difficult to argue against the fact that this bill is a vicious assault on the less well-off, the elderly, and women. The AHCA, just as an example, essentially states that, if you report being sexually assaulted, or you are pregnant, you will be asked to pay more for your health insurance if you are allowed to keep it – a lot more, in fact.
“The present proposal would still increase costs, reduce coverage, and cut benefits, putting health, independence, and quality of life at risk for all of us as we age,” Nancy Lundebjerg, the Chief Executive Officer of the American Geriatric Society, said in a statement.
“It Will Make America Sicker”
One recent costing suggests that a 40-year-old with an average type of health insurance will end up having to pay $4,000 more per year if they have asthma, $5,500 extra for diabetes, $17,000 if they are pregnant, and up to $143,000 if they have an advanced form of cancer.
“The TrumpCare bill is not designed to make Americans healthier,” Dr. Jason Westin, an award-winning cancer research expert and assistant professor at the University of Texas, told IFLScience. “It is designed to cuts costs to give a massive tax cut for the richest Americans.”
“As a doctor, I took an oath to first do no harm. This bill will do a lot of harm to a lot of people, and will make America sicker,” Westin added.
“I've seen first-hand the pain that is inflicted on good people with insurance problems. This bill will multiply those problems, not make them better. My patients all have pre-existing conditions, and they and millions more are very worried about what happens next to their healthcare.”
Women, the Poor, and the Elderly
Scientists, doctors, and academics work around the clock to try and provide new forms of treatment, or to move towards cures, for plenty of the pre-existing conditions featured in the AHCA. While this bill doesn’t affect their own research – in fact, Congress gave them a solid funding boost despite Trump’s hopes for the opposite – it won’t have any practical benefit if the AHCA becomes law.
Are you one of the 5.2 million American adults who are suffering from post-traumatic stress disorder this year? Are you one of the 232,000 women in the US that will be diagnosed with invasive breast cancer this year? Are you one of the 2,150 Americans that may die today from heart disease?
If so, under the ACA, you’re covered, and you can be treated, and you will stand a good chance at surviving. Under the AHCA, unless you’re wealthy, you will be left to fend for yourself. The remarkable progress being made by researchers will be made unavailable to the people that need it the most.
Make no mistake – if the AHCA becomes law, people will die.