Why I Voted “No” on TrumpCare
I voted against the Republican bill to repeal the Affordable Care Act (ACA) today because it would rip insurance away from millions of Americans, it would force people to pay more for less coverage and it would repeal protections for up to 129 million individuals with pre-existing conditions, all while giving huge tax breaks to wealthy Americans and special interests.
The latest version of this bill is even worse than what House Republican tried to bring up for a vote six weeks ago. It will gut consumer protections for millions of Americans and allow insurers to discriminate against people with pre-existing conditions. These changes were made to secure additional votes from some of the most radical Republicans in Congress.
Here are just a few reasons why I strongly opposed this bill:
- Rips coverage away from millions of Americans. Before these latest changes were made, the Congressional Budget Office (CBO) estimated that this bill would force 24 million Americans to lose their health insurance over the next decade. It’s possible that number may even increase under this bill – but we don’t know because House Republicans rushed the new bill to the floor before the CBO could analyze it and issue a report. In fact, the latest version of the bill kept changing until the day before the vote.
- People will pay more for less. The average subsidy under the Republican plan would be about 50 percent less than it was under the ACA, and deductibles and copays would increase by approximately 25 percent with moderate-income individuals paying $2,500 more per year.
- Older Americans will be hurt. Premiums for individuals age 50 and older would go up by 20-25 percent. Increased premiums combined with lower tax credits means that a 64-year-old who paid $1,700 in premiums under ACA would pay $14,600 under the GOP plan. By 2026, the uninsured rate for those ages 50-64 who earn less than $30,000 per year would more than double, from 12 percent to 30 percent.
- Medicaid will be dismantled. The bill cuts $880 billion from Medicaid, which would inevitably result in cutting the number of people who are eligible for the program, reducing benefits or decreasing payments to providers. Fourteen million fewer people would be covered by Medicaid – a 17 percent drop – and most of those individuals would likely end up uninsured. This would also disproportionately impact low-income Americans, individuals with disabilities and the elderly who rely on Medicaid for long-term care coverage.
- Guts consumer protections for people with pre-existing conditions. States can apply for waivers that would allow insurers to discriminate against Americans with pre-existing conditions and charge them higher premiums or force them into so-called high risk pools that hurt, rather than help, people with pre-existing conditions. High risk pools segregate sick people into separate, inferior coverage and leave individuals exposed to catastrophic health costs, benefit exclusions and waiting lists. This returns us to the days when people with pre-existing conditions can effectively be denied coverage due to their health status.
- Eliminates coverage for treatment of mental illness and substance use disorders. Removing essential health benefits from the Medicaid expansion population and the health insurance exchanges would strip addiction and mental health treatment services away from millions of people, including many who are receiving treatment for opioid addiction.
- Employer coverage will decrease and get more expensive. Because the employer and individual mandates are repealed, 7 million fewer people would get employer-sponsored coverage by 2026. That may result in higher premiums for those who keep their employer-sponsored insurance if young, healthy people opt out.
In Maryland, over 400,000 individuals have gained insurance coverage since the ACA became law. Repeal of the ACA would put these individuals and families at risk of losing that insurance. Our state’s economy would also suffer if the ACA is repealed with the loss of critical federal funding and thousands of jobs. Eliminating the Medicaid expansion would strip billions of dollars in Federal Medicaid Assistance Percentage (FMAP) funds from Maryland and would affect the state’s ability to provide comprehensive, affordable health coverage for millions of otherwise uninsured low-income Marylanders and would also weaken the state’s ability to address public health emergencies and other crises that require quick and immediate action.
House Republicans rushed their repeal bill to the floor, despite the fact that they haven’t held a single legislative hearing in any committee and not a single expert witness has been able to testify about the potential impact of the plan. This was done so quickly that the nonpartisan CBO didn’t have time to analyze the bill and issue a report that will estimate the cost and impact on coverage. It is abundantly clear that Republicans are trying to rush this bill through before anyone fully understands what it would mean for the American people and for the American health care system.
But I understand what it would mean – and I’m fighting against it. I am proud to serve on the Health Subcommittee of the Energy & Commerce Committee, one of the two House committees with jurisdiction over this bill. After Republicans announced that we would markup this legislation, my Democratic colleagues and I debated the bill for 27 hours straight, arguing that the GOP repeal plan would result in the loss of health insurance coverage for millions of Americans. Moving forward, I will continue to push to make sure that Americans have affordable, accessible, high-quality health care for themselves and their families.
John P. Sarbanes
Maryland's Third Congressional District