To Be Equal
March 15, 2017
Marc H. Morial
President and CEO
National Urban League

The American Health Care Act: Un-American, Un-Healthy and Un-Caring

“All the progress that we’ve made in controlling costs and improving how health care is delivered, progress that’s helped hold growth in the price of health care to the slowest rate in 50 years -- all that goes away.  That’s what repeal means.  It would be bad for everybody.  And the majority of Americans, even if they don’t know that they're benefitting from Obamacare, don’t want to see these benefits and protections taken away from their families now that they have them.” – President Barack Obama, Remarks by the President on the Affordable Care Act, October 20, 2016

It’s no exaggeration to say the Affordable Care Act of 2010 was one of the most significant pieces of legislation in modern American history, particularly in regard to its impact on communities of color.

Before the ACA, nearly a quarter of African Americans were uninsured. That rate has been slashed in half. Nearly 8 million now have access to no-deductible preventative care. The ACA’s expansion of Medicaid was critical for African Americans, who make up nearly one-in-five enrollees. And the investment of billions of dollars in community health centers, which disproportionately serve Black neighborhoods, has helped to narrow health disparities.

Dismantling the ACA, as Congress and the president seek to do with the introduction of the American Health Care Act, would be nothing short of a disaster for communities of color and Americans over 50.  It’s a windfall for the wealthiest Americans, wrenched from the poor, the sick and the struggling. In short, it’s un-American.

More than 24 million Americans could be uninsured by 2026, according to the non-partisan Congressional Budget Office. The White House’s own internal estimate places that number even higher, at 26 million.

The ACA is not perfect, but the American Health Care Act does not seek to address its imperfections. Its primary feature is a massive tax cut for the wealthiest Americans. Premiums for older customers will skyrocket to unaffordable levels, forcing many of them to forego insurance. It further removes the individual mandate, which requires most Americans to purchase insurance, and the employer mandate requiring large employers to provide insurance to employees.

Weakened protections for people with pre-existing conditions would hit communities of color particularly hard, because African Americans have disproportionately higher rates of chronic conditions like heart disease and diabetes and face higher rates of HIV and cancer.

Particularly devastating to America’s most vulnerable citizens would be the gutting of Medicaid. The CBO estimates 14 million fewer people would be enrolled in Medicaid compared to current law. Cutting and capping funding to the states will lead many of the 31 states that adopted the Medicaid expansion to drop it, leaving millions uninsured, and to restrict coverage for those who do remain enrolled. Uncoupling funding for Medicaid from its actual cost will lead to a downward spiral that leaves low-income Americans even more vulnerable.

Nearly every feature of the AHCA benefits the wealthy at the expense of everyone else. Because its Universal Health Care Tax is based on age, instead of income, it redistributes subsidies from the poor and middle-class Americans to the wealthy. Low-income workers who can’t afford the maximum contribution to Health Savings Accounts, designed to cover high deductibles, receive fewer benefits and likely won’t be able to save enough to cover their costs. The proposal also includes a tax cut for insurance company executives making over $500,000.
  
The architects of this un-American proposal have demonstrated breathtaking callousness in response to widespread criticism. Suggesting people choose between a smartphone and health care is not merely absurd but ignores the reality of the working poor. Even under the ACA, annual premiums are easily 10 times the cost of a phone.  Most working poor rely exclusively on their phones, not only for communication, but for crucial access to the internet. 
  
If you’re sick, you can be forced into a more expensive, less-secure plan. If you’re poor, you may lose coverage entirely. If you’re a senior citizen, you could be paying thousands more for your medication.

The American Health Care Plan is: un-American, un-Healthy, and un-Caring.  Let’s abandon this travesty and work on improving the Affordable Care Act.