Pros and Cons of the American Health Care Act

The Republican establishment has longed to repeal Obamacare basically since it became law in 2009. Conservative politicians have centered their campaigns around repealing the health care law, while President Donald Trump promised to get rid of “horrible” Obamacare during rallies.



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On March 6, House Republicans revealed Obamacare’s potential replacement: The American Health Care Act (AHCA). The bill has quickly passed through three different house committees before many have had time to fully comprehend its implications. So, who benefits from this new bill and who doesn’t? Let’s list some pros and cons.



– Repeals individual mandate

Perhaps the most central (and most criticized) proposal of Obamacare is the individual mandate. This mandate requires all individuals to purchase health insurance. Although both Democrats and Republicans lauded the idea of an individual mandate when it was a part of Mitt Romney’s health care plan in Massachusetts, it quickly came under fire when proposed in Obamacare. Opponents described it as an unconstitutional attack on individual freedom—to them, no one should be forced to buy insurance. This criticism does make sense. For example, if you’re a healthy young person, you might not want to spend a lot of money on health insurance that you probably don’t really need. With that said, for these individuals who are passionate about their individual liberties, the AHCA’s repeal of the mandate is a definite pro.


– Reduces federal deficit in the long run

Some, including many opponents of Obamacare, argued that the law was an income redistribution program veiled as health care. In some ways, it was—under Obamacare, taxes levied on the wealthy were used to fund insurance subsidies for individuals in lower income brackets. These subsidies have helped millions of Americans afford much-needed insurance.


But even though Obamacare imposed taxes and asked billion dollar drug companies, insurance companies, and hospitals to help pay for federal subsidies, they still contributed to a huge deficit that grew during the Obama administration.


This raises the question—how can the federal government continue to afford paying for health care without going deeper in debt? Well, under the AHCA, the feds don’t have to worry about answering this very stressful question. By eliminating income-based subsidies, among other things, the AHCA will reduce the federal deficit by $337 billion over the next ten years, according to a non-partisan analysis done by the Congressional Budget Office (CBO).


Now, reducing the deficit may be a plus, especially to our new Republican regime, but it definitely has its cons…which I’ll talk about in greater detail later.


– No discrimination against people with pre-existing conditions

One of the biggest pros of the AHCA is actually one of the hallmarks of Obamacare: insurers cannot overcharge or completely exclude individuals with pre-existing conditions. Previously, insurers did discriminate against people with pre-existing health conditions. They were viewed as too risky and expensive to cover—even though they were in the most dire need to access health care! This is one of the only AHCA proposals that has bipartisan support and, in my eyes, it’s one of the few that look after the well-being of patients.



– Higher insurance premiums until 2020

As I mentioned earlier, the AHCA will repeal the individual mandate. While this seems like a big win for freedom, it comes at a cost—a pricey one.


Insurance prices can only remain stable if both healthy and sick people buy in. For example, if only sick people bought insurance, premiums would skyrocket. Insurance companies would have to pay huge sums of money to cover these ‘risky’ individuals. Because the individual mandate requires all people—healthy and sick—to buy insurance, premiums don’t shoot up too high.


If the individual mandate is repealed as proposed, fewer healthy people are expected to buy insurance. As a result, a larger proportion of sick people will be insured, and the situation I played out above will become a reality. In fact, according to the CBO, average premiums under the ACHA will increase 15-20% until 2020.


– Does not provide coverage for people who need it most

The U.S. healthcare system ranks dead last among 10 other industrialized nations, including France, Australia, Germany, Canada, Sweden, New Zealand, Norway, the Netherlands, Switzerland and the U.K. What’s common among many of the 10 nations above the U.S. is that they provide universal coverage for all. In the U.S., on the other hand, health care is not guaranteed for its citizens. And, it’s often inaccessible to those who need it because treatment is very expensive.


The goal of Obamacare was to get rid of this problem. By providing people with subsidies to pay for insurance, more and more were able to afford care. At the same time, insurance companies and hospitals benefitted greatly as they welcomed new customers who were now able to access care.


This win-win situation will no longer exist under the AHCA. Many may no longer be able afford insurance because the new healthcare act will not provide income-based subsidies. This will help reduce the deficit, but at a great cost—the CBO estimates that in 2018, 14 million more people will be uninsured if the AHCA is enacted.


Many GOP members have already denounced the CBO’s estimation. But, the numbers aren’t part of some make-believe conspiracy (although I wouldn’t be surprised if our president suggested otherwise). They make sense when you consider the lack of aid the AHCA provides to people who can’t afford insurance.


All things considered, under the AHCA, the U.S. may continue to rank last among industrialized nations when it comes to health care.


– Lessens federal funds for states to expand Medicaid

Under Obamacare, the federal government was willing to fund states that wished to expand Medicaid. This was especially great for states with both a large uninsured population and an inability to afford expansion on their own.


One of these states was Kentucky. Before Kentucky expanded Medicaid under Obamacare in 2014, they had some of the worst healthcare rankings in the country—49th in heart disease, 50th in cancer deaths, and 50th in smoking. They also had a high uninsured rate of 20.4%—nearly twice the national average.


However, once Kentucky expanded Medicaid, their uninsured rate dropped to a low 7.5%, much lower than the national average of 11%. Without the federal funding provided by Obamacare, this wouldn’t have happened.


Kentucky’s success story may not be possible for other states hoping to expand Medicaid, under the AHCA. While Obamacare provided at least 90% of the funding for states to expand Medicaid, the AHCA will provide capped funding starting in 2020.


Ultimately, limiting federal funds to support Medicaid expansion reduces the federal deficit. But, it happens at the expense of people’s ability to access much-needed health care.


– Cuts funding for Planned Parenthood

The GOP has long planned to cut federal funding for Planned Parenthood, and now they have their chance. While cutting Planned Parenthood could save $156 million over the next ten years, it again occurs at the expense of people’s health.


For many, particularly in low-income areas with limited healthcare resources, Planned Parenthood is one of the only that provides accessible reproductive health services. Without it, the CBO estimates that 15% of people in these underserved areas will lose access to reproductive health care.


– No systemic change!

Under Obamacare, millions of Americans are now able to afford health care. But, Obamacare is by no means perfect. While many are now able to afford insurance, they’re buying into an inherently flawed system made up of fat-pocketed drug companies and large hospital conglomerates that overcharge patients.


Drug companies have a tight grip on healthcare, and they have the freedom to set astronomically high prices on drugs that can save people’s lives. Meanwhile, hospitals charge patients severely inflated prices for things like pills, gauze pads, and other items used during the patient’s stay.


Obamacare did little to regulate these billion-dollar industries, and the AHCA doesn’t do much of anything either. The GOP establishment promised to “drain the swamp,” and they have an opportunity to do so in their new health care bill. Instead, perhaps unsurprisingly, they’re fine leaving things the way they are—drug companies and hospitals will continue to reap huge profits, while Americans drown in hospital bills.


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Imaz Athar

Imaz Athar is a senior undergraduate student at the University of Pittsburgh, double majoring in Neuroscience and Sociology. He aspires to become a physician and plans on attending medical school in Fall 2017. Imaz fell in love with the art of writing at a young age and is currently the Publisher of Pitt's undergraduate-run science magazine The Pitt Pulse. When he's not writing or keeping up with classes, Imaz enjoys running, playing basketball, watching Empire, singing (in the shower), and listening to all kinds of music.

1 Comment

  1. David C Johnson

    Let me see, if this was auto insurance, you would have to have it to drive, theoretically. Cost of insurance goes up if you have an/many accidents or drive a bigger car (get sick). You can buy low or high cost car coverage. (your option). “Some people” are sickly (accident prone) and need help,
    but you can’t fix everything.