On November 8th 2016, Republicans took hold of the presidency and both chambers of Congress, after heavily campaigning to repeal the Affordable Care Act. It is no wonder that many within the Washington establishment assumed the Affordable Care Act would be gone the day after Inauguration.
Yet here we are, nearly 100 days into President Trump’s administration, and the Affordable Care Act remains the law of the land. What happened?
Early in March, Congress released the American Health Care Act (AHCA).
According to the Congressional Budget Office estimate, under the American Health Care Act, 14 million fewer people would be covered in 2018, and 24 million fewer by 2026. The AHCA cut subsidies for individual health insurance buyers and decimated Medicaid by $880 billion.
Under the Affordable Care Act, you can qualify for subsidies for individual health insurance based on your income. These subsidies significantly help elderly people and low income families with out of pocket costs and premiums. However, under the American Health Care Act, individuals would get a fixed tax credit based on age rather than income. This tax credit maxes out at $4,000 and so if your health plan costs more than that, you are out of luck.
Any replacement that causes millions of Americans to lose access to health care is simply a wolf in sheep’s clothing.
The American Health Care Act devastated Medicaid in two ways. Firstly, it rolled back the expansion that took place under the Affordable Care Act. The expansion made Medicaid accessible to all individuals below 138% of the poverty line in 31 states and the District of Columbia. Secondly, the bill would have implemented Medicaid per capita caps, preventing the program from automatically expanding to respond to spikes in need, health epidemics, or outbreaks. States would then end up having to make up the difference- or more likely cut services from those that turn to Medicaid in times of need. Eventually the program could become totally unresponsive.
It just didn’t make sense. Why would Congress want to leave millions of vulnerable Americans without health care? The answer is that these cuts would provide $600 billion in tax cuts to the wealthy, medical insurance companies, and drug companies.
Once this became evident, constituents began to heavily oppose the bill. Letters to the editor, op-eds, emails, phone calls, and lobby visits with representatives were all tactics used to place pressure on Congress. According to a national poll done by Quinnipiac University, 56% of American voters disapproved of the AHCA, and 46% of voters said they would be less likely to vote for their representative if they supported the AHCA. If doing the right thing wasn’t enough to get Republican representatives to oppose the bill, knowing that they could lose their seats in the next election sure was.
Fortunately, on March 24th, after relentless advocacy efforts on the part of constituents, the American Health Care Act was withdrawn.
What Now?
We had a great victory, but we must remain alert. Members of Congress are looking at new proposals on health care. We can all agree that the Affordable Care Act needs to be improved, but we must be clear that any replacement that causes millions of Americans to lose access to health care is simply a wolf in sheep’s clothing.
If these past few months have shown us anything, it is that as constituents, our voices matter. So that letter you want to write, that phone call you want to make, that lobby visit you want to schedule - do it. Let your member know that they should be opposing bills that hurt America’s most vulnerable. After all, your representative is there for no other reason than to represent you.
