President Donald Trump and his allies are pushing for yet another vote on the American Health Care Act, promising action in the House of Representatives this week and maybe even as soon as Wednesday, according to various reports.
The bill, which would repeal the Affordable Care Act, hasn’t changed much since the last time the House took it up seriously.
The misrepresentations and outright lies Republicans tell about the bill haven’t changed much either.
Many of them are coming directly from Trump. In a series of tweets and during an interview on CBS’s “Face the Nation” on Sunday, Trump made the same basic promise he’s been making ever since he started running for president ― that the GOP plan for repealing Obamacare would reduce both premiums and deductibles, while protecting people with pre-existing conditions.
But this is not what the American Health Care Act would do.
That bill would definitely help some people ― in particular, younger, healthier and wealthier people who buy insurance on their own today and end up paying high prices because they get little or no financial assistance from the Affordable Care Act.
But the proposal would cause real hardship for many millions of Americans ― whether by raising their premiums or deductibles or both, or depriving them of coverage altogether. And it’d be the poor and the sick struggling the most, even as the wealthiest Americans walked away with a sizable tax break.
Whether Trump understands all of this is an open question. During the “Face the Nation” interview, host John Dickerson kept pressing Trump to explain how the health care law could do all of these things ― and Trump, in response, kept modifying his answers.
But Trump isn’t the only prominent Republican making false promises about what the party’s proposal would do. Vice President Mike Pence and House Speaker Paul Ryan (R-Wis.) have made similar comments in the past few days ― Pence during an appearance on NBC’s “Meet the Press” and Ryan during his weekly press conference.
The timing is not coincidental. Pence and Ryan are working hard with their allies to round up votes for the AHCA in the House. Right now the challenge is winning over less conservative Republicans who are anxious about what the AHCA would mean for health insurance coverage ― and how that would play in their districts.
The promise to provide health insurance that is simultaneously less expensive and more comprehensive, all without excluding people who have serious medical problems, is designed to reassure these lawmakers.
But the promises belie what the Republican proposal would actually do.
GOP Bill Would Shift Costs Onto The Poor, Sick And Old
Republicans are calling for a series of dramatic changes to the so-called non-group insurance market ― that is, coverage for people buying insurance on their own, rather than through employers.
Specifically, the bill would shift financial assistance away from people with low incomes and high insurance costs, while giving insurers new freedom to vary prices by age, so that carriers could charge older customers more than five times what they charge younger customers. The bill would also allow insurers to offer skimpier coverage than the law permits today.
And thanks to the amendment that Republicans introduced last week, states could opt out of some of the law’s most important regulations ― a ban on charging higher premiums to people with pre-existing conditions, and a requirement that all plans include a set of “essential” benefits including mental health, maternity care and prescription drugs.
“On net, the new bill has to be worse with this than even the original,” Linda Blumberg, senior fellow at the Urban Institute, told HuffPost. “This doesn’t give new protections to [states that want to keep existing consumer protections], it gives new flexibility to the states that want to set the clock back to the pre-ACA days.”
Although the effect of all the changes to the individual market would vary from person to person and place to place, the net effect would be cheaper coverage for the young, healthy and wealthy, but more expensive coverage for the old, sick and poor ― to the point that many could not get decent coverage at all.
Republicans claim that other provisions of their bill, designed to reimburse insurers for expensive beneficiaries or to create separate programs for people with pre-existing conditions, would take care of people with serious medical problems.
“They say we don’t cover pre-existing conditions, we cover it beautifully,” Trump said on “Face the Nation.”
But as multiple analysts have pointed out, these programs have never provided adequate protection in the past, even though Republican leaders like Ryan keep claiming otherwise.
GOP Bill Would Blow Away Medicaid Coverage For Millions
The changes to the individual market represent just one part of what the American Health Care Act would do. The proposal would also cut Medicaid by a whopping $839 billion over 10 years.
The amendments that supposedly make the proposal so much more appealing don’t do a thing about this. And it’s this cut that would have the single biggest effect on insurance coverage ― with the number of people getting Medicaid coverage falling by 14 million over 10 years, according to the Congressional Budget Office.
That Medicaid cut alone would probably represent the single biggest rollback of a public benefit in American history ― and cause widespread hardship to the millions of people who depend on it for everything from opioid treatment to cancer care.
The vast majority of Americans oppose these proposals, polls now show consistently. Those numbers ― and the backlash Republicans have faced in town hall meetings ― undoubtedly explain why the American Health Care Act hasn’t passed the House yet.
But Republican leaders haven’t given up trying ― and, based on their recent comments, they haven’t given up distorting the truth about their plans, either.
This article has been updated to reflect reports that the House plans to take up the American Health Care Act this week.