Health Care

American Health Care Act (AHCA/Trumpcare/Republicare) talking points

(All analyses are based upon the CBO report):

  1. A total of 52 million Americans will be uninsured under this law if it is passed, compared with 26 million uninsured with the current law. This will hit South Carolina particularly badly since this state has a very high rate of uninsured people to begin with, as compared with other states. Based upon our own study from Clemson, the problem of long-term uninsured is not limited to the minority population: a very significant proportion of the uninsured population are Whites. Having a large population of uninsured is very bad even for those who do have insurance because:
    1. As the uninsured tend to go to the Emergency Department for non-emergency services, this increases the wait time in ED and hence increases the risk of not getting treated in time for everybody;
    2. When the uninsured people go to ED for service but cannot pay, to make up for their loss hospitals increase the charge for those who do have insurance, this means higher out-of-pocket pay for everybody and translate into higher premium;
    3. When people lose their insurance, overall they will be using less health service, from dental care to preventive services. This translates into a significant job loss for the health care sector. That is precisely why South Carolina Hospital Association openly supports the Medicaid expansion in Affordable Care Act: more insurance coverage means more health care sector jobs, which are high-paying, non-polluting American jobs not easily outsourceable to other countries. In that sense, expanding insurance coverage is an economic stimulus and is patriotic.
  2. This new bill, if passed, will have mixed results on insurance premiums. While the insurance premium for those 20-25 might increase at a slower pace than under the current law, the premium for the older adults (before Age 65) will increase at a much faster rate than under the current law. For South Carolina, this problem could be particularly serious since this state faces a larger challenge of aging than states like California. Since the new law offers less subsidy, the insured older adults could end up paying more out-of-pocket expenses in addition to the higher premium.
  3. This new law no longer mandates coverage for substance misuse, which could be particularly deadly for South Carolinians. Cigarette smoking and prescription opioid overdose hit this state particularly hard. Prescription opioid overdose (PDO), in particular, is an epidemic that disproportionately affects rural population, White population and the middle class. If one assumes that these kinds of substance abuse is a minority and immigrant issue, this assumption is totally wrong: indeed first-generation immigrants rarely get killed by PDO.