It’s Time to Set the Record Straight on the AHCA

Congressional Documents & Publications

It's time to set the record straight on the American Health Care Act (AHCA). From the start of this process, I have stated that the responsible path forward includes keeping what works in the Affordable Care Act (ACA) and fixing what doesn't. The ACA is collapsing. Premiums rose an average of 25 percent this year for patients on the healthcare exchanges. Deductibles will average more than $6,000 in 2017 for those in the ACA's lowest-priced plans. A total of 4.7 million Americans have been kicked off their insurance, and 20 million still lack any insurance at all. In the face of this emergency, my Democratic colleagues offered nothing but obstruction and lies. I voted to clean up the mess Washington made.

The AHCA was a vote for lower premiums, lower taxes, and healthcare decisions controlled by patients and their doctors. I fought for and won a number of changes which were included in the bill's final version that passed the House of Representatives on May 4. One, insurers cannot deny coverage to patients with pre-existing conditions. The Washington Post recently debunked the false claim alleging rape victims would lose their coverage or be forced into more expensive plans. It's completely false. Two, children up to 26 years old remain on their parents' health insurance. Three, no member of Congress is exempt; we play by the same rules. Four, $138 billion is available to the states for setting up high-risk pools which will lower premiums and deductibles for everyone. Moreover, states can tap these funds to address specific issues such as maternity care, opioids, and mental health. Five, we've extended refundable tax credits to those without access to employer-provided coverage. This equalizes the tax treatment of healthcare, no matter where you buy it. And finally, there's a property tax cut worth more than $224 million for homeowners and commercial property owners in the 19th District. That's because my amendment to reform the way Albany pays for its share of Medicaid costs was included in the AHCA. Another promise kept.

Today, one in three physicians is unwilling to accept new Medicaid patients. Millions do not have access to doctors or dentists. This is the ACA status quo. The AHCA makes states partners in spending decisions and preserves the low-income health insurance program for those who need it. No one currently enrolled in Medicaid will lose benefits. In fact, the AHCA increases Medicaid payments to the state at a rate higher than medical inflation. What it does not do is continue the unsustainable spending trend of the current Medicaid system. At $63 billion, New York's Medicaid program costs more than Texas and Florida combined. The ACA's Medicaid expansion accelerated the trend toward state and federal fiscal wreck by fully covering the costs of new enrollees and eventually reducing the share to 90 percent. Medicaid is funded with general tax revenues, and the US debt is the world's largest at more than $19 trillion.

Under the AHCA a person's health status cannot affect their premiums and you cannot be charged more for a pre-existing condition. In very limited circumstances, states could request waivers from certain essential health benefits but it won't cost someone with a pre-existing condition more if they've maintained continuous health coverage. In the event that there is a lapse in coverage in a waiver state, a dedicated $8 billion fund has been set aside to cover any additional premium costs. In most states, including New York, waivers aren't possible anyway under state law. Moreover, essential health benefits only cover those in the individual and small group markets under current ACA law. This totals only 16,500 of exchange enrollees in the 19th District. Those who receive health insurance from employers with over 50 employees have never been affected by ACA provisions relating to essential health benefits. This is unchanged under the AHCA.

Now the AHCA moves on to the Senate, where additional improvements are expected. I welcome them. Those interested in reversing the failed status quo and providing affordable healthcare access for millions of our fellow Americans should welcome them, too.