The Affordable Care Act that brought health coverage to millions of uninsured Americans is now being threatened by the GOP’s plan to Repeal & Replace. Under this new plan, our current law requiring insurers to accept all applicants, (at the same rates regardless of pre-existing conditions) is in the talks of being rolled back while its replacement is being voted in; but that’s not all that’s being targeted.
Meet the AHCA (American Health Care Act) and some of its particularly notable sections.
(Sec. 101) Eliminates funding after FY2018 for the Prevention and Public Health Fund.
Among these prevention programs are Alzheimer’s, Diabetes, Heart Disease & Stroke and Immunizations. For the full list of programs, visit: https://www.hhs.gov/open/prevention/
(Sec. 103) Federal funds may be withheld from states for payments to family planning providers.
The one example given? Planned Parenthood. Funds should not be withheld from a state for supporting a non-profit that provides versatile care for women and men’s reproductive health.
(Sec. 112) Beginning 2020, the bill eliminates Medicaid services to adult enrollees made newly eligible for Medicaid by PPACA. It also eliminates the requirement to provide “essential health benefits”
(such as ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative services, laboratory services, preventative and wellness services, and pediatric services) These are services that should remain covered by Medicaid.
(Sec. 113) Eliminates Medicaid Disproportionate Share Hospital. (DSH hospitals received additional payment for treating low-income patients.)
This bill would eliminate the additional funding hospitals get for treating low income patients. Effectively incentivizing hospitals to ignore those who can’t pay.
(Sec. 114) Eliminates retroactive Medicaid coverage to applicants; state can also delay or deny coverage pending immigration status/verification of status – during which time they will not be covered.
If the verdict turned out that the applicant was eligible for Medicaid but required care while being verified, are they expected to hold off on receiving help until they’re officially and verifiably covered?
(Sec. 115) Gives additional federal funding to states that did not expand Medicaid coverage under the ACA. If said state later expands Medicaid under the ACA, they are ineligible for said funding.
Not only do hospitals not receive additional payment for serving those with low-income, the entire state will be ineligible for additional funding if the state expanded their Medicaid coverage. On top of this, why do states that didn’t expand their coverage receive even more money? Why are they getting paid for not helping their poorer residents get health insurance?
(Sec. 116) Medicaid eligibility subject to checks every 6 months, which requires additional funds. (“The bill temporarily increases by 5% the Federal Medical Assistance Percentage”).
Amidst all the cutbacks to preventative health, insurance coverage and hospital subsidies this bill proposes that we allocate funding towards repetitive checks to make sure citizens aren’t falsely eligible to be covered by Medicaid. The frequency of checks is mountainous.
(Sec. 133) Health insurers must increase premiums by 30% for one year for enrollees in the individual or small group market who had a break in coverage of more than 62 days in the previous year.
This sounds like penalizing one for not having health insurance; a familiar complaint, except now the application process is less forgiving (See Sec. 114).
(Sec. 205) Repeals the penalties for those not following the Individual Mandate of having minimum essential coverage (beginning after Dec 31, 2015).
They’ve removed the penalty on individuals for not having health insurance, but Sec. 133 shows that if they were uninsured for 62 days and then later want insurance, they’ll receive a year-long hike in premiums when they do eventually opt in.
(Sec. 206) Removes the Employer Mandate, effective after Dec 31, 2015).
By this section, large employers will not be required to offer minimum essential coverage to full-time employees and their dependents. (All the services listed in Sec. 112)
The takeaway is this, 217 Republican members of Congress decided that we can do without:
– Protection for those with pre-existing conditions.
– Medicaid program requirements to provide essential health services.
– Massive funds to preventative care.
– Health insurance for millions.