Founder and President Emeritus
The Trump Administration and House Republicans are reportedly discussing a deal to revive the House GOP leadership’s Affordable Care Act (ACA) repeal bill — the American Health Care Act. Press coverage of these discussions has largely focused on the possibility that the deal will add new provisions to the House bill that would let states dismantle protections for people with pre-existing conditions and eliminate requirements that health insurance plans cover basic services like maternity care, prescription drugs, and mental health and substance use treatment.
As we’ve explained, such changes could be devastating for millions of Americans, especially the 52 million with pre-existing conditions that would have made them uninsurable under pre-ACA law. But even without these additions, the House bill, if enacted, would represent the greatest assault on low- and moderate-income Americans of any law in modern times. It would also represent the largest direct transfer from low- and moderate-income people to the very wealthy in memory.
The House bill would cut more than $1.1 trillion from Medicaid and from subsidies that help moderate-income people afford health coverage and dedicate most of the savings to tax cuts for high-income Americans and corporations (see chart).
As a result:
The problems with the House bill are so serious and widespread that they simply aren’t fixable. Almost every provision in the bill, from its major cuts to marketplace subsidies and Medicaid to its smaller Medicaid proposals, which have received less attention, would either cause people to lose coverage, make coverage less affordable or less comprehensive, or cut taxes for high-income people.
Congressional Republicans should instead jettison the bill’s Robin-Hood-in-reserve approach, which would cause millions of their constituents to become uninsured while showering tax cuts on those at the top, go back to the drawing board, and seek bipartisan approaches.