insurers to levy a 30% surcharge for a year on the premiums of those who let their coverage lapse. It lifts the taxes that the ACA had imposed on the wealthy, insurers and prescription drug manufacturers. And it loosens one of the law's strict insurance reforms so that carriers can offer a wider array of policies that pick up less of the tab for getting care.
Lower-income folks could be left uninsured
The ACA contains many provisions to help poor and lower-income Americans. It expanded Medicaid to cover adults who earn up to $16,400 a year -- some 11 million people in 31 states and the District of Columbia are now insured as a result.
Also, those with incomes just under $30,000 receive generous subsidies to lower their premiums, deductibles and out-of-pocket costs on the individual market.
The republican plan would end the expanded federal Medicaid funding starting in 2020. Those on it could remain on it as long as they are continuously insured. However, with Medicaid, many go on and off it all the time, and there is no doubt participation would fall off, and new enrollees after 2020, wouldn't even qualify.
The republican plan would remove the subsidies, by instead sending states a fixed amount of money per capita. It would ELIMINATE federal responsibility by shifting that burden to the states, but states don't have the money to make up the difference, and be forced to reduce eligibility and benefits, or cut provider payments.
Older Americans less than 65, and those making 20 thousand a year would take the biggest hit.
However, the key difference for pre-existing conditions in the republican plan is that it would lift the requirement that insurers cover a certain share of the cost of getting care. It would allow the carriers to offer more confusing policies, higher deductibles and co-pays, and make it difficult to find low deductible plans that are affordable, which would put people with less means in a catch 22 situation. They cannot afford to do it, or afford not to do it, and as stated before if their insurance lapses, they could be charged 30% surcharge for pre-existing conditions, and if that was unaffordable, they would never be able to get coverage for pre-existing conditions.
The elimination of subsidies for tax credits would eliminate the most vulnerable in our society from coverage.
One other point is they would know no require the mandate. Because of that, the real threat of insurance companies not participating in the republican plan, especially in certain areas of the country, is very probable.
The republicans have an opportunity to offer Medicare for all, or at a minimum, improve the ACA, but they choose to do neither, and it will be more costly, more unaffordable, and less people will not be insured.
One cannot just say that the republican plan will cover pre-existing conditions, without going into the fine print, because within that fine-print, those with pre-existing conditions may NOT be able to afford the insurance.
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