Insurance Companies Hope Health Care Bill Changes Balance

March 22--In the latest chapter of the Affordable Care Act-to-American Health Care Act saga -- and chapters are only about an hour long -- Republicans released a modified AHCA on Monday to rally conservative and moderate support, and President Trump on Tuesday vowed to "come after" doubting GOP lawmakers.

Those attending a closed-door meeting of Republicans in the House of Representatives quoted Trump as saying to House Freedom Caucus chair Rep. Mark Meadows, R-N.C.: "I'm going to come after you, but I know I won't have to, because I know you'll vote yes."

From the perspective of an insurance agent and purchaser of health coverage, Garrett Barnett of Celeste Looney Insurance of Tahlequah said he is hopeful for changes after implementation of the ACA.

"A lot of companies stopped selling health insurance because of the ACA," Barnett said. "Speaking only of my personal experience, my premiums increased tremendously, and the amount I pay out of pocket when I visit the doctor continues to increase."

Figuring a way to keep health care costs and insurance premiums under control while providing adequate coverage is proving difficult for all facets of health care.

"I don't have the answer to how to fix it, but I know it is broken," Barnett said of the health care system. "I hope we have people in Washington who are smart enough to figure out what needs to be done to fix the problems. Insurance is a collective sharing of risk. Everyone hopes their house doesn't burn down, but if someone's does, there is a payout. Today, it is not collectively paying for the sick guy. It is a mess."

Barnett said he had not met anyone who was overwhelmingly happy with health care coverage under the ACA.

The AHCA modifications announced Monday included a provision to allow states to require able-bodied people on Medicaid to work if they have no dependents -- with funding incentives to apply the requirement. The federal government would give states a lump sum Medicaid allocation for children, and adults who are neither elderly nor disabled. Medicaid funds are currently awarded per capita.

ACA taxes on health care sectors and the wealthy would be repealed.

Such changes are intended to appease hardline Republicans who essentially want "Obamacare" blown up.

To attract moderate Republicans, the bill gives the Senate room to increase subsidies for older people who purchase individual policies. The assistance would help pay premiums that can be 500 percent the price charged young policy holders.

The House Freedom Caucus, which includes deeply conservative Republican lawmakers, on Monday said it was not united in its response to the latest version of the AHCA, but there is still much skepticism on Capitol Hill about the bill's chances.

Despite the AHCA adjustments, a number of GOP legislators remained unimpressed. Meadows said Tuesday that he is still opposed.

No support for the bill is expected from House Democrats, which means no more than 21 Republicans can defect when the measure is brought to a vote. Because the bill uses budget reconciliation, it needs only 51 votes in the Senate, but must comply with the "Byrd Rule" and not add to the federal deficit for 10 years after it is passed. The Senate may rewrite the bill, forcing a conference committee.

Another possibility is that the AHCA dies in the Senate. Eighteen GOP senators have expressed doubts about the bill, and two -- Rand Paul of Kentucky and Susan Collins of Maine -- say they will not vote for it, putting the AHCA one nay from perishing.

The nonpartisan Congressional Budget Office predicted that 24 million Americans would lose insurance by 2027 under the first draft of the AHCA, though that figure includes those who drop their coverage because it would no longer be mandatory. The non-partisan Kaiser Family Foundation predicted in a tweet on Monday that the changes would not reduce the rise in uninsured Americans.

A March 6-12 poll by the KFF indicated Americans are split on repeal of the ACA. A slight majority, 51 percent, want to keep the ACA, while 45 percent want it repealed.

"At the highest level, I think less regulation is better," Barnett said. "If the federal government took the simple stance of letting the free market take its natural course, it wouldn't be perfect, but it would be better than what we have now."

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