On Monday, three Republican senators released The Patient Choice, Affordability, Responsibility, and Empowerment Act, a proposal that would repeal the Affordable Care Act and the powerful consumer protections that exist today. Though the likelihood of its passage is slim, it nonetheless offers a comprehensive picture of how opponents of the Affordable Care Act view the way our health care system should operate.
Because the specifics of this proposal remain unclear, it is impossible to predict the exact implications of the proposed legislation. We can say, however, that it would leave a significant number of Americans without the access to health insurance they’re now provided through the Affordable Care Act.
This new proposal would also eliminate Medicaid expansion. And it would alter the traditional Medicaid system by giving block grants to states and reducing consumer protections, which could cause those beneficiaries who need Medicaid the most to lose access to their health coverage, as a recent Center on Budget and Policy Priorities report underscores.
Someone could be penniless and still not qualify for Medicaid, while states would be allowed to start adding copays and deductibles to their Medicaid programs.
Insurance companies could revert back to old ways, denying coverage to people with preexisting conditions. Women and older people, including those over age 55, could once again be charged more for health insurance in the private market. Further, states would be able to opt out of the current requirement that allows children (up to age 26) to stay on their parent’s plans. Though the proposal contains a tax credit for consumers to help pay their monthly premiums, the new plan would strip middle class families who are between 300 and 400 percent of poverty of their financial assistance. Lower-income families would also lose the current financial assistance that helps them pay for deductibles and other out-of-pocket expenses.
The legislation also curtails consumer protections. In a recent article, the Washington Post’s Sarah Kliff warns that the new plan does not contain exchanges and fails to determine a set of benefits that insurance plans must cover. The proposal lacks requirements for insurance plans to provide certain benefits that consumers expect are covered, such as maternity and mental health coverage. Often times, consumers don’t discover that these benefits are not covered until it’s too late. The plan also removes the current health care marketplaces, which are a critical factor in helping to keep rates competitive.
Finally, the proposal would be financed by taxing employer-provided insurance, but would no longer require large businesses to provide health coverage to their employees.