A Horrible GOP Health Bill is About to Get Much, Much Worse
By Ron Pollack
It's hard to imagine that the recently withdrawn GOP health bill could get any worse.
The bill cuts off insurance for 24 million people. It raises premiums for many others, especially low-income families and older people. It jeopardizes health coverage for approximately 70 million people who count on Medicaid for their lifeline. It plays Robin-Hood-in-reverse by reducing $880 billion in federal health funding for the poor and showers almost $600 billion of it in unneeded tax breaks for the rich and corporate interests.
Little wonder, therefore, that the American public loathes this hastily and poorly conceived legislation. A national poll issued shortly before the bill was withdrawn showed that, by a margin of 56-17, the public opposed this proposal.
So, how in the world can this bill get any worse? The answer unfortunately is quite simple: The Trump Administration desperately wants a health bill -- virtually any health bill -- that it can say repeals Obamacare. And it is willing to go to any extreme with far-right legislators to make that happen.
Numerous news reports indicate how the previously withdrawn bill is expected to get worse. For starters, the Administration intends to make a nullity of the most popular provision in the Affordable Care Act (ACA), the new protection for people with pre-existing health conditions so they are not discriminated against by insurance companies.
Although the new proposal apparently won't eliminate the prohibition preventing insurers from denying coverage to people with health conditions, it makes the protection meaningless. It does so by enabling insurers to charge higher, discriminatory premiums to people with pre-existing health conditions. For people with a history of cancer, diabetes, heart disease, or other significant health condition, premiums will become unaffordable.
It is hard to believe that anyone who wants to be considered "moderate" would be willing to go back to the Health Care Dark Days when health coverage was only available for people in excellent health. It belies what a health care system is supposed to be about.
But that is not the only change being contemplated by the Trump White House and the far-right legislators it is bowing to. As they had previously discussed, the new proposal would eliminate the guarantee that health insurance comes with meaningful coverage benefits. According to recent reports, it is likely that the revised bill would significantly modify, and possibly totally eliminate, the ten essential benefits that must be included in insurance coverage.
Such a change would have a harmful impact on women. A key benefit, like maternity health care, would likely be eliminated so that men could purchase separate coverage without it. While it is no doubt true that men, at least directly, don't need maternity care, it would have a most pernicious impact on women: It means that, once again, women, especially of child-bearing age, would be charged a gender-based discriminatory premium, something that the ACA prohibits.
It would also have a devastating impact on people with health conditions. Insurers would most likely develop very different types of insurance packages -- some for very healthy people and others for people with significant health conditions. Cheap, bare-bones policies would be marketed to the former, and more comprehensive packages would be offered to those with health conditions. Those latter policies would be extraordinarily expensive, both because the coverage would be much more comprehensive and because the latter policies would attract very imbalanced risk pools.
Mental health care would quickly become an unwanted stepchild in the insurance marketplace. It means that decades of work to ensure mental health care is provided on a par with physical health care would be set back tremendously. It would also make it very difficult to meaningfully ameliorate the opiate addiction crisis afflicting people across America.
The net result is simply horrendous: It makes the miserable, withdrawn GOP health bill much, much worse. It inflicts cruel and unusual punishment on huge portions of the U.S. population, especially people most in need of an excellent, affordable health care system.
A self-styled populist president, and a moderate Congress, would be well-advised to go back to the drawing board and start all over again, preferably with bipartisan participation.
For more than three decades, Ron Pollack served as the Founding Executive Director of the consumer health organization Families USA, and he was recently designated its Chair Emeritus. This and future blogs and essays, however, reflect exclusively his own views.