Health Insurance for Obesity After the ACA
Will health insurance for obesity change under the new Republican plan to replace the Affordable Care Act (ACA) with the American Health Care Act (AHCA)? The short answer is maybe and maybe not.
Some of the Basics
The new plan repeals the mandate for everyone to buy insurance or face a penalty. Instead, people will be whacked with a huge hike (30%) in premiums if they ever let their insurance lapse. Tax credits to help people afford health insurance will change dramatically.
Older, sicker, and poorer people will find their healthcare costs more difficult or perhaps impossible to afford. Federal funding for Medicaid will steadily dwindle. Wealthy Americans, health insurers, and providers will get a trillion dollars in new tax breaks. Young, healthy people with higher incomes will get a much better deal on health insurance.
Finally, we’ve got no information on what this will cost. House Republicans don’t have estimates from the Congressional Budget Office yet. Likewise, they have no estimates of how many people will lose coverage. Standard & Poor’s analysts said yesterday that lost coverage could hit ten million Americans.
Direct Impact on Obesity Care
The direct impact on obesity care might be limited. That’s because the direct impact of the ACA on obesity care was minimal. Essential health benefits are still in the proposal, but in most states, they didn’t cover obesity care. Fewer gains mean less to lose.
Indirect Impact on People with Obesity
The indirect impact on people with obesity will likely be considerable.
Obesity hits people hard economically. And it more often hits people who have less of a financial cushion. Many people with obesity gained health insurance for the first time under the ACA. Many of the people who lose it under the AHCA will be people with obesity.
Another indirect impact comes through big cuts in funding for chronic disease prevention. The bill will cut billions of dollars from such funding.
Expect a brawl.
Conservative Republicans hate the proposal because it’s not radical enough. Moderate Republicans hate it because it will hit their constituents – many of them Trump voters – especially hard. Hospitals and other providers have a lot to lose if millions of people lose coverage.
And Democrats hate it just because. Even if it didn’t violate all their core values (it does), they’d likely oppose it just because of the tribal politics behind it.
One thing we love about this story is the poetry of acronyms. The plan is to ditch the ACA and replace it with the AHCA. “Affordable” is out. “American” is in. That means more benefits for the wealthy and more pain for the poor if it passes in its present form.
“Nobody knew that health care could be so complicated.” – Donald J. Trump
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March 8, 2017