ACA Repeal: Fig Leaf for Cutting Taxes and Federally Funded Health Care

The American Health Care Act, recently passed by the House of Representatives, shows the president’s and the Republican- dominated Congress’s willingness to take healthcare from millions of Americans. The effort to repeal Obamacare (the Affordable Care Act), reveals callous indifference to the economic plight of our citizens.

“Americans have to make a choice,” stated Congressman Jason Chaffetz (R-Utah). “Rather than getting that new iPhone …maybe they should invest in their own health care.” “The Medicaid population, which is (on) a free credit card as a group, do probably the least preventive medicine and taking care of themselves…,” sniffed physician-Congressman Roger Marshal

These cynical attacks on the soon-to-be uninsured mask the true agenda of   Republican “health care reform”—to provide extra funds as a cushion for “tax reform”—or tax cuts for the wealthy.  Republicans want to pass massive tax cuts as part of a health care package (rather than a tax reform bill) to avoid having to offset (or make up for) the revenue losses required under the reconciliation process they favor to avoid having to work with Democrats on tax reform. This underhanded strategy, plus the Republican/Libertarian (Rand Paul) opposition to the federal government as protector of the health and welfare of its citizens, lies behind the tactics to repeal (but not replace) Obamacare.

 So, who wins if “Trump Care” (the American Health Care Act, narrowly passed by the House), survives the Senate?

  • High income earners who will enjoy millions in tax cuts
  • Upper middle class without preexisting conditions who will also enjoy tax cuts
  • Young middle class people without (known) preexisting health conditions will enjoy low insurance rates
  • People who choose to “go without insurance” (presupposing no accidents, critical illnesses, or pregnancies will occur)
  • Large Employers who would no longer be required to offer affordable health care to their employees and thus would keep billions of dollars in profits
  • Medical device, prescription drug, and indoor tanning companies that would all have their taxes rolled back.

Who Loses?

  • Americans with preexisting conditions will be forced into very expensive “high risk insurance pools” rather than the general insurance funds where healthy citizens’ insurance payments buffer the exorbitant costs of the chronically infirm. A recent Kaiser Family Foundation study found that 6.3 million people would be at risk for higher premiums under the House bill.
  • Older Americans under Medicare age (65 years old) in most states may lose access to care via “Trump Care,” which would allow insurance companies to quintuple the premiums charged to a 64-year-old person compared to the costs of an 18-year old person.
  • Poor people of all ages in most states will lose access to health care with the slashing of $880 million dollars over ten years of the Medicaid program, which finances one-half of all births and 75 percent of publicly funded reproductive care for beneficiaries who are mostly black and Latina. Millions of frail elderly and disabled citizens will also be stripped of access to health care and nursing home care.
  • State governments will lose millions of dollars in Medicaid funding because states that have chosen the Medicaid expansion (32, 14 with Republican governors) receive a 30 percent increase in state revenues.
  • Hospitals will close due to loss of Medicaid and Medicare dollars. Hospital closures also result in significant job losses in their surrounding communities.
  • 5 million women (and men who request STD testing) will lose Planned Parenthood as their preferred reproductive health care provider due to last- minute concessions to the far-right. The “deal” would strip funding Planned Parenthood via Title X and Medicaid funding for one year.

Citizens over 65 who rely on Medicare will face an uncertain future because some Republicans are threatening to dismantle and “voucherize” Medicare.  

Also, people who choose less comprehensive coverage (not an option under Obamacare) will pay lower rates for insurance that customarily covers too few major health disasters that do not involve preexisting conditions. However, preventive care, prescription costs, and prenatal care including labor and delivery are generally “not covered” and would be billed to each patient. Most Americans are unaware of the paucity of coverage of such health insurance plans

Not surprisingly many professional health care associations (e.g., the American Medical Association, the American Academy of Pediatrics, American Academy of Family Physicians, the American Nurses Association and the American Hospital Association) have strongly denounced the Trump/Ryan bill.

We cannot and we will not allow health care to be denied to any American simply because he/she is perceived to be one of “those people” who are not deserving of the same health care we wish for ourselves and our families. Not ever.

Karen Pataky
Vice President for Public Policy and Political Action
Chair, Healthcare Task Force


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