This week the GOP is scrambling to slap together another version of a Trumpcare plan that will please all party members. The Freedom Caucus, the ultra-conservative wing of the GOP, wants to essentially do away with any government involvement in health care and turn it all over to private, for-profit companies to decide what’s best for Americans. Of course, the people making these decisions have wonderfully comprehensive health insurance provided automatically by the taxpayers at absolutely no cost to them. So, it’s understandable that they might not always understand the dilemma of everyday working people facing the purchase of health insurance. That said, let’s take a quick look at a couple of the primary features of the plan the GOP is currently considering.
First, they want to allow states to obtain waivers if a particular state decides that it does not want to provide all of the ten Essential Health Benefits (EHB) mandated by the current Affordable Care Act (ACA). You’re going to hear more about these so let’s take a quick look at what these EHB’s are.
- Ambulatory Patient Services (Outpatient Care)
- Emergency Services
- Pregnancy, Maternity, and Newborn Care
- Mental Health and Substance Use Disorder Services
- Prescription Drugs
- Rehabilitative and Habilitative Services and Devices
- Laboratory Services
- Preventive and Wellness Services
- Pediatric Services including Oral and Vision Care
Before the ACA, many insurance companies limited Mental Health Care, put very low limits on Rehabilitative Services and often put separate, high deductibles on Pregnancy and Maternity Care. With the waiver system being proposed by the GOP, insurance companies could once again take us back to the pre-ACA days when the could pick and choose what services to offer and limit or exclude those coverages that they did not find profitable. Once again, people needing those services, or any others the insurance companies chose to exclude, would find themselves out of luck.This is the very sort of cherry-picking that the ACA was designed to prevent.
Second, the GOP claims they want to keep the provision of the ACA that requires insurers to accept people with pre-existing conditions, but they now want to allow the companies the right to charge those individuals higher rates. This is the system we already had! How much do you think it will cost someone with a cancer diagnosis to buy insurance? This is the same as saying you have the right to buy a 2017 Lamborghini Adventador SV Roadster — all you need to do is pay $535,500! The word you will hear thrown about is guaranteed “access” to health insurance. Access means absolutely nothing if the insurance companies can single out those with pre-existing conditions and price them out of reach.
As of today, there is no word on what they are now planning to do with Tax Credits that help people buy insurance, or the Cost Sharing subsidies that help offset the cost of healthcare for those making less than 250% of the Federal Poverty Level. Regardless of what their decision is on those items, the two items mentioned above are enough to determine that millions of people will see their health insurance options return to the pre-ACA days. But of course, the people in the House and Senate will see no impact whatsoever on their nice, taxpayer paid group health insurance plans that cover everything.