1. The Republican ‘Plan’ Would Gut Protections For Pre-Existing Conditions, Forcing People To Choose Between Bankruptcy And Staying Alive. The latest Republican repeal plan would repeal key consumer protections, including the guarantee that people with pre-existing conditions can buy coverage at the same price as someone who isn’t sick. Under the repeal plan, states would no longer use single risk pools, meaning those who are sick or at risk of becoming sick could be forced to pay much more. As Loren Adler, the Associate Director of the USC-Brookings Schaeffer Initiative For Health Policy, notes: “The Heritage document attempts to obfuscate this point, but it’s quite clear it would unwind the ACA’s protections for people with pre-existing conditions.”
2. It Would Let Insurance Companies Charge Older People An Age Tax. Under the Affordable Care Act (ACA), insurance companies are barred from charging older Americans more than three times the amount they charge younger consumers. However, under the Republican plan, insurance companies would once again be allowed to charge older people many times more for the same coverage.
3. Insurance Companies Could Deny Coverage For ‘Essential Health Benefits,’ Such As Maternity Care, Prescription Drug Coverage, And Treatment For Substance Use Disorders. The new plan would let states waive the requirement that insurance companies cover the ten essential health benefits established by the ACA. Removing these guaranteed benefits would make it harder for Americans to access comprehensive health care. These ten essential health benefits include ambulatory services, emergency services, hospitalization, maternity care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services, laboratory services, preventive services, and pediatric services.
4.  Millions Would Lose Coverage, Increasing The Number Of Uninsured. The proposal would repeal Medicaid expansion and replace marketplace subsidies with underfunded block grants to states. Under the proposal, 50 percent of the block grants would be spent on private insurance, limiting states’ ability to cover people through Medicaid. These insufficient funds and spending requirements would result in significant coverage losses
5. Medicaid Expansion Would Disappear. States that expanded Medicaid would lose under the Republican plan. As Larry Levitt, Senior Vice President of the Kaiser Family Foundation, highlights: “Over time, federal funding under the new conservative block grant program would be equalized across states based on the number of low-income residents. States that have not expanded Medicaid under the ACA would be winners. States that have would be losers.” Cuts to Medicaid lead to coverage losses, and threaten the stability of rural hospitals.
6. Rich Families Get Yet Another Tax Break. The bill would double Health Savings Account (HSA) contribution limits, benefiting families who can afford to contribute thousands of dollars to these tax-deductible accounts. This, from the same party that just passed a $1.5 trillion tax break that disproportionately benefited the wealthy and gave health industry companies billions.
7. …While Middle-Income Americans Lose Tax Credits That Help Families Afford Coverage. The Republican plan wants to “refocus subsidies” by directing block grants toward the states. As Adler remarks, these cuts target middle-class Americans: “Apparently Heritage also thinks the problem with the ACA is that the middle class [people without] employer coverage get subsidies to purchase health insurance [and] wants to limit that.”