Having failed to enact a plan that would lead 24 million Americans and 1.1 million in PA to lose health insurance, the House Republicans have returned with a new amendment, proposed by Representative Tom MacArthur (R-NJ), which would lead to larger losses.
Though this new proposal is being touted as a compromise between moderate and far-right Republicans, in reality, it is a surrender to the demands of those on the right who have repeatedly rejected the notion that the risks of illness should be shared by all of us, young and old, healthy and sick. The new proposal would place the burden of health care on those who, because of their age or medical condition, find that burden most difficult to bear:
- It allows states to opt-out of the rule that prohibits insurance companies from charging people with pre-existing medical conditions more.
- It allows states to opt-out of the rule that limits the costs of insurance premiums for older Americans to five times that of younger Americans. (The ACA sets this ratio as 3 to 1.)
- It allows states to opt-out of the rule that requires insurance companies to provide essential benefits in all policies and will make it possible for insurance companies to deny health care for critical medical conditions.
Eliminating these regulations will make insurance unaffordable for millions more in the country as a whole and hundreds of thousands more in Pennsylvania. In Pennsylvania, 5.3 million people under the age of 65 — 52% of the non-senior population — have pre-existing conditions. According to a study prepared by the Center for American Progress, a 40-year-old who has breast cancer will pay a surcharge of $32,740 a year for health insurance. If he or she suffered from depression, the surcharge would be $9,700 a year, for diabetes $6,390 and for asthma, $4,950. But it would be just as bad for seniors; in addition to being hit with the surcharges for pre-existing conditions, a 60-year-old making $22,000 a year would see their net premiums rise by an average of $9,271 under this proposed legislation.
While the MacArthur amendment would require states opting out of these rules to establish high-risk pools for those who could not secure insurance, it does not provide the funding necessary to make them work.
This proposal is not a replacement of the ACA’s guarantee of quality, affordable health care for all. It is a near-complete abandonment of that guarantee.
The Pennsylvania members of the House of Representatives who opposed or said they would have opposed the last Republican plan, and who have repeatedly defended the regulation that would be repealed in this new proposal, have been given no reason to support it now.