As the debate around health care intensifies following the release earlier this week of the House Republican's American Health Care Act, several Stanford-affiliated researchers agreed to weigh in on the new bill.
Their comments are specific, so first a bit of background on the plan itself, as I wrote in an article for Stanford Health Policy:
The American Health Care Act would retain the popular provisions to keep children on their parents’ health insurance plans until they are 26 and ban insurance companies from denying coverage to those with pre-existing conditions — unless they have a lapse in insurance coverage.
The proposal drops the requirement that everyone buy health insurance, thereby eliminating the tax penalty for those who don’t buy coverage. It converts Medicaid to a program in which states have a set amount to spend on each enrollee per year. It eliminates several taxes that previously offset to the cost of the Affordable Care Act.
The researchers — Michelle Mello, PhD, JD, a health law scholar; Jay Bhattacharya, MD, PhD, a physician and health economist; and Bob Kocher, MD, a partner at Venrock who is a consulting professor at Stanford and advised the Obama administration on the Affordable Care Act — agree the new plan is unlikely to reduce the number of Americans who are uninsured. Here's Mello:
The bill reduces the amount of financial assistance the government gives low-income Americans to offset the cost of buying insurance. It also wrecks the delicate balance in the Affordable Care Act that prevents insurance premiums from spiraling upward — the so-called 'death spiral'— because the new bill allows people to wait until they get sick to enter the risk pool. The other thing to recognize when people start talking about lower premiums is that increasingly, what consumers pay for their health care comes in forms other than premiums. High-deductible health plans and higher copayments (your out-of-pocket share when you see a physician or fill a prescription) are more and more common. The new bill eliminates provisions in the Affordable Care Act that protect consumers below 250 percent of the federal poverty line from these types of costs. This paves the way for huge increases in what poor and lower middle-class families will pay before they get their first dollar of insurance coverage, and what they will pay every time they need a health-care service.
The researchers also chime in on changes to Medicaid, the proposed tax credits, the effects on preventative and much more. It's well worth a read.
Previously: Repeal of ACA would worsen opioid epidemic, Stanford researchers say, "We took an oath to do no harm": Medical students show support for Affordable Care Act and The current state of women's health in the United States? Uncertain
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