What is the Future of Health Care in the United States?

Image: By United States House of Representatives or Office of the Speaker of the House [Public domain], via Wikimedia Commons
What is the Future of Health Care in the United States?
Brian Oaster

Earlier this month the House of Representatives voted to repeal and replace elements of the Obama administration’s Affordable Care Act, aka Obamacare. Now the Senate is reviewing the healthcare initiative, called the American Health Care Act, for approval. If they pass it, the legislation will be a major step in the Trump administration’s campaign promise to roll back Obamacare.

Here’s how the American Health Care Act will affect Americans if it passes:

Health Care Cuts to Medicaid

Obamacare expanded Medicaid to include health care for millions of low-income Americans, driving down the number of uninsured citizens. The American Health Care Act (AHCA) halts access to Medicaid for new applicants, but for the most part does not take it away from those who already have it under Obamacare. A low income recipient who changes jobs or income, however, would be at risk of losing their healthcare. The bill spends six pages describing how lottery winners will be kicked off of Medicaid.

The AHCA puts more power in the hands of state government and private insurance companies to grant or deny access to healthcare, making at risk citizens more vulnerable and the insurance business more profitable. The AHCA would end Medicaid expansion altogether by 2020, cutting the program by $880 billion.

Most of Americans’ reproductive health care, including coverage for half of US births and three quarters of family planning, is provided through Medicaid.

Removal of “Individual Mandate” Tax Penalty

One of Obamacare’s most controversial features, a tax penalty for anyone who remains uninsured, will be repealed. Though it will do nothing to help the public gain access to healthcare, this will be a relief for citizens whose health care woes were not solved by Obamacare.

Defunding of Planned Parenthood

While the AHCA does not mention Planned Parenthood by name, it blocks certain “prohibited entities” from accepting Medicaid or state funding. The bill describes these unnamed prohibited entities as any “essential community provider” that’s “primarily engaged in family planning services, reproductive health, and related medical care” and “provides for abortions” not resultant of rape or incest.

It’s already illegal for such “prohibited entities” to use federal funding for abortions, so the new health care act would really just cut funding the other things that Planned Parenthood provides: cancer prevention screenings, contraception, treatment and testing for STDs/STIs, and other critical women’s health services. These are the vast majority of Planned Parenthood’s operations.

Tax Cuts for the Wealthy

Obamacare taxed the wealthy with a 3.8 percent tax on investment income (like dividends, interest, and capital gains, as opposed to earned income, like a paycheck) for six figure households. This taxed income effectively redistributed wealth to the poor for much needed healthcare. The AHCA rolls that back, relieving the wealthy of their tax burden. The tax break does not benefit households earning less than $200,000 annually, who need access to health care.

Insurers Can Discriminate Against People With Preexisting Conditions

Under Obamacare, insurance companies were barred from charging people more based on their health or because of preexisting conditions. Under the AHCA, states can opt to allow insurance companies to charge sicker people higher premiums.

States can also choose to opt out of providing maternity care, preventative care, chronic disease management, rehabilitative services, and pediatric vision and oral care, among other critical services that Obamacare compelled them to provide.

Who Voted For and Against This?

Congress is divided into the House and the Senate. The House narrowly voted to pass the healthcare bill 217 to 213. All those in favor were from the republican party, although some republicans went against the party line to vote against it.


Now the bill is in the hands of the senate, who have organized a committee of 13 republican males to review the AHCA bill before it continues down the path to becoming law.

House members have been fielding some public outrage in the states they represent since passing this bill on to the Senate.

Senator Paul Ryan said the AHCA is an attempt to “encourage competition” in the health care insurance business.

Should congress pass this bill, If you’re an insurance company you can look forward to fewer restrictions; if you’re in the top 10 percentile of earnings you can breathe a sigh of relief; and if you’re healthy and can remain healthy, it’ll be business as usual.

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