At least 24 million Americans are expected to lose their health insurance if Obamacare is replaced with the Republican-backed American Health Care Act. The poor, the sick and the elderly are expected to suffer the most.

One of US President Donald Trump's campaign promises was that "everybody
One of US President Donald Trump's campaign promises was that "everybody" would get health care coverage.

The new GOP or Republican public health care plan will leave 24 million people uninsured in nine years. The American Health Care Act will cut funding to Medicaid, leaving those who can't afford insurance unprotected, and increase premiums by 500 percent for older Americans, a new report by the Congressional Budget Office (CBO) has said. This is a far cry from the 20 million people protected by Obama's Affordable Care Act.

Remind me again, what was Obamacare about?

Obamacare — formally known as the Patient Protection and Affordable Care Act — aims to give more Americans access to health care.

One of the ways it did this is by expanding Medicaid, a government insurance programme which assisted those who could not afford medical care. Obamacare also increased medical insurance marketplaces, which gave people health care plan options to pick from, and provided subsidised coverage.

Another provision is the individual mandate — compulsory health insurance. If an American did not have health insurance, they would have to pay a fine.

One of the first executive orders US President Donald Trump signed right after his inauguration in January was to weaken Obamacare. As president he cannot directly repeal it — it's a process which goes through Congress — instead, he directed government departments to take it apart as much as legally possible.

Are more people really going to be worse off under the GOP plan?

At least 14 million people will be uninsured in the first year after the legislation passes. The individual mandate will be scrapped, taking away people's incentive to get medical insurance.

"Some of those people would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums," the report has stated.

Another contributory factor is the expected increase in the premium — the cost of an insurance contract — especially for older people.

It is projected that by 2026, a 64-year-old making $26,500 annually would pay $14,600 if the GOP plan is rolled out.

Under Obamacare, the same person would pay a projected $1,700 for coverage. Basically, aging Americans with less money will take a bit hit.

With its funding slashed by $880 billion over the next decade, Medicaid would be unable to subsidise premiums, the CBO report said. The spike in premium costs will be accompanied by a rise in the uninsured elderly. They simply will not be able to afford medical coverage.

The CBO also pointed out the Prevention and Public Health Fund which helps people from falling sick will lose $9 billion under the American Health Care Act. This fund helps vaccinate children, and pays for outbreak responses, according to Vox.

This fund also supports a significant portion of money spent by the Center for Disease Control. The CDC is integral to public health in the US and its work has a worldwide impact by virtue of the research it undertakes on prevention and contagion.

Why are some Republicans against the GOP plan?

Some conservative Republicans are unhappy that Medicaid has not been scrapped and that refundable tax credits have been introduced. They have dubbed the new plan "Obamacare Lite."

Party moderates warn it provides insufficient funding to help millions retain or purchase coverage.

"It's awful," Republican Senator Bill Cassidy said of the CBO projection, according to the Washington Examiner, calling the report an "eye-popper."

Another Republican, Congressman Rob Wittman, has made clear his opposition to the act. "I do believe that we can enact meaningful health care reforms that put the patient and health care provider back at the center of our health care system, but this bill is not the right answer."

Does this follow through on Trump's election promises?

Not really.

Trump's election campaign was targeted towards repealing and replacing the "disaster" that he called Obamacare.

He promised that "everybody," would get health care coverage, that he would maintain funding for Medicaid and make health care cheaper. This did not happen.

There are two popular Obamacare provisions that are staying.

  • Insurance companies cannot refuse coverage due to pre-existing conditions. However, another bill by the GOP might provide a loophole which can be exploited by employers. If it becomes law, the legislation would allow employers to penalise workers for not undergoing genetic testing.
  • Children can remain on their parents' insurance plan until age 26

Trump has nevertheless remained upbeat. When asked what would happen to the people that lost coverage, he said "If we're allowed to do what we want to do, it will get better. Much better."

Source: TRTWorld and agencies