From Bad to Worse: Forecasting the Effects of Republican Health Care Reform

Photo by Nathaniel St. Clair

It should be abundantly clear to rational observers that, while the U.S. health care system is broken, the Republican House reform proposal – called the “American Health Care Act” (AHCA) – will make matters even worse. The general details of the legislation should now be well known: 1. repeal the Affordable Care Act’s (ACA) mandate that Americans purchase health insurance; 2. Eliminate the ACA’s health insurance exchanges and replace individual federal subsidies for those buying on state health care exchanges with health care-related tax credits; 3. Eliminate the tax increase on individuals earning more than $200,000 a year, and couples earning over $250,000, needed to pay for the health insurance exchange subsidies; 4. Empower states to allow insurers to increase their rates, denying health care to individuals with pre-existing conditions; and 5. Allow states to create high-risk pools for individuals seeking insurance who are priced out of traditional insurance markets due to pre-existing conditions.

The health care system in the U.S. is deeply dysfunctional, and the status quo set up under Obama’s ACA is unsustainable. On the one hand, the ACA’s mandate and subsidies have resulted in millions of Americans registering for care, and the number of uninsured Americans has fallen significantly, from 17.1 percent in late 2013 to 10.9 percent in early 2017. On the other hand, just because more people have health care doesn’t mean…

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