After the rollout of the House GOP plan to repeal and replace the Affordable Care Act, also known as Obamacare, many health policy experts and lawmakers scrambled to address just how the new bill would impact coverage for everyday Americans.
The new plan, called the American Health Care Act (AHCA), would roll back funding for the ACA’s Medicaid expansion and shift the tax credits that help Americans pay for health insurance.
One effect of the proposals on which many health policy experts – and even some Republicans – agree is that the AHCA will result in a lower total number of people covered than under the current system.
Many health policy experts said the bill, if enacted, would lead to a significant number of Americans losing their coverage.
“Reading through the House GOP bill, it’s hard to imagine the coverage loss is any less than 15 [million] versus the ACA,” tweeted Loren Adler, associate director of the Schaeffer Initiative for Innovation in Health Policy at the Brookings Institution.
Larry Levitt, senior vice president at nonpartisan Kaiser Family Foundation, agreed with this assessment.
“With Medicaid reductions and smaller tax credits, there’s no way the House GOP bill covers as many people as the ACA,” Levitt said.
Those assessments could present a major conflict with President Donald Trump’s previous vows to present a plan that would cover “everyone.” So far, Trump’s top health official, Secretary of Health and Human Services Tom Price, has said that the administration supports the bill, but also called it a first step.
As Kaiser broke down, the block credits for insurance proposed in the legislation, ranging from $2,000 annually for people under age 30 to $4,000 for those over age 60, would amount to far less than the credits under the ACA and would likely lead to people forgoing coverage to avoid the higher cost. In addition, the current funding structure for Medicaid expansion would be repealed as of 2020. The expansion has led to coverage for more than 11 million Americans that would otherwise not have insurance.
Republican Rep. Jason Chaffetz told CNN’s New Day that it was “fair” to say that the plan will provide more access but less overall coverage, though he said lawmakers are sill “consuming” the elements of the law.
Rep. Kevin Brady – the head of the House Ways and Mean Committee and a key architect of the law – dodged reporter questions on whether the law would cover as many people, instead saying that the law would provide “access” to Americans.
The use of “access” over the guarantee of coverage has long been a Republican argument. The GOP has long touted “access” to insurance rather than promising increased coverage. A report from Bloomberg before the bill was released said that Republican lawmakers and staffers were aware that their plan would likely result in lower coverage totals overall.
This, however, may be a feature, not a bug, as many Republicans have said the mandate from the ACA was forcing Americans who did not want coverage into getting insurance, a point echoed by Chaffetz.
“Well, we’re getting rid of the individual mandate. We’re getting rid of those things that people said that they don’t want,” said Chaffetz on CNN. “So maybe instead of getting that new iPhone that they just love and they want to go spend hundreds of dollars in that, maybe they should invest in their own healthcare.”