As a 20-year old woman with three autoimmune disorders, legislation like the American Health Care Act is really risky for people like me in multiple ways. However, there is a part of the bill that no one seems to be taking seriously: Subsides based on age. This has been a staple of Republican plans recently that hasn’t gotten as much attention in the headlines as it should. Especially if you’re a young person that voted for Donald Trump.
Here’s why:
Right now, the Affordable Care Act covers people based on income. This is a problem for many middle class families because the ACA leaves out the idea that a family of five with a middle class income can’t always dish out thousands for health insurance. However, this approach based on age would be a new kind of killer, especially to young people and families just starting out. It’s also discriminatory to disabled young adults because it assumes that all young people need less healthcare. That’s not true.
Let’s say you turn 26, can no longer get health insurance from your parents, and have a low-paying starting salary job. Under the AHCA, because you’re young, you have limited options for affording healthcare if you buy it on the private market (outside of work) because the subsidies you’re eligible for are automatically lowered. This means that young people who have the luxury to opt out of healthcare will do so, leaving healthcare providers with only the young and sick who actually need health care to live. Those people, like myself, will not only have to pay more because we’re young, but also because our healthy peers aren’t helping us out anymore by lowering prices. Health care costs would shoot through the roof for anyone with insurance, and the more this happens, the more people with little need will continue to opt out of the system.
That’s a death spiral just waiting to happen.
As for the pre-existing conditions debate, under the AHCA, states would be allowed to raise prices on people with pre-existing conditions by opting out of the system and receiving waivers instead. There are a lot of questions about what states would actually choose to do this and why, but the law is reliant on most states choosing not to do this. In this instance, Republicans are going after the “mandate” idea of the ACA, in order to attempt to give more power to the states like they usually do.
The issue is that people with pre-existing conditions cost much more than you could ever imagine. Putting “all the sick people” in a pool with only sick people will make it impossible for people like me to maintain medical expenses. States forget that their allocated funding won’t cover anywhere near the amount of money they need.
This is also largely missing the point of “affordable health care” in the first place. “Affordable Care” doesn’t mean “just affordable” for healthy people or “just affordable” for the sick. It means creating a system in which you pay for what you use but within reason. This was one of the issues with the ACA, because healthy people were paying far more than they should, creating a “health care gap.”
This legislation won’t fix that gap, it will just reverse it, and it doesn’t even address the actual issue at hand (which is that it’s not always affordable for people in the middle). Instead, it does away with young, sick Americans’ ability to get health care at a reasonable price by refusing them more subsidies. Simply put: Donald Trump promised affordable healthcare. His actions are guaranteeing the opposite for the next generation of Americans.