Even with the amendments to TrumpCare or the AHCA, the American Medical Association [AMA] sent out a dire warning about the new bill that Republicans passed Thursday. The 170-year-old organization representing doctors cautioned that millions of Americans will lose their health coverage.
AMA President Andrew W. Gurman, M.D. released a statement today alerting voters that anyone with a pre-existing condition will suffer:
‘Not only would the AHCA eliminate health insurance coverage for millions of Americans, the legislation would, in many cases, eliminate the ban against charging those with underlying medical conditions vastly more for their coverage.’
ACHA will dump people who either have a pre-existing condition such as diabetes or those who are very ill into what Republicans call “high-risk pools.” Dr. Gurman more accurately called their care “second-class coverage:”
‘High-risk pools are not a new idea. Prior to the enactment of the Affordable Care Act, 35 states operated high-risk pools, and they were not a panacea for Americans with pre-existing medical conditions. The history of high-risk pools demonstrates that Americans with pre-existing conditions will be stuck in second-class health care coverage – if they are able to obtain coverage at all.’
People stuck in high-risk pools will pay much “higher costs” for “limited coverage,” according to Dr. Gurman:
‘America should not go backward to the time when our fellow citizens with pre-existing health conditions faced high costs for limited coverage, if they were able to obtain coverage at all. The AMA urges congressional leaders and the Administration to pursue a bipartisan
dialogue on alternative policies that provide patients with access and coverage to high quality care and preserve the safety net for vulnerable populations.’
High-risk pools have always had serious flaws. Dr. Gurman reported that the American Academy of Actuaries says:
‘Removing high-risk individuals from the insured risk pools reduces costs in the private market only temporarily. Over time, even lower-cost individuals in the individual market can incur high health care costs, which would put upward pressure on premiums.’
The AMA reported on the Kaiser Family Foundation’s explanation of the AHCA’s high-risk pools:
- State high-risk pools featured premiums above standard non-group market rates – with most states capping them at 150%-200% of standard rates. Many also featured high deductibles, some $5,000 or more.
- Despite the fact that many individuals were forced into high-risk pools because of a pre-existing condition, nearly all states excluded coverage for these conditions for 6-12 months.
- Almost all high-risk pools imposed lifetime limits on covered services, and some imposed annual limits.
- Some states capped or closed enrolment.
- Combined net losses for the state high-risk pools totaled more than $1.2 billion for 2011, or $5,510 per enrollee, on average.
- Furthermore, a 2010 paper by James Capretta and Tom Miller that appeared in National Affairs estimated that the cost of adequately funded high-risk pools would be $15 billion to $20 billion per year.
Feature Image via Getty Images/Mark Wilson.