I have a cursory understanding of how subsidies introduced by the Affordable Care Act (alias Obamacare) allow me to pay simultaneously for health insurance and rent, which is delightful. I know people who, due to pre-existing conditions, only have coverage because of the ACA. I know that Medicare is for the elderly, Medicaid for the poor. I know that President Trump promised quite vigorously to keep both of them intact.
I was the first & only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid. Huckabee copied me.— Donald J. Trump (@realDonaldTrump) May 7, 2015
In terms of health care reform, he also promised to eliminate the individual mandate (#53) and increase doctor choice (#64). Unless my feeble woman-brain is mistaken, doesn't one need health care coverage to go to a doctor at all?
Pause and reflect.
The American Health Care Act, or Trumpcare, as it has been dubbed, recently passed through two committees in the House of Representatives. If passed in its current form by the House and the Senate, it will disproportionately impact (that is to say, hurt) the people who voted for Trump believing in his promises to improve, not annihilate, their access to health care.
The "for dummies" (myself included) low-down on the American Health Care Act is this: lower taxes on the ultra-rich, less health care for the poor. In no particular order:
- Lower-income individuals and will lose access to health care. While the ACA raised the Medicaid income eligibility ceiling to $16,400 and provided generous insurance subsidies to those making less than $30,000, much of that will be reversed by AHCA. (Is that what we're calling it now? Or is it Trumpcare? Wealth Care, perhaps?)
- Insurance companies whose CEOs make more than $500,000 will receive a tax break that will, over the next 10 years, amount to $400 million in lost tax revenue. This is a huge deal, not just because of the principle behind it, but because it proves an unwillingness to maintain -- much less grow -- health care spending enough to fund Trump's promise of higher-quality, less expensive health care for all.
- No more individual mandate, i.e. no more penalization of those who don't enroll. However, to cover the revenue gap, insurers will be allowed to "impose a surcharge of 30 percent for those who have a gap between health plans."
- They'd keep two very popular pieces: Young adults would be able to stay on their parents' health plans until the age of 26, and insurers would not be able to deny coverage or charge more based on pre-existing conditions. (They would, however, be able to charge their oldest customers up to 5x what they charge their youngest. The ACA set that limit at 3x.)
- Planned Parenthood, whose services include anemia testing, cholesterol screening, high blood pressure screening, diabetes screening, physical exams, flu vaccines, help with quitting smoking, thyroid screening, tetanus vaccines, sex education and counseling (including abortion counseling, family planning counseling, and STD testing), cancer screenings, psychological support, and relationship counseling, among other things, would be ineligible for Medicaid reimbursements or federal family planning grants. While not surprising, this is still devastating -- especially for the poor, and especially for poorer women.