American Health Care Act hasn’t gotten better with time

On March 14, 2017, I wrote a column explaining the then-proposed American Health Care Act would result in many Americans being uninsured. A redrafted bill, now passed by the House of Representatives with no support from Democrats would also have the same result but worse. The majority of Republicans voted in favor but locally Ryan Costello did not. To give you an idea of how much credibility the version passed by the House has currently it could be noted that the Republican controlled Senate decided not to introduce it but to craft their own version of the law. Stay tuned for the Senate.

Those who have followed the trek of the newer and less improved version of the American Health Care Act know the revised House version would also give states the option for waivers to allow insurance companies to write policies without basic benefits such as maternity care, emergency care, prescription drugs, and mental health. So, although I previously stated it would be difficult to draft a worse bill than the first, it appears that premise was also wrong.

Here is the argument. “The Affordable Care Act (Obamacare) is collapsing” and therefore something must be done to deal with healthcare. One analogy might be that the patient (the ACA) is dying or, if the ACA is not dying, now is the time to kill it.

This is what I said on March 14 and that still holds true.

The bill would insure fewer people at higher cost, still be expensive for the government and leave the most vulnerable uninsured …

• With the mandate to purchase health insurance gone, fewer healthy people can be expected to buy health insurance coverage and the fund for payments from insurers will be reduced. The elimination of the mandate to purchase health insurance was regarded as one of the main reasons for repeal. The reasoning here is that this is a free country and who is the government to tell people to go out and buy insurance even where it is private insurance. In fact, in another of Speaker Ryan’s presentations, he explained that the problem with the ACA is that people who are healthy would be required to buy insurance that benefits people who are sick. Actually, this is the idea behind insurance itself. People who own houses that have not been damaged by fire buy homeowner’s insurance that benefits others whose homes have been destroyed. This is with the expectation that someday the in-

dividuals who did not suffer the casualty loss might suffer a loss and they would also be compensated. Insurance provides a pool of money that can be accessed to pay when there is a loss. The greatest cost would be to suffer the loss and have no insurance to pay for it.

• Tax credits would replace subsidies under the health care exchanges. Ironically, opposition to tax credits in the bill by many conservatives was finally a recognition that previously unrecognized tax benefits and payments under government programs do the same thing. They can increase the national debt. The tax credit provision is in the bill to make it more palatable for people who would suddenly lose their subsidies for health insurance under the ACA. However, for people who pay little taxes because their income is low, the provision does not help to encourage them to take out individual health insurance…

• The bill would penalize those who try to reestablish health insurance coverage. Under the proposed bill, you would be fined 30% of the premium additionally if you lost insurance coverage and tried to reestablish coverage… So, if you lose your job and your COBRA from your old employer runs out or you could not afford the premiums or you find a new job with an employer who does not provide insurance, it would cost you 30% more to get health insurance later, a clear disincentive. Employers, unless obligated by a state law, would not under the new law be required to provide insurance regardless of the employer’s size.

This review does not begin to cover loss of insurance from Medicaid expansion or age rating that would substantially increase the cost of insurance for older adults before age 65. Stay tuned for more – Daily Local News, March 14, 2017

Janet Colliton, Colliton Elder Law Associates, PC, limits her practice to elder law, life care and special needs planning, Medicare, Medicaid, estate planning and administration and is located at 790 East Market St., Suite 250, West Chester, Pa., 19382, 610-436-6674, colliton@ collitonlaw.com. She is also, with Jeffrey Jones, CSA, co-founder of Life Transition Services, LLC, a service for families with long term care needs. For more, listen to radio WCHE 1520 “Planning Ahead” Janet Colliton, Colliton Elder Law Associates with Phil McFadden, Home Instead Senior Care, on Wednesdays at 4 p.m.