Ask The Experts

SU professors analyze Republican’s proposed American Health Care Act

Jensen Stidham | Contributing Photographer

House Republicans and Speaker of the House Paul Ryan are the American Health Care Act’s primary supporters.

Although experts agree the new health care plan designed by Republicans — the American Health Care Act — could cut down on some government spending, Syracuse University professors said the proposal could also hurt the people who need health insurance the most.

The American Health Care Act is a health care bill designed to replace former President Barack Obama’s Affordable Care Act, which is commonly referred to as Obamacare. House Republicans and Speaker of the House Paul Ryan are the new bill’s primary supporters.

There are several reforms included in the American Health Care Act. Under the Affordable Care Act, for example, insurance tax credits were based on income, but the new act replaces this with a flat tax credit based on age. Experts say these credits are not enough to keep most people insured.

A larger number of people are not going to be eligible for Medicaid, said John Palmer, University Professor and dean emeritus at SU’s Maxwell School of Citizenship and Public Affairs. Because the tax credits are not income-based, poor people may not get as many tax credits as they need, he said.

Kristi Andersen, a professor emeritus of political science at the Maxwell School, said states, localities and nonprofits will end up paying the social costs of caring for those who cannot afford insurance.

The proposed bill will affect insurance across the board, not just for people who depend on Medicaid expansion, said Shana Gadarian, associate professor of political science at the Maxwell School. The American Health Care Act would allow companies to offer “less comprehensive” employment health care plans, she said, which could affect benefits that employees receive, such as reduced costs for birth control, among other things.

Experts agree, though, that it’s unlikely the bill will make it successfully through the Senate. Even certain Republican senators have said they would not vote for the bill or have expressed serious concerns about the bill. Andersen said senators are under pressure from their constituents who are scared they’re going to lose their insurance coverage.

Palmer also said more conservative senators believe the bill is too generous, while more moderate senators think that — relative to the Affordable Care Act — the bill doesn’t do enough to help certain constituencies.
Republicans might use reconciliation to try and pass the bill, Gadarian said. Reconciliation means the bill would be a part of budget negotiations for the upcoming fiscal year. It would need a simple majority vote to get through the Senate and would not be subject to a filibuster.

However, because some Republican senators will not support the bill, it would also need support from a few Democratic senators. Because the American Health Care Act cuts a significant amount of money from Medicaid, it is “very unlike the priorities Democrats would have for health care,” Gadarian said.

Under the proposed plan in the long term, the federal government will spend less money, because they will not be expanding Medicaid, Andersen added.

Palmer also said that while other initiatives by the Trump administration will increase the current deficit, this act will save around $300 billion dollars and will help decrease the deficit. According to the Congressional Budget Office, about 15 million people will lose their health insurance and that number could increase to 24 million if Medicaid is scaled back further, Andersen said.

“That’s a big political liability for the Republicans,” Andersen said.

Palmer called it “a step away from more affordable, expanded health care.”

Multiple times, Gadarian said, Trump has promised that Americans wouldn’t lose health care coverage and that the coverage would be better than what it was under the Affordable Care Act. However, the ultimate goal really seems to be to lower costs, not extend coverage, she said.

“In a sense, the Republicans want to get rid of (the Affordable Care Act) because Obama did it, but they don’t know what they want in place of it,” Andersen said.


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