By Kristen Mitchell
Congressional House Republicans released a plan Monday to repeal and replace the Affordable Care Act, former President Barack Obama’s signature health care legislation. The plan would eliminate the mandate requiring most Americans to have health insurance and would roll back Medicaid expansion.
The Republican proposal would implement a tax credit system to encourage people to buy insurance on the open market. Democratic critics have said the new plan would cause millions of people to lose health insurance, and some Republicans have said the plan does not go far enough in rolling back ACA benefits.
Leighton Ku, director of the GW Milken Institute School of Public Health Center for Health Policy Research, studies access to affordable health care and has evaluated the economic impact of repealing the ACA, which has come to be known as Obamacare.
Dr. Ku told GW Today with opposition from both parties, he doubts the bill would be able to pass. Here, in his words, is what he says the Republican bill means for affordable health coverage:
“To fairly evaluate the new draft bill, we would need to see the Congressional Budget Office's assessment, but House of Representatives’ leadership apparently wants to push the bill through without people fully understanding how many people will lose insurance or how much it will cost.
“My quick assessment is that the bill would make insurance less accessible for millions of Americans, particularly working-class Americans. It would seriously cut back the Medicaid insurance coverage, which provides insurance for about one-fifth of Americans today, particularly those living in the 31 states and the District of Columbia that expanded Medicaid. For the millions who bought insurance through the health insurance exchanges and received tax credits to help afford insurance, it would generally cut back the tax assistance—by about one-third to one-half on average— that made insurance affordable.
Contrary to the impression given by House Republican leaders or President Donald Trump, the bill does almost nothing to contain health care costs. In fact, for those who cannot afford insurance if they lose their jobs or suffer a setback for a few months, it raises the cost of getting coverage again by as much as 30 percent, making it harder for them to buy coverage. It offers greater use of health savings accounts to consumers, but that type of insurance always has high deductibles making it even more expensive to visit the doctor. Those using high-deductible insurance could set up tax-advantaged savings accounts, but research shows those plans mostly favor those with high incomes who are in excellent health and offers little to those who really need medical assistance.
It will be almost impossible for a bill like this to pass. There will be too much opposition from Democrats, from conservative Republicans and from the many congressmen and senators who come from the 31 states that expanded Medicaid.
