Obamacare vs. Trumpcare: A Public Health Dilemma

03/20/2017 03:42 am ET Updated Mar 22, 2017
President Obama & President-elect Trump meet in the Oval Office.
Photo Credit: Wikipedia
President Obama & President-elect Trump meet in the Oval Office.

The Affordable Care Act, colloquially known as Obamacare, is far from perfect ― but is its replacement better? The Congressional Budget Office (CBO), a nonpartisan government agency tasked with assessing the fiscal efficacy of federal programs, suggests otherwise.

Last week, the CBO released its analysis of the American Health Care Act, the White House-backed alternative to Obamacare. The bill, which has been coined Trumpcare, was originally touted as a viable replacement to Obamacare, yet the details do not support such a claim.

The CBO estimates Trumpcare would reduce the federal deficit by $337 billion over the next decade, but it would do so at the expense of the nation’s most vulnerable citizens. The current bill would ultimately cut Medicaid and insurance subsidies significantly, and immediately discontinues Essential Health Benefits, which include substance abuse and mental health services. Perhaps the most staggering statistic is the increase in the number of uninsured Americans over the next 10 years. According to the report, enacting the legislation would cause approximately 14 million people to lose health care coverage in 2018, a shocking figure that swells to 24 million by 2026.

Obamacare Is Not Without Flaws

Insurance companies continue to opt out of the exchange marketplace, and many states are left with only one or two provider options. The public exchange was structured on the premise of healthy people offsetting the cost of the sick, yet the Obamacare model does not effectively account for an unbalanced risk pool. In markets such as Arizona, the sick constitute the majority of the risk pool, which has caused premiums to rise considerably. In addition, federal regulations have required insurance companies to expand their basic policies to cover conditions that may otherwise be included a la carte. Consequently, insurance companies have passed on the additional overhead to its policyholders.

The biggest criticism ― the federal mandate ― was initially imposed to guarantee the enrollment of healthy constituents in the risk pool. While well-intended, the mandate has not effectively served its purpose; healthy individuals are enrolling in the program at a substantially lower rate than projected. Furthermore, many legal scholars argue the mandate itself is unconstitutional and encroaches on civil liberties.

While well-intended, the mandate has not effectively served its purpose; healthy individuals are enrolling in the program at a substantially lower rate than projected.

Even with its flaws, however, Obamacare trumps its alternative. Trumpcare does little to mitigate the issues mentioned with regard to Obamacare. In fact, Trumpcare has been dubbed Obamacare-Lite due to its striking resemblance.

Similarities aside, Trumpcare and Obamacare have key differences. Most notably, Trumpcare gets rid of the unpopular federal mandate, but a monetary penalty is still imposed on individuals who allow their insurance to lapse. Additionally, older individuals could be charged as much as five times more than their younger counterparts. Trumpcare also takes direct aim at Planned Parenthood and freezes funding for one year. Generally speaking, Trumpcare places the sick, poor, and elderly populations at a major disadvantage and appears to neglect high-risk groups’ core health concerns.

The country may be divided on the specifics, but Americans remain united around the idea of access to affordable health care. President Trump and congressional leaders should take heed.

Have you or your family benefited from the Affordable Care Act? If you’d like to share your story on HuffPost, email us at ACAstories@huffingtonpost.com.

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