REPUBLICAN REPLACEMENT PLAN (AHA)
‘Talking Points with references’
All these organizations say “no” to the AMERICAN HEALTHCARE ACT:
The AARP , The American Medical Association, American Nurses Association, American College of Physicians, National Nurses United,National Physicians Alliance, Association of American Physicians and Surgeons, American Academy of Pediatrics, American Hospital Association, Federation of American Hospitals, America’s Essential Hospitals, and Families USA [#19]),
GOP’s Replacement Plan, AMERICAN HEALTHCARE ACT [AHA]
[#1], deletes the ACA’s limit on corporate tax deductions on executive pay; costing taxpayers over $70 million/year [#2] and give a $600 Billion tax cut to the rich over 10 years. [#3] The nonpartisan Congressional Budget Office estimates by 2026, $337 billion will be less spent with GOP plan, but with 17% increase in uninsured (52 million uninsured people).[#18] HR 1313 bill, approved on Mar 10, 2017 by all GOP’s in House Committee, and expected to be added to the AHA, allows “companies to require employees to undergo genetic testing or risk a penalty of $1,000’s, and would allow employers to see that genetic and other health information.” [#23]
(1) ELIMINATE MEDICAID EXPANSION by 2020 or sooner.
Under ACA, Medicaid qualification is based upon % of income to national poverty level ($24,600 for family of 4). [#20] Under GOP AHA, federal government would block grant funds back to states. [#13] Each state administers its own Medicaid program similar to before the ACA. If eliminated, 9.6 million are at risk of losing health insurance . [#21] GOP AHA eliminates up-front premium subsidy-payments and replaces them with TAX CREDITS that are claimed when you file
your federal income tax. [#4] Premium tax credits under the GOP AHA are substantially smaller than the ACA premium subsidies and are determined by age and NOT INCOME. Go to the Kaiser (KFF.org) Interactive Calculator [#4]
(2) HEALTH SAVINGS ACCOUNTS [HSAs] [#5]
allow individuals to put away pretax money to pay for healthcare expenses. Currently the amount you can save is $1,300 per person and
$2,600 for a family. The GOP AHA increases to $3,350 per person and $6,750 for a family. [#11] Currently a High Deductible Health Plan (HDHP) [#6] is required in order to be eligible for a Health Savings Account- limiting the number of insurance plans. Also, that means one must pay out-of-pocket costs of a minimum of $1300 per person or $2600 per family “before your insurance begins to cover a portion of your bills.” [#6]
Rand Paul, in his separate plan, wants to remove this requirement.[#7a] [#7b] Not a viable solution for low and middle income people, whocannot afford to put money away to save and pay for expensive medical costs if they face a medical emergency.Enrolled in Medicare, you cannot have an HSA. [#8] In 1984, the government established the mechanism of flexible spending accounts (FSAs) under section 125 of the Internal Revenue Code. Unlike HSAs, FSAs have a “use it or lose it” provision—any unused balance remain- ing in an account at the end of the year is for- feited. Nevertheless, by 1999 between 15 and 28 percent of the workforce had some form of flexi- ble spending account. This suggests that about one-fifth of the workforce already has some tax subsidy for payment of coinsurance and deductibles, although this subsidy is much smaller and more uncertain than what is provided by HSAs.[#24]
(3) Requires CONTINUOUS COVERAGE [#9] If you lose your health insurance, such as losing your job that pays for your health insurance or could not afford to pay your monthly premium, and you do not buy new health insurance in 60 days, your health insurance provider can charge you for a new plan up to 30% more for your monthly premiums than the standard premium price for one year, especially if you have a pre-existing condition. [#6] Plus, the 60-day waiver for no surcharge is only if you “were covered by insurance for at least the 18 months immediately
(4) No MANDATE [#11] allows healthy to not buy insurance. Mandate combines healthier people with those with pre-existing conditions, allowing the overall health insurance premium costs across the country. Plus, if you apply the 45 day-limited annual enrollment period, you will be charged a surcharge up to 30% more for your monthly premium. [#11]
(5) HIGH-RISK INSURANCE POOLS [#12] are for people with pre-existing medical conditions. With no mandate, most will fall into this category. In U.S. 9.6% have diabetes, 11.5% have cardiovascular disease, 8.5% have cancer, 1.9% have kidney disease, 36.5% are obese (classified as a disease), and 15.7% suffer neurological diseases (e.g., strokes, Alzheimer’s disease & Parkinson’s disease). [#17] GOP AHA replaces federally funded state Medicaid with annual block grants [#13] for states to use towards funding these high-risk insurance pools . 35 states tried this and found: these plans offered limited coverage, were often underfunded, had waiting lists, did not guarantee coverage availability, and the premiums were prohibitively expensive. [#6]
(7) Rand Paul’s favorite: MEDICAL CHARITY CARE and BAD DEBT DEDUCTION FOR PHYSICIANS. [#7a] [#7b] His bill: Amend the IRS Code to allow physicians tax deductions equal to the amount physicians would otherwise charge for charity medical care, uncompensated care and for bad debt. This deduction is limited to 10% of a physician’s gross income for the your health.
(8) ESSENTIAL HEALTH BENEFITS: [#15] EHB’s set a minimum floor for our health insurance benefits. GOP AHA allows states to decide which EHBs to keep, if any, [#11] such as: pregnancy, maternity, newborn care, prescription drugs, preventive, habilitative, and mental health care. [#22]
 The American Care Act. 2017 Mar 6.
Summary American Care Act. Kaiser Family Foundation. 2017 Mar 7.
Proposals to Replace The Affordable Care Act. Kaiser Family Foundation. 2017 Mar 7.
 Hiltzik M. Here’s the secret payoff to health insurance CEOs buried in the GOP Obamacare repeal bill. Los Angeles Times. 2017 Mar 7.
 Matthews D. The GOP health bill is a $600 billion tax cut-almost entirely for the wealthy. 2017 Mar 17.
 Cox C., Claxton G., and Levitt L. How Affordable Care Act Repeal and Replace Plans Might Shift Health Insurance Tax Credits. Kaiser Family Foundation. 2017 Mar 01.
http://kff.org/health-reform/issue-brief/how-affordable-care-act-repeal-and-replace-plans-might-shift-health-insurance-tax-credits/ and Calculator :http://kff.org/interactive/tax-credits-under-the-affordable-care-act-vs-replacement-proposal-interactive-map/
5] Bylskal J. How Health Savings Accounts Work-HSAs are a critical—and controversial—part of some Republican health careproposals. Consumer Reports Organization. 2017 Feb 24.
 Rosato D. How to Survive a High-Deductible Health Plan-Knowing you’re on the hook for thousands in medical bills might make you less likely to seek care you need. Here’s how to save money and stay safe. Consumer Reports Organization. 2016 Nov 17.
[7a] Paul R. The Obamacare Replacement Act (S. 222) Sen Rand Paul, M.D. Senate.gov. 2017-01-25
[7b] Rand Paul Offers ACA Replacement Proposal. Health Affairs Organization. 2017-01-27
 Signing Up for Medicare. U.S. Centers for Medicare & Medicaid Services. Accessed 2017 Mar 6.
 The “Continuous Coverage Exclusion” For Pre-Existing Conditions.
 Rosato D. 4 Changes That Might Be Coming to Your Health Insurance– Now that Tom Price is HHS Secretary, what to expect in an Obamacare replacement plan. Consumer Reports Organization. 2017 Feb 10.
 Rosato D. Understanding the GOP’s Latest ACA Replacement Plan. Consumer Reports Organization. 2017 Feb 24.
 Pollitz K. High-Risk Pools For Uninsurable Individuals. Kaiser Family Foundation. 2017-02-22.
 Luthra A. Everything You Need To Know About Block Grants-The Heart Of GOP’s Medicaid Plans. Kaiser Health News. 2017 Jan 24.
[14a] NPR Staff. For Rhode Island, Interstate Health Insurance Sales Didn’t Pan Out. National Public radio [NPR] 2017 Jan 31.
[14b] Pianin E. Here’s the problem with Trump’s plan to sell health insurance across state lines. The Fiscal Times/Business Insider. 2016 Dec 6.
 ObamaCare Essential Health Benefits. Obamacare Facts. Accessed: 2017 Mar 10.
 Witters D. Kentucky, Arkansas Post Largest Drops in Uninsured Rates. Gallop.Com. 2017 Feb 8.
 Latest statistics from the CDC. Centers for Disease Control & Prevention. (CDC ).
https://www.cdc.gov/obesity/data/adult.html and American Academy ofNeurology 2016 Jan 26. [ U.S. Census Bureau Updated: 2016 Oct 11]
 Rmuse. GOP Prohibits CBO From Reporting How Much ACA Repeal Blows Up the Deficit. Politicususa. 2017 Jan11.
[ 19] Groups lining up in opposition to GOP health care plan. CNN. 2017 Mar 8.
 U.S. Federal Poverty Guidelines Used to Determine Financial Eligibility for Certain Federal Programs. – Office of The Assistant
Secretary or Planning and Evaluation U.S. Department of Health & Human Services [HHS]. Accessed: 2017Mar 10.
 Medicaid Expansion. American Action Forum. 2017 Jan 4.
 What Marketplace health insurance plans cover? HHS.
 Begley S. House Republicans would let employers demand workers’ genetic test results. STAT News. 2017 Mar 10.
[ 24] Commonwealth Fund pub. #811 The Effect of Health Savings Accounts on Health Insurance Coverage
CALL YOUR: U.S. SENATORS: [Entire List]
Senator Bob Casey (D): ( 202) 224-6324 or email:
Senator Pat Toomey (R): (202) 224-4254 or email :
CALL YOUR: U.S. HOUSE OF REPRESENTATIVE [Entire List]
Congressman Robert Brady (D-District 1) (202) 225-4731 or email
Congressman Dwight Evans (D-District 2)(202) 225-4001 or email
Congressman Ryan Costello (R-District 6) (202) 225-4315 or email
Congressman Pat Meehan (R-District 7) (202) 225-2011 or email
Congressman Brian Fitzpatrick (R-District 8) (202) 225-4276 or email
Congressman Brendon Boyle (D-District 13) 202) 225-6111 or email
Congressman Charles Dent (R-District 15)(202) 225-6411 or email
Congressman Lloyd Smucker (R-District 16) (202) 225-2411 or email
GET INVOLVED: www.ofa.us or www.ourrevolution.org or
https://www.indivisibleguide.com/ ( see: Take Action Locally)
SEPAGrassroots@gmail.com Updated: 2017-03-11
 The American Care Act. 2017 Mar 6.