Contributed by Max Plesset MD – retired physician
Mr. Zeldin’s email:
This week, the American Healthcare Act was introduced in the House to repeal and replace the Affordable Care Act, commonly known as Obamacare. You can read the bill here…
I want to know your thoughts on the bill just released. Please let me know what you think of the bill here.
I will continue to monitor the progress of this bill as it goes through the markup process in committee. One of my top priorities in Congress is to improve healthcare in America.
With Best Regards, Lee Zeldin
Member of Congress
My response to Mr. Zeldin:
Why the Republican changes to the ACA will not work:
1. Tax credits will not cover the ever-rising premiums, particularly for older people up to age 64. Many have modest incomes and will face a 5 fold increase in premiums that they will not be able to afford.
2. Health Savings Accounts (HSA) are only for those who have enough discretionary income to fund one. Also, many will be unable to manage an HSA along with their catastrophic insurance plan. People on limited incomes faced with a choice between funding the HSA and buying food (or other necessities) will choose the latter.
3. Without the mandate healthy young people will not buy insurance, which will lead to an insurance pool with adverse selection (only sick people) and the pool will fall apart due to sky-high premiums (the so-called death spiral).
4. The block Medicaid grants will be limited to those currently enrolled in the state’sMedicaid program and will not be expanded after 2020. As health care costs inevitably increase, the states will not be able to fund the care for the Medicaid recipients since the grants will not increase as more people become eligible and costs rise.
5. Most state high-risk pools historically have had great difficulty being sustained due to extremely high medical costs and unaffordable premiums for these patients.
In summary, all this will probably lead to many more uninsured people who will be showing up in ERs without insurance, and with unattended chronic medical problems. Many of them will cost the health care system much more due to the uninsured patient not having regular preventive services and a lack of management of serious chronic diseases. This leaves hospitals with bad debt and ultimately will raise the cost of services and the cost of health insurance premiums for everyone. We will be left with the myriad problems that existed before the passage of the ACA or even worse.
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