First Read of the American Healthcare Act

Republicans released a draft or the American Healthcare Act (AHA) today.  I knew I would probably be writing something about it, so I downloaded a copy.  The document is essentially a list of edits to the Affordable Care Act and is not understandable without applying the edits to a copy of the Affordable Care Act.  

The bill was not written this way as a matter of procedure.  It was written this way so it would be difficult to understand and would take considerable effort for average Americans to truly understand what it will do when enacted.  Paul Ryan's web site has a link for downloading the bill, but he has also posted a few talking points about it in a more understandable but tragically inaccurate form on the same web page.  The hope is that most Americans will glance at the bill and decide that reading his summary is enough for them to understand it's details and implications.

I'll admit that I've just started going through the original ACA and applying the American Healthcare Act edits to that document, so I'm no expert.  I did notice that it does strip all federal funding from "prohibited entities."  Later in the same paragraph it references abortions, so it is apparent that one provision of the bill defunds Planned Parenthood by withholding federal funds either paid directly or through service provider contracts with the states.  Yes, another underhanded trick that the Republicans hope you won't notice.

So, as I started to go through the American Healthcare Act, I followed the trail of edits back through the ACA and ended up in a bill called the 21st Century Cures Act.  The section of that bill referenced is 4002 - Prevention and Public Health Fund.  It established a fund "to provide for expanded and sustained national investment in prevention and public health programs to improve health and help restrain the rate of growth in private and public sector health care costs" and  "for prevention, wellness, and public health activities including prevention research and health screenings, such as the Community Transformation grant program, the Education and Outreach Campaign for Preventive Benefits, and immunization programs."  

This means $2 billion per year is designated for public health programs, immunizations, and wellness education.  These are things that would make our quality of life better and reduce insurance costs across the board for everyone, not just people who use Obamacare.  The AHA removes all funding for this after 2018.  Who really cares if we are healthy, right?  Why not take that $17 that is spent on immunizations for low income children and put it toward something more meaningful, like covering the $12 million salary of an insurance company executive or a subsidy to Exxon Mobil to drill for oil in the Gulf of Mexico??

It also appears that Republicans will bring back benefit caps.  This means that there will now be a maximum benefit amount that insurance companies are obligated to pay out.  While  most Americans won't experience a catastrophic illness during their lifetime, it still affects all of us by increasing healthcare costs and in turn increase our insurance costs.  If you have a catastrophic illness like lung cancer or heart failure, then you had better have a hefty Healthcare Savings Account account or be ready to sell your house to pay for some of your treatment.  Of course you wouldn't be taxed on some of the $2 million you've been saving to pay for your catastrophic health care costs.  To put things in perspective, If I put 100% of my income into a health savings account, then it would take me over 22 years to save enough money to pay for a major medical crisis.

And if you're a senior, be prepared to pay up to five times as much for your insurance as a 30 year old pays.  That's just the Republican way of saying thanks for working hard all your life to make America great again.

The paragraphs above were written last night.  Today, after the world has had a chance to take a look at the American Healthcare Act, an even more frightening scenario has emerged.  Conservative Republicans are now saying that the cuts to benefits do not go far enough.  Knowingly depriving low income Americans of healthcare is not enough?  What exactly motivates these people and has the Trump presidency emboldened them?  Washington is literally coming unglued over this issue.

Just two more things before I stop writing this post.  The Republicans are saying that the American Healthcare Act will reduce insurance costs for everyone.  This is simply not true.  It will result in an increase in uninsured Americans, which in turn will result in medical providers having to write off more unpaid healthcare bills.  The cost of these write-offs will be passed on to all of us in the form of higher healthcare costs and will result in insurers increasing premiums to cover these costs.

Prevention and healthcare education is also drastically cut in the American Healthcare Act.  It is a proven fact that healthcare education and the promotion of healthy lifestyles lowers healthcare costs, thus reducing the cost to insurers and in turn lowering insurance premiums.  The bill drastically cuts or eliminates expenditures on prevention, which will drive insurance premiums higher.  History has already shown this to be true. 

The next few months will certainly be interesting.  If the American Healthcare Act is passed, then it will result in higher insurance and healthcare costs for all of us whether we are currently Obamacare consumers or not.  This will price many people out of the insurance market and will only widen the gap between the "haves" and the "have-nots" in our country.  This may be the most important legislative action we will see in our lifetime and it's time for all Americans to stand up and fight for what is right.