Showing posts with label Health Care. Show all posts
Showing posts with label Health Care. Show all posts

June 27, 2020

Trump Tells The Supremes Obamacare Must 'Fail'~} Millions Loose health Care During Pandemic}}Do U Think He Cares?


In a filing with the U.S. Supreme Court, the Trump administration has reaffirmed its position that the Affordable Care Act in its entirety is illegal because Congress eliminated the individual tax penalty for failing to purchase medical insurance.

Solicitor General Noel Francisco, the government's chief advocate before the Supreme Court, said in a brief that the other provisions of Obamacare are impossible to separate from the individual mandate and that "it necessarily follows that the rest of the ACA must also fall."

Shortly after the brief appeared on the court's docket late Thursday, House Speaker Nancy Pelosi said in a statement: "President Trump and the Republicans' campaign to rip away the protections and benefits of the Affordable Care Act in the middle of the coronavirus crisis is an act of unfathomable cruelty."

In a speech on the lawsuit Thursday, Vice President Pence said he was proud of the ACA and denounced the administration's position. "It's cruel, it's heartless, and it's callous," he said.

The case before the high court began with a lawsuit brought by 20 states, led by Texas, calling for the elimination of the ACA. It has been consolidated for argument with another case brought by 17 states, led by California, seeking to preserve the law. The court is likely to hear the case in the fall. 

"President Trump, in this cruel lawsuit, has shown us who he really is," California Attorney General Xavier Becerra said in a statement. He added that they intend to prevail "with the facts, the law and the American people on our side."

The lawsuit was first heard in Texas in 2018 by U.S. District Judge Reed O'Connor, who struck down the entire ACA as unconstitutional. At the time, the Trump administration had not taken that all-or-nothing position but since then has come to support the lawsuit.

Eliminating the ACA would end medical insurance for more than 20 million Americans. It would also end widely popular provisions of the law, such as extending parents' coverage to children up to the age of 26 and prohibiting insurance companies from denying coverage based on preexisting conditions.

Trump and congressional Republicans have long said they want to "repeal and replace" Obamacare but have yet to offer legislation addressing what would take its place.

The cases before the Supreme Court are State of California, et al., v. State of Texas, et al. (19-840) and State of Texas, et al., v. State of California, et al. (19-1019).

April 27, 2019

In About 9 Days Trump Plans to Roll Back Protections For Transgenders


The Trump administration is preparing to roll back protections for transgender patients while empowering health care workers to refuse care based on religious objections, according to three officials with knowledge of the pending regulations.

The long-expected rules have alarmed patient advocates and public health groups, which have warned the health department that the rules could harm vulnerable populations’ access to care. Meanwhile, the rules have been eagerly anticipated by religious-rights groups and conservative states that have lobbied for the changes.

The controversial rules — which the Trump administration has been scrutinizing for more than a year to prepare for expected legal challenges — have been closely guarded inside the administration, following several media reports on the efforts that sparked backlash and complicated officials’ strategy. Officials say the two health department rules are now expected within the next 10 days.

One rule would replace an Obama administration policy extending nondiscrimination protections to transgender patients, which have been blocked in court. A second rule would finalize broad protections for health workers who cite religious or moral objections to providing services such as abortion or contraception, a priority for Christian conservative groups allied with the administration.

The Obama administration issued transgender patient protections as part of a rule enforcing Obamacare’s Section 1557 provision banning discrimination in health care based on sex, but they were halted in 2016 by a Texas federal judge who found Congress didn’t intend to protect gender identity. The Justice Department this month told the judge it agreed with the ruling and signaled that the administration would soon issue a replacement rule.

HHS declined to comment on the forthcoming rules, citing ongoing litigation and the confidential rulemaking process. HHS officials have said the heightened conscience protections are necessary because religious discrimination in health care is significant and overlooked.

“HHS is committed to fully and vigorously enforcing all of the civil rights laws entrusted to us by Congress, to ensure that people are not subject to unlawful discrimination in HHS programs and in the provision of health and human services,” said HHS spokesperson Caitlin Oakley.

Officials told POLITICO the forthcoming conscience regulations build on an administration proposal from last year, but they declined to offer more details. That proposal would give HHS “a lot more authority and power” to effectively remake and enforce existing conscience protections, said Katie Keith, a Georgetown University law professor who’s studied the regulations.

For instance, a medical school receiving federal funds could not deny admission to applicants who refuse to perform abortions; providers could not require staff to inform patients about services like sterilization procedures or advance directives rejecting end-of-life care, and doctors and nurses would gain further protections to refuse to provide services like vaccinations.

The forthcoming HHS nondiscrimination rules are the latest example of President Donald Trump violating a campaign pledge to protect the LGBTQ community, advocates for transgender people say. The administration’s ban on transgender troops took effect just weeks ago, and the health department reportedly tried to effectively eliminate the federal definition of “transgender.”

The National Center for Transgender Equality and other advocacy organizations believe the rules will make it easier for providers or insurers to refuse transition-related care based on religious beliefs. They also worry the rules could make it easier for providers to refuse routine care for patients based on their gender identity.

Transgender patients say they often face discrimination when seeking medication, check-ups or other routine procedures. The liberal-leaning Center for American Progress in 2018 obtained documents, through a Freedom of Information Act request, that the bulk of transgender patients’ complaints to HHS between 2012 and 2016 focused on discrimination when seeking general care, rather than being denied complex procedures like gender transitions.

The Obama-era anti-discrimination rule also sought to protect women who were seeking an abortion or had previously undergone one. Advocates expect the Trump administration’s rewrite will curtail those protections, based on what the Justice Department this month told the Texas judge overseeing the lawsuit against the rule.

Anticipating backlash over the provisions affecting transgender patients, the administration will emphasize that its overhaul of Obamacare’s anti-discrimination rules will reduce the industry’s regulatory burden and save billions of dollars in time and paperwork, officials said. For instance, they point out that insurers have sought to ease the rule’s requirement to publish most communications to patients in 15 languages.

The Trump administration also will argue that the new rules collectively strengthen religious liberty protections in health care, an administration priority that resulted in the creation of a conscience division within the HHS civil rights office last year.

That division, which is overseeing the upcoming rules, has quickly grown to at least 10 staff and contractors who include a mix of former Hill GOP staff and Christian conservatives. The Office for Civil Rights’ budget request last month sought a $1 million raise and six more staffers for the conscience division, even as it proposed cuts to other parts of the office that much more frequently respond to complaints.

Of the approximately 7,600 civil rights complaints HHS received in the fiscal year 2018, just 10 of those involved conscience rights protections that required a formal investigation, according to an analysis from the Center for American Progress. HHS said more than 700 conscience-related complaints from that year remain open.

August 9, 2018

Trump and GOP Congress Took A Health Care Law that Was Working and Getting Better and Killed it Because it Was Working and Not Theirs

Yesterday, the Trump administration unveiled plans to allow insurers to skim healthy customers out of the insurance pool by offering skimpy plans that last for up to three years. The legally dubious maneuver is the crowning touch on the administration’s persistent efforts to undermine the Affordable Care Act. Conservative intellectuals are justifiably ecstatic. “Wednesday’s rule came to be because dedicated people within the Trump administration worked hard to push federal policy in a libertarian direction,” exults Cato Institute scholar and onetime author of the “Anti-Universal Coverage Club Manifesto” Michael Cannon. Indeed, Trump’s attacks on Obamacare, taken together as a sum, provide a fair picture of the American right’s unique, social Darwinist philosophy of health-care policy.
Many people are either too poor or too sick to afford access to medical care. In every democracy in the world save the United States, a broad social consensus accepts the need to subsidize care for those people. This includes the conservative parties in those countries. Among right-of-center parties in the developed world, only the Republicans are so committed to anti-government dogma as to oppose measures to subsidize medical care for those who can’t afford it themselves.
But whenever Democrats have attempted to expand access to health care, Republican leaders have generally declined to present themselves as principled opponents of universal health care. Instead, they have promised they could accomplish the same goal in a better, cheaper fashion, without any of the painful trade-offs in the existing Democratic-authored proposals. No such plan ever emerged, in part because Obamacare was the most market-friendly way to accomplish the bare minimum objectives of any humanitarian health-care reform. The only space to Obamacare’s right involved punishing the poor and sick with medical and financial deprivation. 

It is now clear that, on its own terms, Obamacare’s policy design worked. When the new marketplaces opened, insurers initially set premiums far lower than the Congressional Budget Office expected, and — as it turned out — lower than the market would bear. After correcting their initial under-pricing, insurers settled their premiums at a stable level that was both affordable to most consumers (especially in states that tried to make the markets work, as opposed to sabotaging them) and profitable for them.
Amazingly, the exchanges have survived despite eight years of legal attacks and administrative sabotage by both Republican state-level government and now the federal government under Trump. Republicans have eliminated outreach advertising for the exchanges, refused to issue required payments for insurers who accept disproportionately sick customers, and are now trying to lure healthy customers out of the exchanges, driving up costs for those who remain. The Republican line maintains that all these blatant attempts to kill the law are somehow the fault of the law’s designers. “Democrats want to blame the GOP for increases that are baked into the health law’s faulty design,” insists a pious Wall Street Journal editorial.
This is demonstrably false. A new study by Matthew Fiedler of the Brookings Institution shows that insurers in the exchanges have made a healthy 10 percent profit this year, and if the Trump administration had taken no additional steps to sabotage the exchanges, premiums would be coming down by an average of 4.3 percent next year.
poll by Axios finds that, by a 20-point margin, Americans would rather keep Obamacare or do more than repeal it or do less. Republican politicians, caught between the unpopular extremism of their ideological vanguard in Washington and the moderate demands of the electorate, are retreating to evasions. In a New York Times story about Democrats focusing on health care, a Republican spokesperson gamely retorts, “A contrast between single-payer health care and our ideas — a more patient-centered approach — is a debate we fully welcome.” If you don’t know what “patient-centered” means, don’t worry. It has no meaning at all. Which is the point. The entire purpose of the phrase is to obscure the party’s health-care agenda.
Trump’s most recent step is to allow insurers to sell those skimpy plans with little coverage — excluding customers with expensive medical needs, who would be left in exchanges without healthy customers to help share the costs. This would provide some immediate cost-benefit to healthy customers, who would be free from cross-subsidizing the less fortunate. Of course, if they happen to suffer unexpected medical misfortune themselves, they will be out of luck.
The new Trumpcare plans will be cheap for people who are healthy enough to qualify. But they don’t cover much. If you find you’re having a baby, or need a weekend stay at a hospital, or even something as exotic as prescription drugs, you’re out of luck. The Journal editorial page insists this will all be fine, because “not everyone needs all benefits,” and also, “[t]he HHS rule also stipulates that issuers must prominently display a notice that the coverage isn’t compliant with the Affordable Care Act. Everyone will know what they’re buying.” Right, because everybody in America is already aware of what the essential benefits of Obamacare contain, and thus what their absence implies. Anyway, insurers are definitely going to make sure you’re aware of all the shortfalls and gaps in the product they’re selling you.
What is striking about the Trump-era Republican health agenda is the lack of policy ambition. Having spent years insisting they had an army of wonks who could design a better alternative to the Obamacare “train wreck,” the Republican plan of attack has dissolved into a rearguard sabotage campaign with no pretense of doing anything to help the poor and sick afford medical care. Health care remains a policy ground with which conservative-movement dogma cannot grapple.

February 7, 2018

Trump's Cuts to Health Care Programs Threaten Their Basic Health

This article by MICHELLE ANDREWS on NPR( National Public Radio) describes how much more it will cost to get less health care to get less of it. It affects the middle class but mostly the people that have the least amount of means to pay more.

Comprehensive health care coverage for more than 800,000 low-income people in New York and Minnesota, who pay a fraction of the typical cost of a marketplace plan, may be in jeopardy after the federal government partially cut funding this year.
The Basic Health Program, in which these consumers are enrolled, was created under the Affordable Care Act to provide another coverage option for people with incomes up to 200 percent of the federal poverty level ($24,280 for an individual in 2018) who would otherwise qualify for subsidized marketplace coverage. Only New York and Minnesota have set up such programs.
The funding dispute is tied to a high-profile decision by President Trump to stop paying cost-sharing reduction subsidies, which reduce the deductibles and out-of-pocket costs for people in marketplace plans whose incomes are up to 250 percent of the federal poverty level (about $30,000 for one person). Money that would have paid for cost-sharing reduction subsidies also helps fund the Basic Health Program in New York and Minnesota.
These plans must be as comprehensive and affordable as marketplace plans, but for many they're significantly cheaper, with monthly premiums of either zero or $20 in New York and up to $80 in Minnesota, along with a very small or no deductible and nominal copayments.
In November, for example, when May Brown lost her job as a produce repacker — breaking down 40-pound boxes of fruits and vegetables into 10-pound boxes for grocery stores — she also lost her job-based health coverage. On the advice of a friend, the 62-year-old signed up for MinnesotaCare this month. Her $50 monthly premium is about half what she was paying for coverage on the job.

Brown, who lives in St. Paul, says she is pretty healthy. But having this coverage, she says, gives her peace of mind.
"You never know. Life is unpredictable," she says. "I like to have something."
Under the Basic Health Program, the federal government is responsible for paying states 95 percent of the amount it would have paid in premium subsidies and cost-sharing reduction payments on the marketplace for these enrollees.
In December, the Department of Health and Human Services notified the two states it would withhold the cost-sharing reduction portion of the payments — nearly $300 million in the first quarter of 2018, about a quarter of the total amount expected.
Over the course of a year, the amount withheld will exceed $1 billion.
When it cut back on funding of the Basic Health Program, the administration cited its October 2017 decision to eliminate cost-sharing reduction payments to insurers.
Last month, the attorneys general of the two states filed suit to restore the federal funding.
Noting that New York's Essential Plan covers more than 700,000 low-income New Yorkers, Attorney General Eric Schneiderman said in a press release, "I won't stand by as the federal government continues to renege on its most basic obligations in a transparent attempt to dismantle the Affordable Care Act."
In their lawsuit, Schneiderman and Minnesota Attorney General Lori Swanson arguethat, among other things, the administration's decision to cut off CSR payments is procedurally flawed and violates its obligations under the health law. They want the court to restore the states' Basic Health Program funding.
Regardless of the lawsuit's outcome, officials in both states have offered assurances that the program is safe — for now.
In New York, Gov. Andrew Cuomo's budget included sufficient funds to leave the Basic Health Program intact for this year.
Officials at the Minnesota Department of Human Services released a written statement, maintaining that "people enrolled in MinnesotaCare should feel confident in their coverage, based on current information."
Under the health law, any state can offer coverage under the Basic Health Program. One possible reason New York and Minnesota adopted the program is because they were already covering many in the target population through Medicaid and typically sharing the cost equally with the federal government. Under the Basic Health Program, the state's funding responsibility drops to just 5 percent.
So what happens next year? If federal funding isn't restored, advocates are concerned that costs may rise and coverage shrink.
"It could trigger major changes to the eligibility structure, the benefits or increases in premiums," says Maureen O'Connell, president of Health Access MN, which helps people enroll in marketplace coverage.
Elisabeth Benjamin says she is "really worried" for the program next year if the courts don't order the federal government to start making payments.
Benjamin, the vice president for health initiatives at the Community Service Society of New York, an advocacy group, says there is a snowball effect as states grapple with the delayed approval of Children's Health Insurance Program funding for low-income kids amid continued uncertainty over federal funding for community health centers.
"It's terrifying how much the feds can do, particularly for states like New York that are so reliant on federal funding," Benjamin says. 
Kaiser Health News is an editorially independent news service that is part of the nonpartisan Henry J. Kaiser Family Foundation. Michelle Andrews is on Twitter @mandrews110

adamfoxie🦊 Celebrating 10 years of keeping an eye on the world for You brings you the important LGBT news others ignore. Does not repost from gay sites [except only when importat athlete comes out].Will post popular items with a different angle or to contribute to our readers🦊

September 22, 2017

Trump Plainly Lies About Pre-Existing Conditions Having Guarantee Coverage


President Donald Trump and Republicans on Capitol Hill are trying to assure Americans their latest effort to repeal and replace the Affordable Care Act (ACA) covers people with pre-existing conditions.

Both the president and Senator Lindsey Graham (R-S.C.), who with Senator Bill Cassidy (R-Louisiana) is co-sponsoring the health care bill known as the "Graham-Cassidy plan," took to Twitter to defend the legislation, expected to be up for a vote on the Senate floor next week. "I would not sign Graham-Cassidy if it did not include coverage of pre-existing conditions. It does! A great bill," Trump wrote Wednesday night. "Repeal & Replace."  

Graham quoted the president’s tweet later Wednesday, adding that any claims his bill doesn’t cover those with pre-existing conditions should be called "#FakeNews on steroids!" 

Unlike former President Barack Obama's landmark health care law, however, the new Republican bill would not guarantee coverage for people living with pre-existing conditions. Instead, the Graham-Cassidy plan would disproportionately harm sick people and Americans living with a variety of medical factors, who could see their insurance costs soar if the legislation were to pass.

The bill would allow states to opt to waive Obamacare rules requiring basic health benefits, essentially cutting protections for sick people in an effort to keep premiums from rising. The waivers allow states to charge more for health insurance offered to people with pre-existing conditions—including cancer, heart disease, Alzheimer's (or dementia), cerebral palsy and even pregnancy, among other medical factors that could have resulted in denied coverage prior to Obamacare—while continuing to receive federal block grant funding.

Experts say the bill could raise health care costs for those with pre-existing conditions to a point where insurance would be virtually unaffordable for millions of people. 

The Graham-Cassidy plan would allow states to more easily gut protections for sick people than the previous Senate bill, the Better Care Reconciliation Act, as well as the House’s failed effort, the American Health Care Act. The earlier Senate bill would have let states request a reduction from the federal government in what was considered “essential health benefits," while the House bill would have allowed states to charge more for people living with certain pre-existing conditions when searching for insurance.

The new bill—seen by House Majority Leader Paul Ryan as "our best, last chance" to repeal Obamacare—has received criticism from the even health care industry, which said it would damage existing benefits and do little to reduce insurance premiums that continue to tick upward for millions of Americans.

"The Graham-Cassidy plan would take health insurance coverage away from millions of people, eliminate critical public health funding, devastate the Medicaid program, increase out-of-pocket costs and weaken or eliminate protections for people living with pre-existing conditions," Georges Benjamin, executive director of the American Public Health Association, said in a statement. 

Meanwhile, Democrats are warning that if a sudden vote on the legislation is held before the nonpartisan Congressional Budget Office (CBO) can issue a full report on it, there could be serious implications for years to come.

"Thus far, every version of Republicans’ effort to repeal and replace the ACA has meant higher health costs, millions of hard-working Americans pushed off coverage, and key protections gutted with devastating consequences for those with pre-existing conditions," House Minority Leader Nancy Pelosi wrote in a letter Monday to CBO Director Keith Hall. "A comprehensive CBO analysis is essential before Republicans force a hasty, dangerous vote on what is an extreme and destructive repeal bill."

So, while those with pre-existing conditions wouldn't have their insurance suddenly ripped away, the Graham-Cassidy plan could make it increasingly difficult for sick Americans to afford any insurance at all. Until the CBO is able to fully assess the latest Republican-led attempt to overhaul the nation's health care system, the bill's total impact will remain unknown.

July 11, 2017

"Why Should I Pay For Health Insurance for The poor?" What does Money means to the Wealthy?

 The United States Has More weathy people on the very top than any other nation ,plus the most amount of  people making a low salaried compared to the western nations, some of which have spread out distribution of wealth with less billionaires but more people living well without debt. Health services are povided by the government from everyone's taxes. Everyone's covered and everyone has pleanty of money left over for  house, cars, college, overseas vacations. The Nordic countries do particularly well. They have wealthy people but they dont swallow the wealth from everyone else. The ones that would like to become super rich they come to the US.the land of the very rich and the poor.

"If we taxpapyers are required to pay for the health care of some of our fellow citizens, what are they required to do for us?"

 I wondered if she was religious but I could not make this a religion answer to her question which was not a serious question becasue she thought she knew the answer. {Actually JC in the Bible asked something smilar to what she asked but in a serious way and meaning you could not use it as an excuse of giving while expecting something}. Instead I gave figures on my remarks to her (below) from the government of who is got the most money, who are the people she is paying for their health Insurance and by the way every year the amount of people in that chunk gets smaller. Good right? No, because the amount of people with all the money gets smaller the chunk of money they get, thanks to the government gets bigger! Wealthy gets more wealthy but the money has not trickled down but poured up. Those are the people we all pay for their well being and best doctors. No body bitches but just think about it.

This inequality of who accumulates the money is easily fixable in theory if people were educated and less selfish. People are into this American Dream way of mind;  If you work hard then you can get promoted and make a lot more money. Some believe if you work hard and then get into a mortgage of 60 yrs and have two cars financed then that is your right to feel like a real american that is made it.   Most people believe that if they work hard and get lucky, this is the country where they can get rich and join those rich cats up in what ever mountain they reside in. They have this faith that it could happen to them. They don't stop to think what is being wealthy? How much does it take? What does it cost to get there? As Trump and his children how much it cost them? We know that the founder of Facebook went from middle class to wealthy. Why? He came up with an invention. If you are an inventor you do have a shot. But is a very intestimal small shot. The patent office will tell you about the millions of patents they have isssued to people they never see again.

So How does one gets Wealthy? There are so many books written about it by poor people trying to make it rich on your money!

The problem is that happens less often than lightning hitting people on the right shoulder. Wether inventor,  blue , white collar workers. Still people have faith and like to belive they have a chance.
Wwalth when it happens it tends to stay in the family for ages. Like the children of any succesful inventor, they will be wealthy for ever with no need to hold a regular job but to work for the family to protect the wealth. Don't confuse rich with wealthy. Rich is a few Million dollars while wealthy is billions to trillions. So much money is hard for someone to wrap their head around it. If you have ever set foot on a yact belonging to a wealthy person and the following month on a yact from a rich person you will see the difference. The wealthy man brings stuff from the ends of the world to fill a corner in one of their houses. A rich person never pays full price, people want to be in good graces and be called again. It cost less to be wealthy than to be poor. When you have to stand 8-12 hrs a day in your job to affor to pay for your house, that is very costly.

Even if I ended up in becoming the President of my company when I was working full time I still would have to work 6-7 days a week to afford the trappings of success. Real wealthy people don't work, don't tip and do not pick up the morning paper in front of the house. They don't drive and they don't fly first class. They have someone to fly for them and when they do fly a long distance the plane is empy with the exception of his employees that fly his plane. They get pay more for the honor of working for such a man (seldom a woman) than for the actual money and they will never become wealthy. 

Wealthy people can not stopped making money because is not about money but power. The same way a rapist is, not a testostatrome filled man that can't control his sexual urges but someone in need of power over his victims. "Not about sex but power." Not about money but power. and...there is no mercy for those that don't have the power.
Adam Gonzalez

This I saw While I was reding up for information on health care. Adam.

Mary K. Sykes · 
RxoseX Hill, Kansas
If we taxpapyers are required to pay for the health care of some of our fellow citizens, what are they required to do for us?--lose weight? exercise more? eat healthier? not impregnate casually? spend less of their available cash on entertainment and "things"? New, federal health care law must have a quid pro quo aspect to be acceptable to me. Until there's a new amendment to the US Constitution, health care is NOT a RIGHT.
LikeReply32 hrs
Catherine Siebert · 
SDSU (San Diego State University)
I told my various representatives when they passed the ACA they needed to give healthy people rebates ie:all insurance companies should be required to give the same percentage of rebates to people who are healthy enough that all they need is preventive care (and list exactly what that preventive care is) and insurance just in case they have an accident not ocvered by other insurances. Needless to say they didn't listen to me.
LikeReply33 mins
Adam Gonzalez · 
Mary I guess you don't know you already pay for the health care of the 01% in this country which owns the wealth in this country. No other country have so many poor, opposite the very rich which no matter how much we work we wont be part of even the bottom part of that group.What do they do for us, you? They collect your money and make sure the laws that make them so rich wont change.They work 24 hrs at that and hire many people to go and make their points to the other people in power.. To be fair if you dont want to pay for the poor's health insurance (you will stil pay more when they need hospitalization because they never could afford check ups or visits for things that have not turn into infection yet, etc.)
that cant pay for health insurance, you should stop paying for the very rich. I bet you you never bitched about that. It sounds you are not religious otherwise I would say is that what you would tell your god? What do the poor do for me besides do my lawn, clean my toilet and do my laundry, clean my house? Sometimes being too concern with "me" makes you loose the big or "higher' picture.
LikeReply13 mins

May 26, 2017

LGBT,HIV+,Latins,Blacks Would Disproportionately Loose Health Insurance

The Fenway Institute: People With HIV, LGBTs, and Black and Latino People Would Disproportionately Lose Health Insurance Under Affordable Health Care Act

BOSTON, MA (PRWEB) May 26, 2017
On May 24, the Congressional Budget Office (CBO) projected that the amended American Health Care Act (AHCA), which narrowly passed the U.S. House on May 4, would result in 23 million Americans losing their health insurance by 2026 as compared with what would be expected under continued implementation of the 2010 Patient Protection and Affordable Care Act (ACA).
"It is clear from the CBO analysis that the amended Republican health care plan is no better than the original bill," said Sean Cahill, Director of Health Policy Research at The Fenway Institute. "Of the 23 million Americans projected to lose their health insurance under the GOP healthcare bill, children, older adults, and other vulnerable populations--including people living with HIV and lesbian, gay, bisexual, and transgender people--would be disproportionately affected."
The ACA greatly expanded access to health insurance by permitting states to cover more residents through Medicaid, an insurance program funded jointly by the federal government and states that covers low-income people and those in need, including children and people with disabilities. The ACA also allowed for immediate coverage of those living with HIV via Medicaid without first requiring a diagnosis of AIDS.
The Medicaid expansions that have taken place in 32 states and the District of Columbia under the ACA have been crucial for expanding access to health insurance for lesbian, gay, bisexual, and transgender (LGBT) people, people living with HIV (PLWH), and Black and Latino people. Between 2013 and 2015, the rate of uninsurance among lesbian, gay, and bisexual people decreased from 22% to 11%. Between 2012 and 2014, the rate of uninsurance among people living with HIV decreased from 22% to 15%. During the same time period, uninsurance among Blacks was nearly cut in half, from 19% to 11%, while among Latinos it fell from 30% to 21%.
The bill passed by House members on May 4 would also permit states to opt out of ACA provisions that mandate coverage for preexisting conditions and essential health benefits such as cancer screenings. The CBO analysis found that premiums in states opting out of the ACA regulations would be 10 to 30% less expensive than they are now because health insurance companies would not be compelled to insure people with preexisting conditions equally or to provide coverage for essential health benefits. The CBO warned, "People who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive nongroup health insurance at premiums comparable to those under the current law, if they could purchase it at all."
Additionally, the CBO estimates that premiums for older adults would skyrocket under the AHCA. A 64-year-old American with an annual income of $26,500 should expect to see their health insurance premiums rise from $1,700 a year under the ACA to between $13,600 and $16,100 a year under the AHCA.
"The American Health Care Act would make it much more difficult for people with pre-existing health conditions such as HIV, as well as older Americans, to obtain health insurance that is affordable," Cahill added. "The CBO score confirms our earlier analysis that the American Health Care Act will make it harder to obtain coverage for health care, not easier."
For more information, please see the following policy briefs:
Since 1971, Fenway Health has been working to make life healthier for the people in our neighborhood, the LGBT community, people living with HIV/AIDS and the broader population. The Fenway Institute at Fenway Health is an interdisciplinary center for research, training, education and policy development focusing on national and international health issues. Fenway's Sidney Borum Jr. Health Center cares for youth and young adults ages 12 to 29 who may not feel comfortable going anywhere else, including those who are LGBT or just figuring things out; homeless; struggling with substance use; or living with HIV/AIDS. In 2013, AIDS Action Committee of Massachusetts joined the Fenway Health family, allowing both organizations to improve delivery of care and services across the state and beyond.

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