By Jane Anderson*
On May 8, U.S. Rep. Rob Wittman (R-Va. 1st district) issued a press release called “The Case for the American Health Act.” The AHCA is the bill congressional Republicans have passed to repeal the Affordable Care Act.
In his press release, Congressman Wittman attempted to explain his vote in favor of approving the AHCA (a.k.a. Trumpcare). This fact sheet summarizing Congressman Wittman’s statements shows that he’s not telling the whole truth about the GOP’s efforts to repeal – and to undermine – the Affordable Care Act
- Wittman: “The Affordable Care Act is failing. The Affordable Care Act promised to lower costs, increase access to care, and expand health care choices. It has failed on all three.”
FACT: The Trump administration and Republicans in Congress are intentionally destabilizing the individual health insurance markets in the hope that doing so will provide them with political cover for repealing the Affordable Care Act.
(https://www.nytimes.com/2017/05/20/us/politics/trump-death-spiral-affordable-care-act.html)
As part of this destabilization effort, Trump is refusing to guarantee that health insurers will receive the payments they were promised to subsidize care for the lowest income people on the exchanges. Experts estimate that this alone will increase health insurance rates by up to 25% for next year.
Meanwhile, congressional Republicans continue their efforts to repeal the ACA and replace it with Trumpcare. This is causing insurers to exit the individual markets – insurers fear instability and unpredictability, and by constantly threatening repeal, the GOP is intentionally causing instability and unpredictability. Insurers that stay in the ACA markets say they will need to increase rates – in some cases substantially – to make up for the uncertainty.
Absent these threats from the Trump administration and Republicans in Congress, none of this would be happening. In fact, the Affordable Care Act marketplaces would be stable and rate increases would be low for 2018. With these threats, the GOP is intentionally trying to turn its prediction of a failing ACA into reality.
And, despite Wittman’s statement, there’s zero question that the Affordable Care Act has increased access to care substantially: According to Gallup Polls, the uninsured rate peaked at 18% in 2013, immediately before the ACA took effect, and since has fallen to 10.9%. More than 20 million people gained health insurance coverage as part of the ACA.
- Wittman: “The Republicans’ plan to repeal the ACA will replace it with a bill that expands choice, increases access, and reduces cost.”
FACT: Trumpcare, will “expand choice” by allowing states to opt out of the Affordable Care Act’s requirement that insurance cover a set of minimum benefits. This means insurers once again will be allowed to sell junk policies that don’t provide the care you need when you need it. So you’ll have the “choice” of buying inadequate insurance coverage.
The AHCA also will “increase access” by allowing insurers to discriminate against older people and (in states that decide to opt out of the ACA’s protections) people with pre-existing conditions. This will increase the number of younger, healthier people buying insurance, but it certainly won’t help those who most need the help.
Finally, Wittman says that Trumpcare will implement “a more effective Medicaid funding model.” In reality, Trumpcare cuts federal Medicaid funding by a frightening 25%, meaning states will need to slash their Medicaid programs significantly. This places care for low-income children, adults and the elderly at high risk – it’s simply impossible for the Medicaid program to care for as many people for 25% less money.
- Wittman: “Will the AHCA kick 24 million people off of their health insurance? No.”
FACT: This is flat-out wrong. The Congressional Budget Office estimates that 24 million people would lose their health insurance in the next nine years because of Trumpcare.
To make up for some of those losses, Congressman Wittman and other GOP representatives say they will rely on “other planned legislative and administrative actions, which will help bring down costs and expand coverage.” In other words, the AHCA would cost 24 million people their coverage, but then Congress and the Trump administration will try to repair the damage by offering some unspecified package of “actions” at some unspecified “later date.”
The truth is, Trumpcare will kick 24 million people off their health insurance.
- Wittman: “The Congressional Budget Office has a spotty track record when it comes to projecting health insurance coverage. When CBO originally scored Obamacare, they projected that 21 million Americans would have coverage in 2016. The reality was half that number, about 10.4 million gained coverage.”
FACT: Estimates for coverage gains under the Affordable Care Act included the gains from all states expanding their Medicaid programs. However, Republicans sued over this provision, and the U.S. Supreme Court ultimately said states could opt out. A total of 19 Republican-led states – including Virginia – chose not to expand their Medicaid programs.
The GOP is the reason so many fewer people have health coverage today than had been expected under the Affordable Care Act. The GOP also is the reason the Congressional Budget Office overestimated coverage gains under the Affordable Care Act. It’s truly dishonest to say anything different.
- Wittman: “Under the AHCA, insurance companies cannot deny you coverage based on pre-existing conditions.”
FACT: This is true, but outright misleading. It’s true that under Trumpcare, insurers in states that have opted out of protections for pre-existing conditions would be required to offer you a policy, even if you had a very expensive medical condition. But they wouldn’t be required to make that policy affordable – in fact, they could charge you whatever they wanted.
A Kaiser Family Foundation study found that 6.3 million people could face higher premiums under Trumpcare. (http://kff.org/health-reform/press-release/analysis-6-3-million-people-with-pre-existing-conditions-would-be-at-risk-for-higher-premiums-under-the-houses-health-bill/)
It’s true that people who keep their health insurance continuously wouldn’t be affected by this, even in states that opt out of these important protections. But if you lose your health insurance for longer than two months – for whatever reason, even if it’s not your fault – you will be affected.
Wittman also says Trumpcare provides “added resources to help people in waiver states who have not been continuously covered to gain coverage.” But the reality is, these so-called “added resources” are ridiculously inadequate – there wouldn’t be enough money for even one-tenth of the people who need help.
- Wittman: “The MacArthur amendment (the waiver allowing states to opt out of protections for pre-existing conditions) only applies to the individual insurance market, where roughly 7 percent of the country purchase coverage.”
FACT: Approximately 9 million Americans purchase their health insurance on the individual market. By stating that only these 9 million people would lose these protections (and no one else would), Wittman essentially throws everyone who has benefited from these protections on the individual market under the bus.
In addition, some analysts believe that the pre-existing condition provision in Trumpcare would apply to employer-provided policies, along with individual policies. If that’s the case, then this provision will affect tens of millions of Americans, not “just” 9 million Americans.
FACT: Trumpcare is a massive tax cut for the rich disguised as a health care bill. While the details may change some in the Senate, the goal of this legislation is not to improve health care – no matter what Congressman Wittman may tell you. The goal is to cut taxes for the rich. The vast majority of the money given to the rich as part of the tax cuts in this bill – $592 billion – will come from cutting health care for the middle class and the poor.
The truth is, Trumpcare is terrible policy, and Wittman should be ashamed for his vote in favor of it.
*Anderson is a freelance writer tracking healthcare policy for the Williamsburg Indivisible Group.