AHCA: The American Health Carnage Act
For the Republican House of Representatives, the third time was the charm. With some last-minute tweaks in early May, the Republicans squeaked through the American Health Care Act.
This latest effort to repeal and possibly replace the Affordable Care Act, also known as Obamacare, has now been scored by the Congressional Budget Office. The Congressional Budget Office’s estimate of the impact of the GOP’s plan is that 23 million more Americans would be uninsured by 2026, barely changed from the two earlier failed attempts (“Analysis: House bill would leave 23M more uninsured,” May 25).
These are sobering numbers indeed. We want health insurance to improve our health and guard against economic hardships. But in focusing on the tens of millions who would lose insurance and be put at increased risk, we may lose sight of the actual life or death consequences of that increased risk.
Let’s look at the consequences of just one of those risks — premature death. Having health insurance reduces the risk of death, and not having it increases that risk. A recent Council of Economic Advisers report examined research on prior coverage expansions similar to Obamacare, and concluded that those expansions reduced the rate of mortality. For example, a study of the Massachusetts health reform found that for every 830 people who gained health insurance, one death was avoided annually.
Apply that to the Congressional Budget Office estimate of 23 million fewer insured from the American Health Care Act, and you get nearly 28,000 additional deaths. And that’s for Every. Single. Year.
How do these tens of thousands of deaths annually from losing insurance stack up against other fates we fear? The Center for Disease Control and Prevention’s National Center for Health Statistics offers some comparisons in its bleakly titled “Deaths: Final Data for 2014.”
Taken as a group, “AHCA loss of insurance” would place in the top 15 leading causes of death in the U.S., between essential hypertension and hypertensive renal disease (30,221) and Parkinson’s disease (26,150). It would be far more than gunrelated homicides (10,945) and gun-related suicides (21,334). Every. Single. Year.
“AHCA loss of insurance” would be somewhat less than, but in the same ballpark as, deaths from motor vehicle accidents (35,398), alcohol-induced causes (30,722), and druginduced causes (49,714). Every. Single. Year.
Within drug-induced causes, opioid and heroin deaths have been rising, and our attention has been drawn to these epidemics. The American Society of Addiction Medicine reports that in 2015, there were 20,101 overdose deaths related to prescription pain relievers, while 12,990 overdose deaths were related to heroin. Both are fewer than the 28,000 additional deaths that would come from “AHCA loss of insurance.” Every. Single. Year.
U.S. fatalities in military operations in Iraq and Afghanistan total about 7,000 cumulative over the past 15 years. “AHCA loss of insurance” would be nearly four times that 15-year total. Every. Single. Year.
House leadership named their bill the “American Health Care Act.” But if there was truth in legislative labelling, the AHCA should be more accurately named the “American Health Carnage Act.” So for those who seek to repeal what they regard as the scourge of Obamacare, and especially for those who partied at the White House after the House vote, here is my question: Is this really an acceptable price to pay?