Yesterday, House Republicans resurrected the American Health Care Act (AHCA), a bill that gifts nearly $900 billion in tax cuts to the wealthiest Americans by robbing more than 20 million Americans of health coverage. This cruel bill—and its celebration by President Trump, Vice President Pence, House Speaker Paul Ryan and a notably white male crowd of lawmakers and supporters—sends a clear message to millions of Americans of all political stripes that conservative lawmakers regard them with absolute contempt.
There are no two ways about it. This bill rewards those who have already reaped the benefits of our staggering economic inequality while punishing those who are hurting the most.
- The AHCA enables states to opt out of the Affordable Care Act’s requirement that all providers cover a package of “essential benefits,” which include emergency care, pediatric care, contraception, laboratory testing, maternity and pregnancy coverage, pharmaceuticals, and many other basic services. You know, the things that are essential to the health and wellbeing of American families.
- It has a provision that would enable states to increase costs for individuals with pre-existing conditions, which include pregnancy, domestic violence and sexual assault, genetic disorders, headaches, diabetes, physical problems —basically anything else that’s ever brought you to a doctor’s office. Conservatives make themselves felt better about this deeply unpopular move (more than 6 in ten Americans don’t like it) by creating high-risk pools that would help these individuals pay for their more expensive coverage. But experts say the amount earmarked for these pools won’t be enough.
- The bill ends Medicaid expansion by 2020 and allows states to make radical and historic changes to the program, resulting in the erosion of benefits for the most vulnerable Americans. The CBO estimated that the previous version of the AHCA would leave 24 million additional individuals uninsured by 2026, and that much of that increase would result from changes to Medicaid.
- The bill would defund Planned Parenthood for a year, leaving millions of low-income women, women of color, immigrant women, young people and plenty of men without a source of trusted, quality care.
- It would allow insurers to charge older Americans up to five times as much as younger Americans, while reducing the tax credits that help older consumers afford their coverage.
As I’ve argued many times in recent years (here, here, and here), the Affordable Care Act isn’t perfect, but it vastly improved a health system that had routinely failed the American public and had discriminated against women, poor people, and sick people for too long. The ACA allowed more than 20 million Americans to secure health coverage, raised the quality of care for everyone, and nudged us toward the promise of greater health and economic equality.
The bill still needs to clear the Senate. It’s up to all of us to let senators of both parties know what these proposed changes would do to the health, economic security, and overall wellbeing of our families and communities. In the meantime, we should all hope that Senate conservatives are not so focused on ruining Obama’s signature policy achievement that they’re willing to ruin American lives in the process.
Also published on Medium.