Trumpcare Returns

Last month, repealing Obamacare was so unpopular that it couldn’t get a vote in the House of Representatives. Today, a new version of that bill is back on the table, and this time it enjoys the backing of some of the most conservative members of the House of Representatives. Here’s what the new bill contains and how it will affect your health.

First, it still includes everything that was problematic in the old bill, including:

  • $ 880 billion cut in Medicaid funding. Politically, this is the most important function of the bill, as it frees up money that can later be used to lower taxes. (Republicans can pass such “budget reconciliation” bills without Democratic support, but they must keep income neutral.) Tons of people rely on Medicaid for services, and with this change, Medicaid will become more difficult (and ultimately impossible) to obtain and cover even fewer services than it already does.
  • Sky-high premiums for seniors . Like the old bill, the new one allows insurers to charge older people more than they currently do, and it changes the subsidies so they are not tied to the actual costs of the plans.
  • At least 24 million people will lose their insurance , including those who “choose” not to buy it because they can no longer afford it.
  • The deductibles will get even higher because there is no longer a rule that insurance premiums must cover a certain amount of health care costs. So you can buy insurance that looks cheap, but once you get sick, you screw up.

In other words, we still consider the bill last month, the law on the American health care , but now with the new amendment. This means that the new bill has most of the problems of the old bill that we discussed earlier .

The draft amendment was leaked to Politico , but the Washington Post reports that the official text cannot be published until Republicans are confident they have enough votes to pass it. The draft amendment says states can implement any of the following:

  • Allow insurers to charge seniors any rate they want . The ACA limited this to a 3: 1 ratio; The AHCA changes it to 5: 1. The amendment allows states to choose a “higher ratio” if they so choose.
  • Eliminate significant health benefits . Right now, if you buy insurance, it should cover any reasonable medical care – so if you have a child, or have cancer, or need surgery, your insurance should cover some or all of the amount. Under this new bill, states can create their own list of top health benefits. If they leave all the expensive things behind, we can go back to the days when you had insurance plans that took your money but covered almost nothing .
  • Make insurance unavailable for people with pre-existing conditions . Technically, insurers can’t deny you coverage, but they can raise your premiums in a separate market – yes, yours personally – if they don’t like the health problems you’ve had in the past. States can permit this if they participate in the stability fund, so these are the high risk pools that you have heard of. But the law doesn’t require states to use that money to pay premiums for high-risk patients, so if you already have a medical condition, you screwed up anyway .

Members of Congress and their aides are required to buy insurance on the individual market, which limits their severity about insurance law before it affects themselves. But the new amendment says that no state changes can apply to insurance for members of Congress and their employees . Thus, they do not want the insurance that comes from the new bill, but they do not mind imposing it on their voters.

Be sure to call your representatives , but don’t panic just yet: this law is far from law. Even if he gets through to the House of Representatives, he will still have to get through the Senate – where he could fail because of his overly conservative stance. Is he popular enough to get a vote in the House of Representatives? We’ll have to look.


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