How Is This Happening Again: Congress and Trump are Trying to Repeal the ACA and It’s Even Worse This Time

Some members of Congress and the Trump Administration are at it again.  They are trying to repeal the Affordable Care Act (ACA) with a bill that was so unpopular, House Speaker Paul Ryan and President Trump were forced to admit defeat and withdraw the bill from consideration just four weeks ago.
You’d think they would listen to voters and stop their attempts to repeal the law – thousands of people called their Representatives to voice their opposition to ACA repeal the first time and in recent public polling, 61% of voters support keeping and improving the law. But instead, House Speaker Paul Ryan and President Trump are once again trying to take insurance coverage away from millions of people. And they are using the same bill – with amendments that further strip protections for women and people with preexisting conditions.
So here is a short reminder why ACA repeal failed last time and why we are resisting this latest attempt to gut health care:

  1. It was estimated that 24 million people would lose coverage under the first ACA Repeal Bill. And even though the bill’s backers have sped through the process so quickly that the nonpartisan Congressional Budget Office has not had the opportunity to assess the impact of the Repeal Bill with the Amendments, we know the new Amendments have the potential to make that number even worse.
  1. Under the ACA Repeal Bill, those who can least afford it will be stuck paying the price. Analysis of the first ACA Repeal Bill showed that repeal will  hit low- and moderate- income families the hardest, depriving them of affordable coverage while giving a nearly $600 billion tax cut to the wealthiest 0.1%.
  1. The new ACA Repeal Bill Amendments allow insurers to charge people more based on preexisting conditions. Even though 70% of voters support protections for people with preexisting conditions, the new ACA Repeal Bill Amendments would undermine those protections by allowing states to opt out of one of the main provisions protecting individuals with preexisting conditions.  While pre-existing conditions include illnesses like cancer or chronic conditions like asthma or diabetes, prior to the ACA, insurance companies also frequently considered care specific to women as a preexisting condition and used it as an excuse to deny or charge women more for health coverage.  In other words, just being a woman was considered a preexisting condition.  For example, insurance companies denied women coverage or charged them more for being pregnant, having a previous cesarean delivery, or for seeking medical treatment for domestic or sexual violence.  The new Amendments would return women to these days when they were treated as a preexisting condition.
  1. Under the ACA Repeal Bill, millions of people will once again fall into a coverage gap. The ACA Repeal Bill makes several changes to Medicaid, such as eliminating the Medicaid expansion, that will throw individuals and families back to a time when they did not qualify for Medicaid and also could not afford private coverage.  These changes will have a potentially devastating impact on women of color and working women in particular.
  1. The new ACA Repeal Bill Amendments eliminate the ACA’s nationwide guarantee of important services, like maternity coverage, prescription drug coverage, and mental health coverage. The ACA requires insurance plans to cover a core set of important “essential health benefits,” like preventive services, prescription drugs, hospitalizations, and maternity and newborn care.  This is another popular provision of the ACA, partly because prior to this provision, the individual market seriously failed women, depriving them of services that they need.  For example, prior to the ACA, only 12% of individual plans actually covered maternity care.  The first ACA Repeal Bill eliminates this provision for individuals who gained coverage under the ACA’s Medicaid expansion and the new ACA Repeal Bill Amendments allow states to establish their own rules about which essential health benefits do and don’t have to be covered in the individual and small group markets – meaning women in some states will be thrown back to the time when they had to pay the same (or more) for coverage that didn’t even meet their needs.
  1. Under the ACA Repeal Bill, women are not treated as separate legal entities from their husbands.  As we’ve pointed out before, the ACA Repeal Bill will throw us back to a time when married women weren’t treated as separate personsapart from their husbands.  The ACA Repeal Bill requires married couples to file a joint tax return in order to receive tax credits to help them pay for health insurance coverage with no exception for situations of domestic violence, pending divorce, or spouse abandonment.
  1. The ACA Repeal Bill denies federal reimbursement to Planned Parenthood – the only source of low-cost preventive and other health care for millions of people, largely women of color, people struggling to make ends meet, and young people.
  1. In another provision that blatantly discriminates against women, the ACA Repeal Bill denies individuals the bill’s already significantly limited tax creditssimply for purchasing a health insurance plan in the individual market that includes coverage of abortion.

The public has spoken – and they do not want President Trump and Paul Ryan taking away their health care.  They do not want to lose their insurance coverage or protections for people with preexisting conditions.  They do not want this.  If President Trump and Paul Ryan would like to do something useful with our government resources, we have a few ideas…