Editor’s Note: For an alternative viewpoint, please see: Counterpoint: A Better Way — Repeal the $9 Trillion Health Insurance Tax
In the wake of House Republicans’ failed attempt to pass their bill to repeal the Affordable Care Act, the key lesson is clear: It’s time to move on.
The ACA is the law of the land, and it has become a fundamental part of our nation’s health care system. Not only do more than 20 million Americans have coverage thanks to the ACA, the law also put in place important protections for consumers, and it has helped slow the growth in health care costs compared to pre-ACA trends. While there’s more work to do to make affordable, quality health care a reality for all Americans, repealing the ACA would take us backward, jeopardizing the health and financial security of tens of millions of Americans.
Unfortunately, it appears that the Trump administration and House Republicans haven’t gotten the message. They are reportedly discussing a deal to revive the House Republican leadership’s ACA repeal bill — the American Health Care Act. This is a mistake.
A recent poll found that just 17 percent of the public supported the Republican bill. And, for good reason. The bill would be a disaster for the country. It would cut more than $1.1 trillion from Medicaid and subsidies that help moderate-income people afford health coverage and would spend the savings on tax cuts for high-income Americans and corporations. As a result:
—Twenty-four million people would lose health insurance coverage by 2026, according to Congressional Budget Office estimates.
—Millions more people would end up with skimpier or less affordable coverage. For people who currently purchase coverage through HealthCare.gov, total out-of-pocket costs would rise by an average of $3,600 under the House bill — and by even more for older people, people with lower incomes, people in rural areas, and people in states with high health insurance premiums.
—High-income households would receive billions in tax cuts. By 2025, tax cuts would average more than $50,000 per year for households with annual incomes above $1 million. And the 400 highest-income taxpayers would get annual tax cuts averaging nearly $7 million each starting in 2017.
The problems with the House bill simply aren’t fixable. And changes reportedly being considered to gain the support of House conservatives would only make it worse. They would let states dismantle protections for people with pre-existing conditions and eliminate requirements that health insurance plans cover basic services like maternity care, prescription drugs, and mental health and substance use treatment.
So, how should we move forward?
First, stop talking about repeal. Republican leaders’ continued talk of bringing some version of their ACA repeal plan to a vote is harmful to individual market consumers. That’s because insurers are currently making premium and participation decisions for 2018, with state rate filing deadlines starting in just a few weeks. If enacted, the AHCA would substantially increase per-enrollee costs and reduce individual market enrollment next year. Continued talk of bringing the bill to a vote will lead insurers to propose higher rates, or it could discourage them from offering plans in the individual market at all.
Second, support, don’t sabotage, the ACA. President Trump says the ACA is “exploding right now” — but it’s not. In reality, health insurance markets are generally stable under the ACA, and insurers’ financial situation has improved. What could cause a crisis in the market, however, is if the president takes more steps — on top of some troubling actions to date — to make his prediction of this being a “very bad year” for the ACA come true.
These steps, all of which would be costly for consumers, could include:
—Halting cost-sharing reduction payments that help lower out-of-pocket costs for more than 6 million people with ACA marketplace plans.
—Weakening or failing to enforce the ACA’s mandate for individuals to have coverage or pay a penalty.
—Undermining the enrollment process to reduce enrollment in ACA plans, particularly among healthier people.
Public support for the ACA is at an all-time high, and three-fourths of the public think the Trump administration should do what it can to make the current health care law work. That means that even opponents of the law recognize that sabotaging it would only hurt the millions of Americans who rely on the ACA for health coverage.
It is time for congressional Republicans and the administration to move on from attempts to undermine or repeal the ACA. Instead, they, along with the states, should work to strengthen it so we can continue our historic progress toward making health insurance affordable and accessible for all.
