Like Obamacare, But Worse: The GOP ACA Healthcare Bill Explained, Part 4

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NYC FEDERAL BUILDING AT 26 FEDERAL PLAZA, NEW YORK, NY, UNITED STATES – 2017/03/21: Outside the NYC Federal Building (26 Federal Plaza, Bway between Worth and Duane), which contains Medicaid offices, hundreds of New Yorkers who rely on Medicaid, including seniors and people with disabilities, will conduct political theater to protest congressional Republicans’ plan to remake Medicaid. (Photo by Erik McGregor/Pacific Press/LightRocket via Getty Images)

Trumpcare has been amended before it will be voted on by the full House. The changes do nothing to address the many problems with the bill, and in fact could make the situation for Medicaid enrollees even worse.

The House is set to vote on Ryancare/Trumpcare tomorrow, and they have proposed a number of changes since the last time I wrote about the bill that you should be aware of. I’ll explain more below, but first…

If you have concerns about this bill, now’s the time to contact your House representative before the vote tomorrow…and it probably couldn’t hurt to contact your Senator as well, since if the bill passes the House it will go to the Senate very soon.

Here are my concerns with these amendments/changes…which can be piled on top of the concerns I laid out a couple of weeks ago. The amendments to this legislation do not address those problems in any way.

And here are the new details:

1. The bill would allow states to implement work requirements on Medicaid enrollees who are not children, pregnant women, or college students. If you don’t work the required number of hours (or whatever threshold they will establish) that your state demands while you’re on Medicaid, you’d lose your coverage.

The amendment does not exempt disabled people, older people, or actively sick people from these work requirements. So if you live in a state where you think your representatives would jump at the chance to cut Medicaid, or if someone you love has a disability or medical condition that might limit their ability to work some undefined amount, this is something in this proposed legislation that you should be aware of.

(This doesn’t mean that work requirements would be implemented immediately, but it does mean that states – for the first time – would be explicitly *allowed* to require that Medicaid enrollees work in order to maintain their coverage.)

2. The bill immediately repeals taxes (mostly on the investment income of extremely wealthy people) that are currently used to fund various things in the ACA, especially the monthly subsidies that some ACA enrollees receive to make their premiums more affordable.

So while it’s impossible to know what impact taking away that tax revenue would have on healthcare if the current law passes, I am not particularly optimistic about the chances of a good healthcare program remaining in place if we remove hundreds of millions of dollars of tax revenue from it.

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