Like the zombie in a bad horror movie that keeps rising, again and again, the Trumpcare bill to repeal the Affordable Care Act (ACA) is once again threatening our health care. With Donald Trump’s 100th day in office just two days away, the media-obsessed White House has been in a panic to notch a win—even if it means stripping affordable health care away from millions of people. At the same time, members of the House Freedom Caucus and conservative think tanks have been under pressure to avoid the blame for killing ACA repeal.
A vote in the House could come as early as next week. We must keep the vote from ever being scheduled at all. With so many calls to action over the last few weeks and no vote scheduled, advocates and activists may wonder if there’s really cause for alarm this time. Are we “crying wolf” (or crying zombie!)?
Citizen engagement through phone calls, town halls, and protests has been the only thing keeping Trumpcare from passing. Reluctant to re-live their March humiliation of scheduling and then scrapping a vote, Republican leaders have made clear that they won’t schedule a vote until they know for certain that the bill will pass. Every week without a vote is a sign that our collective outreach is working. We can’t stop now!
What can you do? Call your member of Congress at 1-844-898-1199. Use the Trumpcare toolkit developed by the Protect Our Care Coalition: www.trumpcaretoolkit.org. Share our Raising Women’s Voices social media alerts, including the new #Zombiebill graphic shown above. You can find us @RWV4Healthcare.
How the #Zombiebill has become even worse
When the Congressional Budget Office (CBO) scored Trumpcare I, it concluded that 24 million people would lose health insurance. Republicans are anxious to vote on Trumpcare II before CBO can score these new changes because they know the number of people losing insurance is going to be much higher.
That’s because, just like in a horror movie, this zombie has only grown more grotesque over time. Under the legislative text released by House Republicans on Tuesday, states would be allowed to drop two important provisions of the ACA:
- The requirement that insurance plans cover 10 Essential Health Benefits, such as maternity care, hospitalizations, doctor visits and prescription drugs.
- Provisions (known as “community rating”) to prevent insurance companies from discriminating against sick people by charging them much more.
If states drop the Essential Health Benefits requirement, then insurance companies could sell plans that are cheaper but don’t cover much at all. If we get sick or become pregnant, we would have to pay out of pocket for anything that isn’t covered—like cancer treatment or childbirth and newborn care. Comprehensive health plans would be significantly more expensive than they are now—or they might disappear altogether.
If states get rid of community rating, insurance companies will once again sort us based on how healthy or sick they think we are, and charge millions of people substantially more for their insurance, pricing many out of coverage altogether. We will once again have to fill out lengthy questionnaires about our health status and history and could once again have our policies canceled if we forget to list even mild pre-existing conditions like acne. These policy cancellations were common before the ACA.
The people who would be hurt are those who need good health insurance the most—like pregnant women and people with pre-existing medical conditions! Insurance companies couldn’t refuse them coverage under Trumpcare, but they could sell bare-bones plans that don’t cover the medical care that sick people need, or they could charge such expensive premiums that sick people couldn’t afford coverage.
Trumpcare’s sponsors claim that no one with pre-existing conditions would be hurt under these changes because states would set up high-risk pools for the very sickest—even though when high-risk pools were tried in the past, they didn’t work. But we know what members of Congress really think because the bill text released Tuesday explicitly exempts them from the provision letting states drop Obamacare’s protections for pre-existing protections. While this exemption is likely to be dropped, it has revealed the gap between GOP talking points and what they really think.
Would we be able to stop states from dropping these important coverage protections? It could be difficult. Under the bill, state plans to drop these critical consumer protections would be filed with the U.S. Department of Health and Human Services (HHS) and automatically go into effect after 60 days unless HHS objected. How likely is it that HHS Secretary Tom Price, a Trump appointee, would object to states carrying out provisions of Trumpcare?
Don’t forget: Trumpcare II keeps all the bad parts of Trumpcare I
These new provisions in Trumpcare II have been added on top of all of the worst parts of Trumpcare I:
- A massive tax cut for corporations and the ultra-wealthy paid for with $880 billion in cuts to Medicaid. Under the guise of “Obamacare repeal,” this bill rewrites the rules for original Medicaid, eliminating the federal government’s guarantee to cover a percentage of the costs of every eligible enrollee. The bill caps and ratchets down federal support so that it provides less and less help each year, forcing states to cut benefits or drop children, pregnant women, disabled people, and seniors from coverage. All to give the 400 richest households in America an average tax cut of $7 million.
- Elimination of the ACA’s Medicaid expansion. The CBO predicts that more than two-thirds of those who gained coverage through Medicaid expansion will lose their eligibility within just two years of implementation of the repeal bill.
- Deep cuts to the subsidies that help low- and moderate-income people buy insurance. For example, a 60-year-old woman making minimum wage receives (on average) almost $10,000 in subsidies (premium tax credits) from the ACA to help her buy good insurance—and more if she lives where premiums are high. Under the GOP repeal, she would get just $4,000—no matter where she lives or how expensive her insurance.
- Permission for insurance companies to charge older Americans five times more than younger ones. CBO predicts that Trumpcare will “substantially rais[e] premiums for older people.” Women in their 50s and 60s who lose coverage through divorce or widowhood will be hard pressed to find affordable coverage.
- Higher copays and deductibles. CBO noted that “lower-income people’s share of medical services paid in the form of deductibles and other cost sharing would increase.”
- An attack on Planned Parenthood. The bill would prevent women from being able to use their public health insurance, such as Medicaid, at Planned Parenthood, which would be barred from receiving federal funds. Planned Parenthood is often the only women’s health provider in rural and other underserved areas. CBO reported that “The people most likely to experience reduced access to care would probably reside in areas without other health care clinics or medical practitioners who serve low-income populations.”