The Senate’s version of the TrumpCare bill is out, and it’s as monstrous as we thought it would be. In order to give billions of dollars in tax breaks to the wealthy and corporations, TrumpCare continues to make the deepest cuts to Medicaid in its 52-year history. Not only does it end the Medicaid expansion, it fundamentally (and permanently) restructures Medicaid in a way that threatens the well-being of low-income families across the country. TrumpCare fails people with pre-existing conditions.
But it also would drive costs for consumers way up. Even if your Senator claims to be a “no” on this bill right now, don’t fall for the charade. It’s all a trick. It’s so that they can later claim that they’ve worked to “fix” the bill, when in reality this bill is beyond repair. Here’s what consumers can expect under the Senate version of TrumpCare, and why you should tell your Senator to vocally and unwaveringly oppose it.
Premiums will go up
Like the House version of TrumpCare, you can definitely expect premiums to go up if the Senate version becomes law. That’s in part because it allows insurance companies to charge seniors more than they can under current law. TrumpCare also gets rid of what’s called the “individual mandate,” the requirement that people have health insurance or face a penalty. This key feature of the Affordable Care Act is what kept premiums from rising more steeply.
Consumer costs will increase while subsidies go down
The percentage of consumer costs covered by plans will decrease. Currently, plans have to cover at least 70% of the health care costs incurred by a consumer. TrumpCare drops that number to 58%, meaning consumers could see their out of pocket costs go up for things like co-pays and prescriptions. It will be much more expensive for you if you get sick or injured.
At the same time, TrumpCare reduces help to consumers buying insurance. Current law provides many Americans tax credits that offset the cost of their monthly premiums. The tax credits are available to anyone who makes less than 400% of the Federal Poverty Level. (In 2016, that is about $48,000 for a single person.) The Senate version of TrumpCare lowers that threshold to 350%—meaning higher premiums for middle-class families. But it gets worse: the tax credits under TrumpCare would be pegged to a lower-quality plan in your area. So not only will tax credit be less, they won’t go as far. And that affects anyone who receives them.
Higher costs for worse benefits and services
TrumpCare provides a loophole for insurance plans participating in the exchanges that allows states to get waivers of what are called “essential health benefits” (EHBs). EHBs define the menu of health care services that insurers must cover, including maternity care, mental health care, and prescriptions. If insurance plans aren’t required to cover certain services, then the health insurance is meaningless. By allowing waivers of EHBs, TrumpCare sends people back to the days of skimpy health plans and deciding whether to buy prescription drugs this month or eat. And, if consumers want better services, they’ll have to pay for them out of pocket, at a drastically higher price.
Consumer rebates end along with key insurance restrictions
Another feature of the the ACA is a requirement that insurance companies use money paid by consumers on actual health care services, and not wasted on other things. More specifically, plans must spend at least 80% of the premiums collected on providing actual health care, and not on administrative costs, marketing campaigns, CEO salaries, or—most importantly—profits. This ACA requirement returned a staggering $396 million to 4.8 million families in 2015. On average, families that paid premiums got a rebate of $138 back, taken out of shareholder profits. But TrumpCare would get rid of this starting next year. After that, it’s up to individual states to decide whether they’ll keep protecting consumers from insurance plans’ wasteful spending.