As we review the latest stats about the American Health Care Act (H.R. 1628) still awaiting any Senate fixes, it seems the estimates on both sides of who and what may or may not be affected don’t match up yet. In part one, the focus was on covering some of the more vocal concerns. We will now give it a try with what is being said from our government’s perspective, along with the more conservative arena. Consider this series our "Healthcare Housekeeping" chores for this month's lifeskill, Housekeeping!
Certain key conservative Congressmen also see some concerns along with the positives. The hope is these concerns will be worked out in the Senate, and the positives will prove themselves with time. The main view I see here, at least from the conservative side, is to find ways to reduce the monumental deficit while providing a variety of insurance choices for all Americans, rich or poor. Not a small task, that’s for sure in this messy political climate our nation is witnessing.
As of May 4, 2017, changes to the H.R. 1628: American Health Care Act of 2017 (GovTrack.us), as reported by the Rules committee, were summarized as follows:
- States may opt-out of providing the ACA’s essential health benefits. (This requirement was already dropped in the bill for Medicaid but not for the individual market.)
- States may opt-out of requiring premiums to be the same for all people of the same age, so while individuals with pre-existing conditions must be offered health insurance there is no limit on the cost of that insurance. A new $8 billion fund would help lower premiums for these individuals.
- States may opt-out of limiting premium differences based on age.
- There would be a new $15 billion fund for risk sharing to help states lower premiums.
There are also some key assessment takeaways from Robert Moffit, Assessing the American Health Care Act: Moving Toward a Fair Federal Tax Treatment of Health Insurance (Heritage Foundation, April 18, 2017).
- he proposed American Health Care Act (AHCA) repeals Obamacare tax penalties for individual and employer mandates—necessary but insufficient steps.
- The AHCA does not repeal Obamacare’s 40 percent tax on “high-cost” employer plans, nor does it address the federal tax exclusion for group health insurance.
- If Congress is serious about controlling the growth of health care costs, it must reform the federal tax treatment of the health insurance markets.
Even the Heritage Foundation has concerns in the AHCA. No matter which side you are on, their assessment may prove a worthy read.
On the topic of premiums, there seems to be significant differences of opinion on the comparative data between ACA and AHCA. According to Dept. of Health and Human Services, Individual Market Premium Changes: 2013 – 2017 (May 23, 2017, ASPE Data Point), “Comparing the average premiums found in 2013 MLR data and 2017 CMS MIDAS data shows average exchange premiums were 105% higher in the 39 states using Healthcare.gov in 2017 than average individual market premiums in 2013. Average monthly premiums increased from $232 in 2013 to $476 in 2017, and 62% of those states had 2017 exchange premiums at least double the 2013 average.” That means instead of paying about $2784 per year, the premium costs went up to about $5712 per year. During those years, many insurers pulled out of the marketplace where it wasn’t cost-efficient for them to provide services, leaving people with fewer options at higher prices.
Another concern creating confusion and division is on the number of uninsured predicted with the AHCA. In part 3 coming your way, we will see what the Congressional Budget Office has to say, along with those who may not necessarily agree with their numbers and why. And hopefully, we will find ways to actually fix some of the lingering divide.