Thoughts on the American Health Care Act

It is time for a paradigm change in healthcare. Access to insurance is not care. Tax credits to offset insurance costs are not care. Until we can make care affordable and accessible, too many people will continue to suffer unnecessarily, and health equity remains a dream.
We must develop a comprehensive strategy to address the needs of all citizens, regardless of income, employment, education, or current health status.

First off, let me state that I think the Affordable Care Act was a good start, but needs vast improvement to ensure healthcare is both affordable and accessible for all citizens.
The Republicans are in an incredibly powerful position today.  They control both houses of Congress, the White House, and a majority of Statehouses around the Country.  This presents them with a unique opportunity to truly change healthcare in America for the better.  Unfortunately, where they appear to have no power is against the insurance industry.
If ‘Obamacare’ was a gift to insurance (and it was), the GOP version introduced in the House yesterday wrapped that up, added some cash, and put a bow on it.  The insurance industry must be thrilled.
Nowhere in the new legislation do healthcare providers benefit. Worse than that, there is no great benefit to people and patients.  For those of us who can afford insurance, and are part of an employee sponsored plan, not much changes.  Rates and deductibles will continue to rise, while benefits continue to decrease.
For those who couldn’t afford healthcare before, it probably won’t become any more affordable.  While there might be some new ‘bargain’ plans, it remains to be seen what that coverage would look like, and what providers would actually accept it.  There is nothing in the proposed law that guarantees lower premiums, puts a limit on annual premium increases, ensures acceptance of your coverage, or anything beneficial to people and patients (that we don’t already have today).  Participants may qualify for a tax credit, but you must pay the premiums first.  For those who cannot afford the premiums, there is no longer a tax penalty for not having insurance.
While many did not like the ‘mandate’ that required insurance coverage, the ‘penalty’ was less than $700 for an individual.  In the new bill, if you have a gap in coverage, insurance companies can penalize you up to 30%.  On a $4000 annual policy, this is $1200.  That money doesn’t go back to the government to offset costs, by the way, it goes straight to the insurers.
The States themselves will be hurt by this legislation, as well.  Today, as always, the burden of caring for the uninsured falls on State and Local programs.  Previously, those costs were reimbursed by the Federal government.  The idea behind the ACA was that with insurance, these reimbursements should be minimalized, if not nearly eliminated.
Under the new plan, those reimbursements are capped.  The States will now have to contend with more uninsured citizens and less money to care for them with.
I’m not sure how any of this can be considered ‘better’, unless you want to only reduce the upfront costs of the program; in that case, great job.  The reality, however, is that the long-term costs will be significantly greater, and the impact on the economy can be devastating.  Rather than doing something to truly change how we provide care to our Citizens, this bill has just limited who gets access to existing care.  Those who struggled to pay premiums may no longer be able to afford the coverages they so desperately need.
If we continue along the path we’ve been following, the sick will get sicker, insurance becomes less affordable, care is restricted, and we all will feel the impact. The staggering costs of healthcare remain the number one underlying cause of bankruptcy. Families should never have to chose between food and healthcare, between heat and healthcare,  or anything else and the care we all eventually need.  This should not be acceptable anywhere, let alone in the United States in 2017.
It is time for a paradigm change in healthcare.  Access to insurance is not care.  Tax credits to offset insurance costs are not care. Until we can make care affordable and accessible, too many people will continue to suffer unnecessarily, and health equity remains a dream.
We must develop a comprehensive strategy to address the needs of all citizens, regardless of income, employment, education, or current health status.