NH Congressional delegation unanimously opposes AHCA

Earlier this week, the US House passed the American Health Care Act (AHCA).

The bill repeals the Affordable Care Act—also known as Obamacare—and replaces it with a set of new policies. These include:

• Eliminating the requirement that uninsured people buy insurance or pay a tax penalty. Instead, the bill allows insurers to charge 30% more for premiums the first year a person seeks coverage, if they let their insurance lapse.
• Eliminating the mandate that employers offer health coverage.
• The bill removes income-based tax credits, replacing them with age-based credits. These range from $2,000 per year for younger adults to $4,000 per year for those over 60.
• The bill rolls back Obamacare’s taxes on insurers, medical-device manufacturers and the wealthy, which were used to subsidize insurance costs for lower-income people.
• The new plan would gradually roll back Medicaid expansion, by stopping enrollment and then cutting funding for adults who leave the program.
• Additionally, the government would no longer pay the full costs for patients enrolled in standard Medicaid. Instead, states would have the option to receive either a block grant or a fixed amount of money per patient.
• States are given the power to apply for waivers that would let them authorize insurers to charge higher premiums to older adults; cut coverage for maternity, mental health and prescription drugs; charge higher rates for patients with pre-existing conditions; or return to imposing lifetime or annual benefit limits. States that use the waiver would still be required to create some program to cover patients with more expensive illnesses who aren’t otherwise able to get insurance, and the plan sets aside funding for such “high-risk” pools (though policy experts warn that the amount budgeted is likely to be insufficient).

Supporters of the AHCA point to estimates that it will significantly lower Medicaid costs. They argue that giving insurers more flexibility will enable them to offer lower premiums to younger, healthy adults, which will encourage more of them to enroll and therefore expand the risk pool.

“Premiums are skyrocketing and choices are disappearing... And that is why we have to repeal [Obamacare] and put in place a real, vibrant marketplace with competition and lower premiums for families,” said House Speaker Paul Ryan. “That’s what the American Health Care Act is all about. It makes health care more affordable, it takes care of our most vulnerable, and it shifts power from Washington back to the states, and most importantly, back to you, the patient.”

“It’s a very good bill right now,” said President Donald Trump, who personally advocated for the AHCA. “Premiums are going to come down substantially. Deductibles are going to come down.”

Both of New Hampshire’s US representatives, Carol Shea-Porter and Anne McLane Kuster, voted against the bill.

“If this bill passes, we will go back to the days when people with pre-existing conditions could be denied coverage or charged more, when insurers could decide whether or not to cover basic care like hospitalization, and when sick babies might hit their insurer’s lifetime coverage limit before they could even walk,” Shea-Porter said.

Shea-Porter also pointed to the elimination of tax credits for veterans and provisions in the bill that allow insurers to charge higher premiums to older patients.

According to Lucy Hodder, director of the Health Law and Policy program at University of New Hampshire, “By any definition, if we go to a block grant system under Medicaid, states like New Hampshire would get less money.”

The AHCA will now proceed to the Senate, which may opt to significantly reshape the legislation. Both of New Hampshire’s senators, Jeanne Shaheen and Maggie Hassan, have issued statements that they plan to oppose the bill.

Do you think the AHCA would be good for NH? Why or why not? Leave a comment and weigh in.