Affordable Care Act

4 Myths about the Republican Health Reform Bill (AHCA), or American Health Care Act

Published on May 04, 2017


After some back and forth among different Republican factions, the House of Representatives has now passed a bill that would make significant changes to the Obamacare law.
The new health reform bill, known as the AHCA (or American Health Care Act) will move to the Senate now and is being hotly debated in the media.
For the average American, it can be hard to separate the facts from the spin when it comes to the AHCA. In order to help you better understand what the bill may mean – and what it won’t – we’ve debunked four myths about the legislation.

Myth #1: Obamacare could simply be left as is.
In fact, the cost of coverage under Obamacare has been spiraling out of control. People who get subsidies under Obamacare may be shielded from the true cost of coverage, but unsubsidized middle-income Americans have seen their premiums increase 99% since 2013, the year before Obamacare took effect.
The number one reason for these spiraling high costs is because young people have not signed up for Obamacare. Having young, healthy people insured is critical to the success of Obamacare and they’re enrolling at about half the anticipated rate.
In addition to this, several major health insurance companies have pulled out of the Obamacare market in the past year, saying it’s too difficult to do business under current rules.

Myth #2: People with pre-existing conditions will lose their coverage or pay more.
In fact, people who have health insurance and want to make changes to their coverage during open enrollment or after a qualifying life event (birth of a child, job loss, marriage, death, divorce, move, etc.) cannot be charged more for health insurance because of a pre-existing condition.
That said, if someone went uninsured and waited until they got sick to enroll in a health insurance plan, the MacArthur amendment to the AHCA gives states the authority to try to prevent that from happening.
One of the things a state could do, under this amendment, would be to allow insurance companies to charge people with pre-existing conditions more money for their health insurance, if they’ve been uninsured for an extended period of time.
Those higher charges can last a maximum of one year. 
The AHCA also provides $138 billion to help states cover the high cost of caring for people with pre-existing medical conditions.

Myth #3: It takes private health insurance away from people.
In fact, while some people could find that they are no longer eligible for Medicaid, many Medicaid enrollees who are currently ineligible for subsidies to purchase health insurance on their own, may be able to receive tax credits and buy their own coverage under the AHCA.
It’s also important to note that more people who are eligible for Obamacare opt out, instead of enrolling. 6.5 million pay Obamacare’s uninsured tax penalty and another 12.7 million file hardship exemptions. By comparison, only 18 million people have signed up for private insurance under Obamacare.
The AHCA also includes massive Medicaid reform that gives states the authority and flexibility to manage their Medicaid programs more efficiently to meet their population’s needs. One example of the success of this approach is in Indiana, where Medicaid reforms have led to higher satisfaction, increased use of preventive care, and a reduction in E.R. visits, all at a reduced cost.

Myth #4: New subsidies are not big enough to cover the cost of health insurance.
In fact, subsidies may be big enough for many folks to cover their monthly insurance premiums.
Estimates that say otherwise are typically based on the cost of coverage under Obamacare as it exists today, but disregard the potential impact of reforms in the AHCA that could lower the cost of insurance premiums for many Americans.
A 2013 report from eHealth found that health insurance plans that covered a comprehensive list of 8 health benefits cost 25 percent more than plans with a more limited set of benefits. A 25 percent difference in price, combined with a 5 to 1 age rating and expanded access to tax credits could actually lower premiums for millions of Americans who buy their own health insurance.
BONUS MYTH: The AHCA is not the law. The United States Senate will make changes. Many pundits speculate that the Senate will provide more funding for Medicaid and lower-income Americans.
No matter what happens, we’ll continue to keep you informed about any developments that may affect your health care future.

Join Our Newsletter

Get healthcare news, wellness tips, and coverage resources