As of Thursday, April 13, 2017
To the editor:
Thought the AHCA was dead, and we were back to the ACA as before? Not by a long shot, and the new version is worse than ever.
The GOP is now courting the conservative House Freedom Caucus to revive the ACA replacement bill, proposing to allow states to apply for waivers to repeal two ACA regulations that conservatives argue are driving up premiums:
• Essential health benefits (EHBs), which mandate which health services insurers must cover, and
• Community rating, which prevents insurers from charging sick people higher premiums.
Conservatives are expecting that repeal of the two regulations in question would provide enough "yes" votes to pass the previously tanked Trump/Ryan/Walden American Health Care Act.
Let's be clear on the argument that EHBs and community ratings are responsible for high premiums.
EHBs, in fact, do not drive up health care costs. They account for a very minor portion of health are costs, and in the larger view support a healthier population with less need for expensive, should-have-prevented-this-problem interventions.
Charging sick people higher premiums is not in any way a smart or ethical way to control health care costs.
It only makes those sicker individuals less able to afford healthcare coverage. They are still sick, they don't get the regular care they need, then their medical conditions occur more frequently and are more expensive than before. Who then pays the bills?
The general public, and in rural settings like ours, poorly funded rural hospitals, many of which might have to close under the proposed plan.
Mr. Walden, the proposal to allow states to choose to apply for waivers to repeal essential health benefits and allow insurers to charge sick people higher premiums is completely unacceptable.
There are many aspects of the current ACA that can and should be improved. You need to break your lockstep with Ryan and Trump, think for yourself, and start working to benefit your constituents.
Get serious about a bipartisan effort to improve the ACA. Or, better yet, support a single-payer Medicare-for-All.