Latest Update on Changes to Our Health Care System – Our Worst Fears Realized

Our Worst Fears RealizedOnce again we find ourselves in the position of having to share some frightening news when it comes to health care system.  Last week, an amendment (referred to as the MacArthur Amendment) was proposed to the American Health Care Act (AHCA), the legislation designed to ‘repeal and replace' the Patient Protection and Affordable Care Act (ACA). In the last few days there have been additional negotiations to try to secure enough votes in the House of Representatives to pass this legislation.  According to new reports a vote is expected on this new version any day now. To state it plainly, the MacArthur Amendment is our worst fears realized.

The MacArthur Amendment makes a bad bill worse, and would:

  • Result in more than 24 million people losing their health insurance coverage;
  • Eliminate the Medicaid expansion program and cut more than $800 billion from Medicaid over the next decade;
  • Decrease the solvency of the Medicare Trust Fund by four years;
  • Eliminate the critical premium tax credits which lower the monthly premiums of plans being sold in the Marketplace for people;
  • Eliminate public health funding by repealing the Prevention and Public Health Fund established by the ACA;
  • And possibly most significantly, the new proposal would allow states to opt out of consumer protections, which would allow insurance companies to:
  • Not cover Essential Health Benefits – this means that insurance companies could decide to no longer cover chemotherapy, prescription drugs, prevention services, or hospitalization.
  • Increase costs for older adults – currently older adults can only be charged up to 3 times more for their coverage. This bill wants to increase that ratio to allow insurance companies to charge up to 5 times more for their coverage. Read this fact sheet for more information about how this bill would hurt older adults.
  • Charge people with pre-existing conditions higher premiums – while those states would then have to create a high risk pool, coverage in high risk pools could cost more, be delayed, or even have enrollment limits. High risk pools are not a new idea. In fact, more than 35 states had high risk pools to try to help people with pre-existing conditions access health insurance coverage, before the ACA became law. While those high risk pools offered a lifeline for many people to get access to coverage when they couldn’t get it another way, they were not a solution to the problem. For example, in California, the state’s high risk pool only offered coverage up to $75,000 a year. Cancer care is often much more expensive than that, which left people to pay for their care out-of-pocket. Many of those state high risk pools had 6-month waiting periods for coverage if you had a pre-existing condition, wait lists due to state budget constraints, and very high deductibles and out-of-pocket costs. Kaiser Health News has a video describing why high risk pools may sound like a good idea, but have some challenges in reality.

The Kaiser Family Foundation has an excellent side-by-side comparison of the ACA and the AHCA and the potential changes to our health care system.

It is important to note that the current bill specifically exempts these changes from impacting Members of Congress, so that their coverage is not reduced or their costs are not increased by this legislation.

We hope that our elected officials will keep these issues in mind as they make their decisions over the next few days, weeks, and months on any changes to health care system.

What You Can Do

We will have to continue to wait and see what happens, but in the meantime, there is something that you can do.

  • Share your experience and concerns: Call or email your elected officials and share your health insurance concerns. To reach your U.S. Representative, you can call the US Capitol Switchboard at (202)-224-3121, and an operator will help to connect you. To find your elected officials or learn more about becoming an advocate, visit our Advocacy resources page. You can also find the Facebook and Twitter handles for the current members of Congress here.

Do You Need Health Insurance Now?

We also want to remind you that change is Washington is rarely swift and that we may not see changes for most of 2017.  That means that we have to continue to operate with the system we have for now and ensure that people who need coverage actually get it for 2017. If you do not have health insurance coverage, you can apply for Medicaid at any time or purchase a policy through the State Health Insurance Marketplaces if you qualify for a special enrollment period.

For more information about how to choose a health insurance policy (including making choices between employer-sponsored options), watch our recorded webinar.

If you aren’t sure what your health insurance options are or want to understand more about health insurance, visit

Stay tuned to our Blog and sign up for our newsletter, as we will continue to provide updates as more information becomes available.

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