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Here's Why the Republican AHCA-But-Worse Plan Should Not Be Passed by the House Today

People take part in a protest outside Raritan Valley Community College before a town hall meeting on health care with Republican New Jersey Congressman Leonard Lance on Feb. 22 in Branchburg, New Jersey.
(Photo: Eduardo Munoz Alvarez/AFP/Getty Images)

A vote in favor of the American Health Care Act (AHCA) today would be a vote to make the vast majority of Americans poorer, less healthy and more financially insecure.

The AHCA would cost 24 million Americans their health insurance coverage. The majority (14 million) would lose it to breathtakingly large cuts (almost $900 billion over the next decade) to the vital Medicaid program. Further, 7 million Americans would lose the coverage they get through their employer if AHCA passes.

Costs would skyrocket for those who still needed coverage in the nongroup market. A 64 year-old making 175 percent of the federal poverty line would pay $12,900 more each year for the health insurance plan’s premiums under AHCA, but would also face deductibles and co-pays that would cost thousands more than they do currently. For the entire nongroup market, out-of-pocket costs after premiums would rise by $25 billion each year by 2026 if AHCA is passed.

On top of this severe degradation of health and financial security, the AHCA would also drag on job-growth in coming years. This drag would occur because the AHCA cuts to Medicaid and insurance subsidies reduce growth in economic activity and job creation far more powerfully than the AHCA tax cuts boost this growth. By 2022, this drag could lower employment by 1.8 million unless some countervailing macroeconomic boost neutralized the AHCA job-losses. This drag on job-growth would felt in nearly every Congressional District.


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The tweaks made to the AHCA since March have made it unambiguously worse, not better. Allowing states to tell insurance companies that they no longer have to provide what are defined as “essential health benefits” or provide coverage for those with pre-existing conditions is not a win for health and financial security. Claims that the most-vulnerable and sickest Americans can be held harmless by this provision because money has been allocated for forming “high-risk” pools would be laughable if it was not so damaging to real people. The money allocated for these high-risk pools is wildly insufficient, and there is no serious rationale for segregating the sickest Americans in politically vulnerable coverage schemes unless the plan is eventually to save money by letting them go without insurance.

Further, allowing states to undermine the key regulatory protections introduced in the Affordable Care Act (ACA) will degrade the protectiveness of even employer-sponsored health insurance plans. The ACA instituted bans on lifetime limits and capped annual out-of-pocket spending in employer-sponsored plans, but only for essential health benefits. If a state starts stripping these essential health benefits out of regulatory protections, all Americans with employer-sponsored plans will be exposed to greater risk as the ACA bans on lifetime limits and annual out-of-pocket caps will no longer apply.

Congressional Republicans have taken a terrible bill that was rejected by the vast majority of Americans and made it clearly worse. The only people winning from this action would be those who would receive the lion’s share of benefits from the hundreds of billions of dollars in tax cuts that are bundled in the AHCA.

If it passes the House of Representatives today, it will be a terrible day for Americans’ health and financial security.

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Josh Bivens

Josh Bivens

Josh Bivens is the Research and Policy Director at the Economic Policy Institute (EPI).

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