AHCA Healthcare, part 3

posted in: CYJ Blog, Lifeskills

In the previous article, the AHCA focus was on concerns and affects of premiums and the Dept. of Health & Human Services historical data from 2013 to 2017 that the average individual market premiums increased from $232 per month in 2013 to $476 in 2017. This is an almost 50% increase since 2013.

Then add . . . how will insurers react to AHCA after opting out of Obamacare during those years? Then add to what the states may do if they choose to opt-out of certain AHCA provision, such as limits on premiums; and is $15 billion enough to help states lower premiums?

With all these moving pieces, only time will tell how any portion helps or hurts. Another concern creating confusion and division is on the number of uninsured predicted with the AHCA. In addition, throw in about hospitals price gouging the uninsured, per Newsmax publication, one of the more conservative news sources (primary JAMA Internal Medicine source). According to Newsmax article, Uninsured Charged 4 Times Medicare Rates for ER Visits (May 30, 2017), “The new study found, for example, that for a $100 treatment in the emergency room, some hospitals were charging patients up to $1,260. ‘It points to the practice of price gouging by hospitals because patients often can’t pick their doctors in the emergency department,’ lead author Dr. Tim Xu told Reuters Health in a telephone interview. ‘It’s a system that needs help.’”

According to the JAMA source article, in 2013 “. . . different emergency departments charged between 1.0 and 12.6 times what Medicare paid for the services.” This is the case for both the uninsured and insured patients using out-of-network providers. So how is the AHCA going to address this? How many will choose to be uninsured, particularly our nation’s young adults?

When the Congressional Budget Office, H.R. 1628, American Health Care Act of 2017 (CBO, cost estimate, May 24, 2017) covered how many people will be uninsured under AHCA compared to ACA, the numbers are mixed, depending on the source you read. The confusion often stems from the dividing line between Democrats and Republicans, liberals and conservatives.

Yet, the Congressional Budget Office even stated in their May 24 report, “The ways in which federal agencies, states, insurers, employers, individuals, doctors, hospitals, and other affected parties would respond to the changes made by the legislation are all difficult to predict, so the estimates discussed in this document are uncertain.” Again, there are so many moving pieces.

According to Avik Roy, Believe It Or Not, CBO’s Score Of House GOP Obamacare Replacement Is Better Than Expected (Forbes, May 14, 2017), “The first thing to know about the CBO is that it has long had problems modeling how a competitive, individual insurance market would work. This is reflected in their frequently revised estimates as to how many people would enroll in Obamacare’s insurance exchanges. . . in 2010, when the Affordable Care Act was passed, CBO estimated that 21 million people would enroll in the ACA exchanges in 2016. The actual number was closer to 10 million.”

Roy further stated “CBO coverage estimates could be off by as much as 19 million . . . 7 million off on future exchange enrollment, around 9 million off on the individual mandate’s power, and 3 million off on future Medicaid expansions—the CBO’s estimate of the impact of the AHCA on coverage is off by around 19 million, and that the real impact of the AHCA on coverage is negative 5 million.” Yet, there are certain things that, according to Roy of Forbes, could be improved with the AHCA. He actually considers these to be an easy thing to fix.

These so-called easy fixes will be covered in part 4 coming your way. In the meantime, how many times has your family paid for an emergency hospital or urgent-care visit? Do you have affordable health insurance? If so, has it helped when you needed it? Do you have a wellness team you have come to trust on behalf of your family? Maybe it is time to consider how your family could actually improve your own physical and financial health with proactive wellness actions. You just may be part of the solution to our nation’s mounting healthcare costs and national deficit!