Healthcare Time Machine: The Senate’s Attempt to Roll Back The Progress of the ACA

“We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America”.

In the Preamble to our Constitution, the founders included a clause in which they state that we, as the people of the United States, and more importantly our congressional representatives, are to promote the general welfare in order to form a “more perfect union.” This phrase gives our government a mandate to protect its citizens and to provide for their well-being. Well-being is a vague term and can most definitely be interpreted in a number of ways, which should include the health of the citizens, as well as their ability to access necessary medical attention and care.

Over the last couple of months, Senate Republicans have ignored their mandate to promote the general welfare of the United States citizenry by attempting to repeal the Affordable Care Act (ACA) and replace it with their onerous, lethal bill. This bill has been written in the dark and has been pushed through using a reconciliation process on partisan grounds. In the last few weeks, the American people have seen glimpses of the overarching effects of this secret bill. It includes dangerous provisions that would impact our most vulnerable citizens and would kill our sickest people.

The Senate bill includes a provision which allows for the redefinition of essential health benefits. These essential health benefits, which were codified in the ACA, include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance abuse services, prescription drugs, rehabilitative and habilitative services, laboratory services, preventive and wellness services and chronic disease management, and pediatric services. These are services which benefit millions of Americans and having health care plans that cover these services keep Americans healthy and save lives. This provision allows the states (and insurance companies) to change the definition of essential health benefits. While this bill in its current form and this provision does not blatantly discriminate against those with pre-existing conditions, it does open up a loophole for insurance companies to charge those with pre-existing conditions more for insurance or deny them of quality insurance. By allowing companies to waive plans that cover essential benefits as long as it doesn’t add to the federal deficit or to redefine what they must cover, the bill allows insurance companies to offer skimpy plans to those with conditions and force them to decide between sacrificing the medicine and care that they need- but is no longer covered by a bare-bones plan- or to pay an increased amount for a plan that covers the benefits they need.

These bare-boned plans don’t cover the benefits that people with pre-existing conditions need. This forces them into a high-risk pool at an insurance provider. Younger, healthier people would flock towards the cheaper plans leaving those with the need for a more extensive plan to stay in a pool with others in their circumstance, which leads to higher cost for those with chronic conditions or previous illnesses. This leads to discrimination against the sick and dying through the cost of health insurance. Causing those who are sick to choose between buying food or filling their prescription is disgusting on the part of our senators who proposed this monstrosity of a bill.

Medicaid is one of the essential benefits that people with disabilities, elderly people, and impoverished people receive through the government. It helps these vulnerable groups of people receive the medical care they need as well as have access to preventative services that they otherwise would not have access to. It has also been a key tool in the opioid addiction fight as rehabilitative services have been covered by Medicaid. The Senate Healthcare bill (as well as the House’s proposal) scoffs in the face of the needs of these vulnerable individuals. It moves toward fixing the amount of money each state receives per enrollee into Medicaid. It also moves towards a block-grant type of funding. These fixed grants do not account for increases in prices or the unique needs of individuals on Medicaid. This leads to the states footing the bill for the overage costs which, in turn, leads to states cutting services or reducing eligibility so they aren’t responsible for the extra cost. This problem is compounded with the bill tying Medicaid spending to the standard inflation rate rather than the more generous and more accurate “medical inflation.” These problems lead to those who need Medicaid, the most vulnerable among us, to lose care and vital services. Doesn’t sound like the Senate is accounting for the well-being of all of their citizens, as mandated by the Constitution.

These are only two of the most egregious provisions in the health care bill. This does not include the repeal of the individual mandate (which stabilizes the market by bringing healthy people into the market) and the employer mandate (which would allow companies to not offer insurance to their employees which 49% of Americans rely on) among other things like the reemergence of the lifetime caps on insurance coverage. These all have one thing in common; They limit the accessibility of healthcare especially among the sick and elderly. They pick on those who need help. That is not providing for the well being of our citizens. We need to reject this absurd assertion that taking away insurance from 22-32 million people is somehow palatable. We need to reject this discrimination against those who need our help.

Even though the bill appears to be dead, I believe that the senate will not rest until the ACA is repealed or the Republicans lose control of the senate and house. But, I do believe that the citizens of the U.S. are strong and will not go down without a fight. I believe this because we are not going to accept a rollback of the progress we have made; We are not going to accept 24 million people being thrown off of health care; We are not going to accept cuts to Medicaid that will throw the elderly out of nursing homes and take necessary services from those with disabilities; We are not going to accept discrimination against people with pre-existing conditions to occur again; We are not going to accept essential health benefits being “redefined” or cut; We are not going to accept an assault on young adults ability to remain on their parents plan until they are 26; We are not going to accept a six month penalty for a short term lapse in coverage; We are not going to accept the repeal of the employer mandate; We are not going to accept a repeal of the ban on lifetime caps on insurance. We can only move forward not backward. We will only accept progress, not regression.

Dear Senators, give us a plan that will insure all Americans and will protect those who need protection. If not, we will do everything in our power to make sure your destructive bill will fail. And it will.

Credits: Tasos Katopodis/ Getty

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