There are at least 50 ways to lose your healthcare now thanks to Donald Trump and the Republican-controlled Congress. Let’s start with some of the obvious ones.
Before Obamacare (aka the Affordable Care Act) many people with pre-existing conditions found it prohibitively expensive or impossible to get coverage in the individual insurance market. Obamacare pulled them back inside the tent – but under Trumpcare an estimated 130 million Americans will now face increased health care costs.
Obamacare ensures that health insurance companies have to spend the majority of their members' premiums on medical costs. Under Trumpcare that stipulation ends; they will be free to decide how much of their members' premiums they spend on medical costs.
Obamacare eliminated the long waiting periods that employer-sponsored plans (how most Americans get their health insurance) used to impose for pre-existing conditions. Under Trumpcare you may now have to wait longer.
Additionally, under Trumpcare if you get a new job and are eligible for their health plan you may have to wait much more than 90 days before you’re covered. Obamacare ensured the maximum period you’d wait was 90 days.
#Trumpcare isn't about helping people get covered, it's about notching a political win.— Senator Patty Murray (@PattyMurray) May 9, 2017
Under Trumpcare employers may now place you on scaled back plans that limit your total benefits to $10,000 or even $2,000 a year. That means you will risk the possibility that your plan doesn’t cover major operations. Obamacare ensured that employers offered the minimum value standards, but Trumpcare allows partial coverage plans to return.
Paltry health care plans will limit workers career options. If your health coverage options are a choice between bad and terrible what kind of job mobility do you really have?
Under Trumpcare we will see the return of the dreaded “lifetime limits.” That means that if you or a loved one has a chronic condition you may very well use all of your insurance benefits rapidly until the limit runs out and you have no other insurance company willing to take you on.
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All 48 Democratic Senators to @GOP: Scrap #TrumpCare and work with us to truly strengthen healthcare in a bipartisan and transparent way. pic.twitter.com/APToV15GGL— Rep. Pramila Jayapal (@RepJayapal) May 9, 2017
Women may discover that under Trumpcare they pay more for less, as used to be the case. Controversially even cases of sexual assault could be termed a pre-existing condition now, meaning that the victim would be responsible for all of her costs, eating into her own health coverage. Some observers worry that will lead to a reduction in sexual assault reporting.
Trumpcare has promised to cut $808 billion from the Medicare budget over the next decade, inevitably resulting in higher premiums, higher copays, larger deductibles and coinsurance for Medicare beneficiaries.
Under Trumpcare free routine blood pressure and cholesterol checks will no longer be free. Medicare’s annual wellness visit, free under Obamacare, will end. Maternity care will no longer be covered if you don’t have access to an employer-sponsored plan, and in many states that won’t be an option.
#Trumpcare is devastating to older Americans, middle & lower income Americans, women & veterans – all to give a tax break to the wealthy.— Chuck Schumer (@SenSchumer) May 9, 2017
Free routine vaccinations will no longer be free. Free screening for gestational diabetes will end. Free pregnancy screening will end. Expectant mothers will have to pay the full cost of their maternity care if their coverage comes from the individual market.
Obamacare requires insurers to provide free pap smears and HPV tests. Under Trumpcare you can expect to be charged again. Free screening for HIV, Hepatitis and common STD’s will also vanish.
Under Trumpcare many health plans will actually be sold without any prescription drug coverage, which is fine if you never get sick.
Obamacare greatly expanded Medicare for the poor, but under Trumpcare up to 14 million low-income citizens could find themselves uninsured once again. Some hospitals in rural areas are projected to close since low-income patients suddenly without insurance will be unable to afford or pay for their care.
Young adults will no longer be able to stay on their parents' plans until they turn 26. At college, their total coverage plans could revert to limited benefit coverage plans with cost maximums.
The @HouseGOP’s Trumpcare plan would be devastating for vets in MA & across the country who rely on ACA tax credits to pay for health care.— Elizabeth Warren (@SenWarren) May 9, 2017
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Under Obamacare, there’s an important internal appeals process for coverage complaints, and if you can’t get satisfaction there you have the right to an external review by an independent organization. Under Trumpcare those important protections would effectively vanish.
Under Obamacare, health insurers are compelled to give coverage explanations in easy to understand language. Under Trumpcare that kind of simplification would no longer be mandatory.
Trumpcare and the GOP dearly want to ax “cost sharing subsidies” that benefit low-income workers. These subsidies allow the poor to pay lower out of pocket costs. Without them, health insurance would simply be unaffordable.
Out of pocket costs have caps for in-network care under Obamacare. But those costs will rise dramatically under Trumpcare, putting low-income families at particular risk if they are unfamiliar with the cost dangers.
Small business tax credits for employers make Obamacare more affordable but under Trumpcare those tax credits will be under renewed threat.
Barack Obama finally broke his silence on Trumpcare – and it's a must-see pic.twitter.com/pyDbTKLeUJ— NowThis (@nowthisnews) May 8, 2017
In passing, Trumpcare repeals two major taxes imposed by the Obama administration to help subsidize care for lower-income Americans, the 3.8 percent surcharge on investment income such as capital gains and dividends, and an extra 0.9 percent added to Medicare payroll taxes.
That means those earning more than $1 million a year would see a major tax cut of $51,400 a year on average if the Trumpcare repeal bill is passed.
"If there's one clear-cut message that comes out of that repeal bill it is we're going to cut the hell out of income taxes for the rich on investment income," Berkshire Hathaway Chairman Warren Buffett told the press this week.
“If you just look at the tax provisions of the bill… it dramatically is skewed towards the highest income households."
Critics of the Republican repeal plan say that Congress is simply looking at the bottom line, not the lives and well-being of their fellow Americans.