The narrow passage of the American Health Care Act (AHCA) reached the House Thursday, resulting in victorious chanting reminiscent of a high school sporting event. However, the chants didn’t come from victorious athletes, but from members of the GOP.
The bill received 217 yes votes from Republicans. It needed 216. All Democrats and 20 Republicans voted against it.
Speaker of the House Paul Ryan and Vice President Mike Pence joined GOP members in the Rose Garden at the White House alongside President Donald Trump after the bill passed.
“Most importantly, yes, premiums will be coming down, yes, deductibles will be coming down, but very importantly, it’s a great plan. And ultimately, that’s what it’s all about,” Trump said from the Rose Garden.
The repeal first surfaced in March, but died before reaching the House. However, with provisions like the MacArthur Amendment, the bill scraped by its second time around.
DePaul law professor Wendy Epstein said the MacArthur Amendment was important in facilitating the bill’s passage by securing the votes of the most conservative members of the House. The amendment serves two main purposes: It allows insurers to charge people with pre-existing conditions higher premiums so that healthier people will not subsidize their coverage, but which may result in sicker people being priced out of the insurance market.
It also allows states to discontinue the Affordable Care Act (ACA) requirement that insurance cover a package of essential health benefits.
The amendment leaves these decisions to the states. Should a state choose to apply for a waiver, insurers in the state can charge people differently based on their pre-existing conditions and offer leaner packages of benefits.
However, should they not, under the AHCA, like with the ACA “insurers will continue to not be able to charge any differently for people who have pre-existing conditions, assuming that those with pre-existing conditions do not have lapses in coverage,” Epstein said.
Postpartum depression is one pre-existing condition Epstein mentioned.
For some DePaul students, the bill won’t cause them to see much change as it still allows young people to remain on their parents health care coverage until they are 26.
However, for students not listed under their parents health care, things are different.
“We have plenty of students on Medicaid,” Epstein said. “Those students will likely see cuts to their benefits.”
Medicaid, a federally aided, state-operated health care provider for predominantly low income individuals, will see a roughly 25 percent cut in funding, which is something Epstein said will fall under states to make up the shortfall.
“It’s a real concern in a state like Illinois that already has severe budgetary constraints,” she said. “I think people on Medicaid right now should be watching the bill closely. They should be calling their senators and making their opinions known that these are benefits they depend on for their health and their well-being, and they do not want to see these extreme cuts happen to Medicaid.”
Another potential issue for students under the proposed AHCA is mental health treatment. Under the MacArthur Amendment, if a state opts for a waiver, essential health benefits currently include mental health treatment, don’t have to be covered by insurance companies.
“One concern for students to look out for is whether or not they’re getting insurance that is practically meaningful,” Epstein said.
DePaul alum Julia Hogikyan will be able to stay on her parents health insurance for a few more years. After that, her current job also provides insurance. However, certain provisions in the bill could still affect her deleteriously.
“As a young woman in particular, (…) this bill could very well affect me if it is put into law,” Hogikyan said. “The fact there is no longer protection for those with ‘pre-existing conditions’ is devastating, especially considering what insurers are allowed to term ‘pre-existing,’ such as sexual assault and domestic violence.”
Prior to the ACA, some insurers did consider the medical treatment related to sexual assault and domestic violence a pre-existing condition.
Hogikyan also says the bill is a betrayal by Trump to many of his supporters.
“It goes against everything that Trump campaigned on; it betrays the very people that put him in office,” Hogikyan said. “The poor, predominantly white, working class will be directly hit with higher premiums and less coverage overall.”
Junior Christopher Augustine worries about his grandfather.
“My grandpa is in critical condition right now having his leg amputated in order to stop the spread of an infection,” Augustine said. “Given my grandparents reliance on affordable healthcare I do worry if they will be able to afford my grandpa getting better.”
Under the proposed AHCA, premiums will rise for the elderly. The bill allows insurers to charge older people five times as much as younger people whereas the ACA restricted it to three times as much.
The AHCA still needs to go through the Senate where many are expecting it to be modified if passed at all.
“There are going to be real questions about how the Senate handles the continuous coverage provisions and the waivers to the essential health benefits,” Epstein said. As those issues are not very popular with the American public, Epstein said the Senate might touch on that.