TrumpCare (the AHCA) barely passed the House today, with the unanimous support of Nebraska's GOP representatives, Don Bacon, Jeff Fortenberry and Adrian Smith, with:
- No hearings
- Content hidden until just before vote
- Passage before the Congressional Budget office scored it
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Above: one thing, a huge thing, not mentioned in Waldman's excellent piece |
The bill will kill significant numbers of Americans. Here's how, according to Paul Waldman's piece in the Washington Post's
web site:
- Takes health insurance away from at least 24 million Americans;
that was the number the CBO estimated for a previous version of the
bill, and the number for this one is probably higher.
- Revokes
the Affordable Care Act’s expansion of Medicaid, which provided no-cost
health coverage to millions of low-income Americans.
- Turns
Medicaid into a block grant, enabling states to kick otherwise-eligible
people off their coverage and cut benefits if they so choose.
- Slashes Medicaid overall by $880 billion over 10 years.
- Removes
the subsidies that the ACA provided to help middle-income people afford
health insurance, replacing them with far more meager tax credits
pegged not to people’s income but to their age. Poorer people would get
less than they do now, while richer people would get more; even Bill
Gates would get a tax credit.
- Allows insurers to charge dramatically higher premiums to older patients.
- Allows insurers to impose yearly and lifetime caps on coverage, which were outlawed by the ACA. This also, it was revealed today, may threaten the coverage of the majority of non-elderly Americans who get insurance through their employers.
- Allows
states to seek waivers from the ACA’s requirement that insurance plans
include essential benefits for things such as emergency services,
hospitalization, mental health care, preventive care, maternity care,
and substance abuse treatment.
- Provides hundreds of billions of dollars in tax cuts for families making over $250,000 a year.
- Produces higher deductibles for patients.
- Allows
states to try to waive the ACA’s requirement that insurers must charge
people the same rates regardless of their medical history. This
effectively eviscerates the ban on denials for preexisting conditions,
since insurers could charge you exorbitant premiums if you have a
preexisting condition, effectively denying you coverage.
- Shunts
those with preexisting conditions into high-risk pools, which are
absolutely the worst way to cover those patients; experience with them
on the state level proves that they wind up underfunded, charge enormous
premiums, provide inadequate benefits and can’t cover the population
they’re meant for. Multiple analyses have shown
that the money the bill provides for high-risk pools is laughably
inadequate, which will inevitably leave huge numbers of the most
vulnerable Americans without the ability to get insurance.
- Brings
back medical underwriting, meaning that just like in the bad old days,
when you apply for insurance you’ll have to document every condition or
ailment you’ve ever had.
Naturally the GOP bill contained a provision exempting Congress and its staff, as if anyone needed to ask.
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