Five Myths About the New AHCA

 

(Note: The revised AHCA passed the House of Representatives on May 4 and the bill now goes to the Senate where revisions are anticipated. The news media is in full-distortion mode as I write these words, spreading myths about the bill designed to frighten people. This post reveals some of these myths.)

If you hear a lie often enough you’ll believe it. Opponents of repealing and replacing ObamaCare seem to be following this line of thinking as they spread myths concerning the new American Health Care Act (AHCA).

Congressman Tom MacArthur, chairman of the moderate Tuesday Group of House Republicans has proposed an amendment to the AHCA designed to garner more support from conservatives. I discussed this amendment in my last post (Pre-existing Conditions Dominate Healthcare Debate).

Congressman Daniel Webster (R – Fl) has put on his website a list of five myths about this amendment that are being promoted by opponents of the AHCA. The mainstream media has been assisting those promoting these myths with widespread coverage. Those five myths are listed here:

MacArthur Amendment: Myth v. Fact

  1. Myth: This Amendment does not cover pre-existing conditions.

Fact: The MacArthur Amendment explicitly maintains protections for pre-existing conditions. No State, under any circumstances, may ever obtain a waiver for guaranteed issue of coverage, guaranteed renewability of coverage, or the prohibition on denying coverage due to pre-existing conditions. The amendment specifically clarifies that its provisions cannot be construed as allowing insurers to limit coverage for those with pre-existing conditions.

 

  1. Myth: This Amendment will price those with pre-existing conditions out of the market, making health care unaffordable for them.

Fact: The amendment’s limited waiver for health rating requires states to set up a program for high-risk individuals or premium stabilization, or to participate in the federal invisible risk sharing program. No state may obtain a waiver for health status unless it has taken these efforts to protect those who might be affected. In states with a waiver, individuals who maintain continuous coverage could not be rated on health status.

 

  1. Myth: High-risk pools have traditionally been underfunded by states and the federal government, resulting in poor coverage and high costs for those who need insurance the most.

Fact: The AHCA sets aside $100 billion over ten years to help states with high-risk pools and other innovations. It sets aside an additional $15 billion specifically for maternity care, mental health care, and substance abuse treatment. And it sets aside an ADDITIONAL $15 billion for a federal invisible risk-sharing program – another innovative way to help people access affordable coverage.

 

  1. Myth: Under this Amendment, States do not have to cover essential health benefits.

Fact: This amendment ensures essential health benefits are the federal law of the land and maintains other important protections.

  • States have the options to obtain a waiver regarding federal essential health benefits, but the state must publicly attest its purpose for doing so (to reduce the cost of healthcare coverage, increase the number of people with healthcare coverage, etc.) and it must specify the benefits it will require instead of the federal standard.
  • No State, under ANY circumstances, may ever obtain a waiver for pre-existing condition protection, prohibition on gender discrimination, for guaranteed issue and renewability, or for the right of dependents to stay on a family plan up to age 26.

 

  1. Myth: 129 million Americans have pre-existing conditions and could be denied coverage.

Fact: This legislation addresses the 7% of Americans (22 million) on the individual market, and those in the small group market. Most Americans with employer-provided coverage or government coverage (Medicare, Medicaid, Tricare, VA benefits, etc.) would not be affected. Again, this amendment would not allow any state to deny coverage to those with pre-existing conditions, and would require the extensive protections described above for those with riskier health profiles.

 

Debunking myths is an important part of selling legislation to the public. I hope that this post will alleviate concerns about this legislation you may have had from listening to the mainstream media.

One comment

  1. Good stuff. Keep us updated, clarified, informed.

    Comment by Robert Burden on May 11, 2017 at 3:42 pm