By a mere four votes and with 21 GOP reps voting no or not voting, House Republicans managed to push through legislation that repeals the Affordable Care Act (aka Obamacare) and replaces it with the American Healthcare Act (AHCA).
*If* the AHCA is enacted, experts estimate that 24 million people could lose their healthcare coverage and 130 million people could see a rise in healthcare costs due to the laundry list of pre-existing conditions listed in the bill. Since the House vote, the hashtag #IAmAPreexistingCondition has been used on various social media platforms to highlight the challenges the AHCA bill poses to millions of Americans.
The House of Representatives voted without analysis from the bipartisan Congressional Budget Office (CBO), a move which the former CBO director called a “terrible mistake.”
The next step is a vote in the Senate, an activity that will test the metal of the Republican Party, since the GOP has a tenuous 52/50 hold on the Senate, and a handful of defectors could tank the bill. If some version of the AHCA passes the Senate, here is a list of who the biggest losers would be with this new plan in an Obamacare-less United States.
An amendment to the AHCA states “Nothing in this Act shall be construed as permitting health insurance issuers to discriminate in rates for health insurance coverage by gender.” Yet, that is precisely what it does, because some of the pre-existing conditions that trigger higher costs are either exclusively or predominately experienced by women. These conditions include having an abortion, being a rape or domestic violence survivor, being pregnant, and having a C-section.
Anyone with Pre-Existing Conditions
Though women seem to be particular targets with the pre-existing conditions list, anyone with what insurers deem to be in the “high-risk pool” could see a considerable increase in healthcare costs. A study by the Center for American Progress estimates that premium increases would be $17,320 for pregnancy, $5,600 for diabetes and a staggering $142,650 for metastatic cancer.
Special Education Students
The AHCA slashes Medicaid by $880 billion over the course of 10 years and put a per-capita cap on how much money is allocated. School districts rely heavily on that federal program to fund services for special education students. The Save Medicaid in Schools Coalition, a group representing various education organizations, sent a letter to lawmakers before the vote warning that the AHCA would disproportionately harm children.
That significant cut to Medicaid that impacts special education students also has an immediate impact on poor people as a whole. Approximately 14 million of the 24 million people expected to lose coverage from the AHCA bill are currently covered by Medicaid via Obamacare’s Medicaid expansion. The AHCA effectively eliminates that expansion, leaving low-income people (especially the working poor with fluctuating income) with little to no affordable options.
Planned Parenthood and its Clients
Current regulations do not allow Medicaid to be used for abortions, but the AHCA takes that even further. The bill bans federal money from being used at reproductive health facilities that also provide abortions. Planned Parenthood provides many other services besides abortions, including STD testing, birth control access, pregnancy testing, and pap smears. People who rely solely on Medicaid for health services would no longer have access to those services, and without the hundreds of millions of dollars in federal funding per year, Planned Parenthood would likely have to cease or drastically reduce assistance at locations nationwide.