An independent analysis reveals that the American Health Care Act would leave behind “as many as 15 million people with pre-existing conditions.”
IN a recent Washington Post Op-Ed [“My son has a pre-existing condition. He’s one of the reasons I voted for the AHCA,” May 4] U.S. Rep. Cathy McMorris Rodgers, R-Spokane, wrote that the Affordable Care Act was a disaster, failing and “wrong for America.” In contrast, the recently passed American Health Care Act, McMorris Rodgers stated, would provide coverage for her son, who has Down syndrome. The AHCA, McMorris Rodgers wrote, maintains the “safety nets and protections” for the “most vulnerable in our communities.”
Millions of Americans with disabilities, and their families and friends, do not share McMorris Rodgers’ confidence in the AHCA. Consider the differences in how the existing Affordable Care Act and the AHCA deal with pre-existing conditions:
• The ACA is simple: Insurance companies can’t deny coverage or charge more for pre-existing conditions. The ACA requires everyone have insurance, but provides subsidies for those who can’t afford it.
• In contrast, the AHCA allows states to “innovate” with “waivers” that would allow insurance companies to deny or charge more for coverage for pre-existing conditions. Young, healthy people pay less, while people with pre-existing conditions won’t find affordable — or any — insurance. The AHCA would lump these people in “high-risk pools.” They would face high premiums and less coverage.
Like many House Republicans, McMorris Rodgers promises that the AHCA will “provide federal resources for states to … reduce out-of-pocket costs.”
We are asked to trust that these pools will be financially supported by the government. Unfortunately, the history of high-risk pools and the funding in the AHCA make it clear that the money won’t be there. An independent analysis by Families USA, a nonprofit organization in Washington, D.C., reveals that the AHCA’s funding “leaves behind as many as 15 million people with pre-existing conditions.”
McMorris Rodgers cites Maine’s successful use of high-risk pools. But U.S. Sen. Susan Collins of Maine says that in her state, “we had definite revenue streams supporting the high-risk pool, and that is why it worked. In the [AHCA] House bill, it’s really up to the states to come up with whatever option they wish. … ”
Coverage for pre-existing conditions “might well be unaffordable,” Collins noted.
The AHCA has many serious problems. It severely cuts Medicaid, the source of support for people with disabilities in the community. The nonpartisan Congressional Budget Office said an earlier version of the bill projected the AHCA slashes $880 billion from Medicaid over the next decade.
Medicaid is the primary federal funding source for health care to low-income people with disabilities. These cuts would severely reduce the availability and quality of their health care.
Unfortunately, this is about more than just loss of health care. Medicaid also supports people living in the community instead of nursing homes and institutions. Medicaid helps cover such things as personal care, assistive technology, ramps, shower bars, therapies (occupational, speech, physical), group homes and independent living, educational services that allow students to receive a free, appropriate education, and job development and placement and on-the-job support, to name a few.
Who are these “high-risk” people with pre-existing conditions? They are people who require ongoing treatment and services: people with cancer, heart disease, diabetes, respiratory illness, neurological conditions, and many other conditions. This also includes those who have mental illness, traumatic brain injury, autism and multiple sclerosis, and people with Down syndrome.
In Washington state, where McMorris Rodgers serves, there are 44,000 people qualified for developmental-disabilities services — almost exclusively Medicaid-funded. In Washington state, the projected AHCA cuts to Medicaid over the next decade would be $20 billion. With this in mind, we wonder if future parents of children with Down syndrome will share McMorris Rodgers’ confidence regarding the availability of health care for their sons and daughters.
The good news is that the AHCA must still pass the Senate, where Republicans and Democrats alike are in no rush to pass this bill without serious consideration of the grave consequences for people with disabilities.