Healthcare is a difficult subject and one we don’t always comprehend. The United States is one of two countries that doesn’t provide universal healthcare to its citizens and former President Barack Obama has worked significantly to change that. However, the Patient Protection and Affordable Care Act (ACA aka ObamaCare) has been largely controversial but overall effective. Yet, the U.S. Congress in 2017, in collaboration with President Trump, have released the American Health Care Act (ACHA aka TrumpCare). The republican healthcare plan says that it will lower premiums and increase patient health but will actually hurt many Americans especially the oldest and poorest in the country. The AHCA is a tax cut for the rich while pricing many older Americans out of the market all together. This plan fails to address how it will be paid for, as the ACA forced people into the market in order to subsidize coverage in the US, AHCA repeals these payments without offering a replacement for them. Let’s dive into both of these plans to determine what it means for you and me.
What is ACA
The Affordable Care Act is the current operating healthcare system in the United States.
– Employers provide health insurance, because the ACA required companies to provide affordable insurance or face penalties.
– Ideally, the ACA makes insurance more affordable by reducing premium and out-of-pocket costs for individuals who have been priced out of coverage in the past. In 2013 over 15% of Americans were without insurance despite the goals of the ACA
– The risk is spread equally to reduce discrimination.
– A new competitive health insurance marketplace that didn’t exist before.
– There is a cap on insurance company non-medical, administrative expenditures
– You can no longer be charged more money based on health status, gender, or salary
What is AHCA
The Republican plan, named the American Health Care Act AHCA
is the current insight into how Republicans are are going to tackle healthcare, however as of March 26, the plan has been pulled from the floor of both houses by the Speaker of the House, Paul Ryan, as he felt he didn’t have the votes
o tax credits based on age for people earning a specific kind of income or less, this replaces the subsidies that ACA provided.
o you the ability save twice as much money (from previous years) a year, tax-free, in a health savings account — up to $13,100 starting in 2018.
o The individual mandate (that everyone must have healthcare or face penalties) is gone under this Plan
o The mandate that employers have to provide healthcare for employees are pay a fine
o Repeals the ACA subsidies
Subsidies are payments from the government that act as stimulus
o Puts in place a plan of continuous coverage
Continuous Coverage is the idea that if you always maintain health insurance (or don’t exceed a gap of 30 days) you will never have to pay more than an average amount for insurance in your area.
o Charges older, sick people more
Similarities between ACA and AHCA
– Adult children can stay in a family plan until age 26
– Insurers can not deny coverage to an already sick person/a pre-existing condition
– You can not charge a person more based on their gender.
– Basic benefits are still required by insurers but Medicaid would no longer offer these benefits under ACHA
– Insurers would be barred from imposing annual or lifetime limits
Differences between the two plans
– A 28-year-old could get $2,000 toward your insurance premium under the republican plan. However, if you are at a higher paying job and get laid off and you need to find insurance quickly, because you can be penalized for a gap in coverage, being charged 30% more, for up to a year, compared with someone who never had a coverage lapse.
– The ACA lets insurance companies charge 64-year-old customers only three times as much as the youngest customers. But the ACHA would allow insurers to charge you five times the price for young adults.
– ACA was paid for in large part by a tax increase on the wealthy, ACHA will give a large tax cut to the wealthy. Those making over a million dollars a year will get an average of $50,000 in tax cuts. Those in the .01% of Americans would get an average cut of more than $195,000.
-If you are living in Idaho earning $45,000 a year and your 10-year-old has cerebral palsy and gets insurance through Medicaid then, Medicaid helps your son out a lot by picking up a lot of the bills but Idaho didn’t expand Medicaid under ACA. Luckily, he qualifies for provisions as a “persons with disabilities”. However, ACHA changes this, in 2020 the federal government would scale back Medicaid by providing fixed sums to states to pay a set percentage of your son’s medical bills. If costs increase faster than the federal fixed sum, then Idaho could significantly scale back the the Medicaid subsides they provide.