House Republicans rush through Affordable Care Act repeal

House Republicans yesterday rushed through the American Health Care Act to repeal and replace Obamacare.

H.R. 1628 passed the House with a 217 to 213 vote. House Speaker Paul Ryan (R-Wisconsin) forced a vote even though the non-partisan Congressional Budget Office had not completed its analysis on the fiscal impacts of the latest version of AHCA.

In its analysis of an earlier version of the bill published on March 13th, the CBO projected that AHCA would cause 24 million Americans to lose their health insurance by 2026.

Read more: List of 217 House Republicans who voted to repeal the Affordable Care Act

“Forcing a vote without a CBO Score shows that the Republicans are afraid of the facts.  They’re afraid of learning the full consequences of their plan to push Americans with pre-existing conditions into the cold,” said House Democratic Leader Nancy Pelosi. “It forces families to pay higher premiums and deductibles, increasing out-of-pocket costs…Less coverage.  Trumpcare will take away health care from more than 24 million hardworking Americans.  A crushing age tax.  Trumpcare forces Americans age 50 to 64 to pay premiums five times higher than what others pay for health coverage.  No matter how healthy they are.”

Pelosi said the AHCA would give $600 billion in tax breaks to corporations and wealthy individuals “at the expense of the health insurance of tens of millions of working families across America.” According to the Tax Policy Center, people in the top income quintile will receive 14 times more tax benefits from the AHCA than people in the lowest income quintile.

“Trumpcare is a billionaire’s tax cut disguised as a health care bill.  It’s Robin Hood in reverse.  One of the largest transfers wealth from working families to the rich in our country,” she said.

Some of the nation’s top patient advocacy groups denounced House Republicans for passing Trumpcare, citing the bill’s failure to protect patients with pre-existing conditions, the steep cuts to Medicaid, the new age rating that would significantly increase the premiums and out-of-pocket costs for older Americans, and the roll-back in coverage for pregnant women.

“The bill passed by the House today will result in millions of Americans losing access to quality, affordable health insurance and those with pre-existing health conditions face the possibility of going back to the time when insurers could charge them premiums that made access to coverage out of the question,” said Dr. Andrew Gurman, president of the American Medical Association.

Read more: Reactions from health care & patient advocacy groups to House GOP’s Affordable Care Act replacement bill

The primary concern revolved around the AHCA’s MacArthur amendment, which would “allow states to waive requirements” for insurance companies to cover individuals with pre-existing conditions under the same rate as everyone else.

(Under Obamacare, insurance companies are prohibited from discriminating against individuals with pre-existing conditions by charging “vastly more for their coverage”, according to Gurman.)

The American Medical Association objected to the requirement waiver because “it will likely lead to patients losing their coverage.”

“Although the MacArthur amendment states that the ban on preexisting conditions remains intact, this assurance may be illusory as health status underwriting could effectively make coverage completely unaffordable to people with pre-existing conditions,” according to the AMA.

While states that opt to exercise the waiver would be required to set up a “high-risk” insurance pool, advocacy groups argued that many patients with pre-existing conditions may not be able to afford the coverage.

The American Cancer Society pointed out that patients in high-risk insurance pools prior to Obamacare paid between 150% to 200% above the standard rate for such limited health coverage that they were “virtually meaningless”. Rep. John Yarmuth (D-Kentucky) said most of the state high-risk pools had “caps on annual and lifetime limits”.

“The history of high-risk pools demonstrates that Americans with pre-existing conditions will be stuck in second-class health care coverage – if they are able to obtain coverage at all,” said Gurman.

According to the Kaiser Family Foundation, an estimated 27% of Americans under the age of 65 would be considered to have “declinable pre-existing conditions” based on insurance underwriting rules prior to Obamacare. That rate was significantly higher in states like Tennessee, Arkansas, Alabama, Kentucky, Mississippi, and West Virginia, where one out of three people have “declinable pre-existing conditions” such as diabetes, cancer, obesity, heart disease, epilepsy, kidney disease, multiple sclerosis, Parkinson’s, pregnancy, stroke, and mental disorders.

Older Americans will also see their insurance premiums and out-of-pocket costs increase “dramatically” under Trumpcare, according to the AARP. Americans between 50 to 64 years old could pay as much as five times more for their insurance than younger people under the AHCA’s new age rating.

In addition, the AHCA will slash Medicaid funding to states by more than $800 billion over 10 years, hurting the 30 million children who rely on Medicaid for their health care needs. “The AHCA as passed by the House would be disastrous for our nation’s children,” according to the Children’s Hospital Association.

Expectant mothers could be denied maternity and newborn care because pregnancy could be classified as a pre-existing condition under Trumpcare. As a result of the AHCA, the March of Dimes estimated that more than 6.5 million low-income women of childbearing age could lose their health coverage.

“Trumpcare was a moral monstrosity that will devastate seniors, children and hardworking Americans,” said Pelosi.

She added, “The American people now have to judge them by how they have acted – not by how we have characterized what they stand for. Now, they are on record.”

Learn More:

List of 217 House Republicans who voted to repeal the Affordable Care Act

Reactions from health care & patient advocacy groups to House GOP’s Affordable Care Act replacement bill