The U.S. House of Representatives passed the controversial Republican health care bill on Thursday, in a clear victory for members of the Republican leadership such as House Speaker Paul Ryan and, obviously, President Trump. (In case you forgot, Trump promised to end Obamacare in his first 100 days in office. We hit that mark last weekend, but this is still a significant win for him.)
The House vote fell mostly along party lines, ending 217-213 in favor of the American Health Care Act (AHCA). The legislation aims to repeal and replace big chunks of the Affordable Care Act, better known as Obamacare. Now, the bill will move on to the Senate, where it will likely face the same roadblocks it stumbled upon back in March, when the ideological differences between hard-line conservatives and so-called moderates led the Republican leadership to withdraw the bill before a vote.
By now you should know the AHCA is controversial for many reasons, one of which being that it's highly probable the bill will cause millions of people to lose their health insurance. As of today, we still don't know the exact number, because the plan has yet to be scored by the nonpartisan Congressional Budget Office.
A COB score would illustrate how many people the bill would cover and how much it would cost the nation. The most recent score, which was calculated before the newest amendments, found that 24 million more people would be lose their health insurance over the next decade.
It may be a while before we see the Senate vote, and even longer before it could reach the desk of President Trump. In the meantime, we broke down all the ways this version of the health care bill could directly impact you if it ends up becoming law.
Depending on where you live, some essential health benefits might not be covered
Under the Affordable Care Act, there's a national standard for essential health benefits, which basically means insurers are required to cover 10 basic health needs: hospitalization; ambulatory patient services; emergency services; prescription drugs; laboratory services; mental health services; preventative care; pediatric care; rehabilitative services and devices; and pregnancy, maternity, and newborn care.
Under the Republican bill, states could get waivers allowing them to not require insurers to cover these benefits. It's basically up to them to determine which, if any, of these essential health benefits should be covered by insurers. This could lead to insurers refusing to cover maternity care, which 88% of the market didn't cover prior to Obamacare.
Are you a sexual assault or domestic violence survivor? Those could be considered "pre-existing conditions"
A 2016 Kaiser Family Foundation poll found that 53% of Americans say they or someone in their family has a pre-existing condition. Like with the essential health benefits, Obamacare requires insurers to charge everyone the same amount of money, without factoring in a person's health history.
But that won't be the case if the AHCA becomes law. States will also be able to get a waiver and let insurers take into account pre-existing conditions to determine what premium people should pay.
The list of pre-existing conditions is long, including things like heart disease, cancer, lupus, and even being pregnant.
And you can also add being a sexual assault or domestic violence survivor to that list. Yep.
Before Obamacare, insurance companies could consider these two things a "pre-existing condition" because of the cost of medical treatments related to them (think rape kits, medication for sexual transmitted infections, mental health treatment, among other types of help).
Under the AHCA, insurers could charge the most vulnerable people even more money to get covered. And in many cases, this could drive people to remain uninsured because they can't afford the high premiums.
If you depend on Medicaid, know that it would undergo big cuts
The Affordable Care Act made it possible for childless adults with an income of up to 133% of the federal poverty line to get health coverage through the Medicaid program, decreasing the number of uninsured folks by 48% in states that allowed the expansion and 28% in states that didn't.
But under the GOP bill, this Medicaid expansion will continue only until the end of 2019. After that, people who would have been considered newly eligible won't be able to enroll in the program. Because people on Medicaid often cycle in and out of the program as their employment situation and incomes change, that would lead to a drop in Medicaid coverage.
The previous CBO report estimated that if the AHCA passes, about 14 million people will be dropped from the Medicaid program in the next 10 years.
You could end up paying a lot out of pocket, even if you're insured through your employer
If you think you're safe because you have health care through your employer, think again. Health experts have said a little-known provision in the GOP's plan could put people with their employer's insurance at risk of losing the Obamacare protections that limit out-of-pocket costs in case of severe illnesses.
As we previously explained, under the AHCA there wouldn't be a national standard for essential health benefits. And without a standard, large companies could easily decide to go by the insurance rules of any state — including those that chose to waiver the requirements. If your employer does that in order to lower costs, they could enforce lifetime limits and also limit their plans' cap for out-of-pocket costs.
Therefore, if you get really sick, it's likely you will have to pay the difference — which was almost impossible under Obamacare.
You can still be on your parents' plan until the age of 26
There's a small silver lining in the AHCA if you're still a young adult. Between 2010 and 2016, about 6.1 million previously uninsured adults between the ages of 19 and 25 gained health care coverage thanks to Obamacare. The GOP health care bill will keep this feature, allowing people under the age of 26 to stay in their parents' health insurance.
The AHCA would bring many more changes to the U.S. health care system, affecting everyone from children to seniors. In this day and age, we should all agree that access to affordable health care is a human right, not a privilege.