Checking a patient’s vital signs is a key way medical providers assess recovery and whether further treatment is needed. Congressional Republicans also have an ailing patient — a controversial health reform plan — under their care. Unfortunately, party leadership is ignoring critical signals from health care providers and public opinion polls about the legislation’s health and what prescriptions it still needs.
After seven years of decrying former President Obama’s signature health reform law, the House’s Republican majority rolled out their replacement last month. The bill, known as the American Health Care Act (AHCA), deserved the drubbing it received from the nation’s doctors and hospitals. The Congressional Budget Office estimated it would insure 24 million fewer Americans than the Obama law. It also would have significantly shifted both short- and long-term care costs onto older and sicker patients.
The AHCA never even made it to the House floor for a vote after support collapsed from hard-line and moderate Republicans. The political defeat resulted this week in a rushed, ill-advised push to resurrect the bill before the Easter recess.
The move comes on the heels of poll results released this week by the nonpartisan Kaiser Family Foundation. Roughly, two-thirds of those surveyed said it was a “good thing” that the AHCA did not pass, with 55 percent also responding that the bill lacked support because it “went too far in cutting programs.” Seventy-five percent also said the GOP should try to make the Obama law work vs. undermining it.
Yet the “fixes” the GOP proposed this week ignore public sentiment and previous objections from the American Hospital Association and the American Medical Association. In trying to appease hard-line conservatives, GOP leaders have offered the wrong prescriptions for making coverage broadly affordable, widening support and stabilizing the insurance market.
The revisions focus on weakening a requirement in the Obama law called “essential health benefits.” The rules require health insurers to cover the services or conditions that most consumers would assume are included — such as hospitalizations, emergency care, lab tests, prescription drugs, mental health and maternity care.
Before the Obama law, however, some people who were buying in the individual market, meaning they didn’t get coverage through their employers or programs such as Medicare, could buy insurance a la carte style. The argument for doing it this way is that coverage is cheaper for some. The arguments against it are far stronger.
Those who buy the skimpy plans likely won’t have the money to pay for hospitalization and other care if they need it, shifting uncompensated care costs to others. Those who require more comprehensive policies would likely be priced out of the market. The reason: Only people with ongoing medical needs or those at higher risk for them — such as older or sicker people — would want these broader policies, which would eventually cause costs to soar. The GOP plan may still maintain protections for those with “preexisting conditions.” But these protections are rendered useless if consumers with heart disease risk factors, for example, can’t afford to buy a plan that would cover hospitalization for a heart attack.
Health care, as President Trump has noted, is complex. Spending on it also accounts for nearly 18 percent of the nation’s annual gross domestic product. Reforms require care and consensus. This is not an undertaking to simply be checked off a to-do list before spring break.