A path forward on healthcare

     This month the House of Representatives passed the American Health Care Act (AHCA) to fix Obamacare. After standing up to my own party and helping to improve the legislation, I voted yes on the bill’s passage in the House. With so much misinformation surrounding the bill, I’d like to explain why I voted for it.

     Here’s an important and indisputable fact: Obamacare is totally collapsing in Iowa. After years of rising premiums and reduced choices, the two largest insurers have announced they won’t offer plans on the individual market in 2018. And the third and final insurer has indicated they will likely leave the market as well – leaving 70,000 Iowans with ZERO options for health insurance next year in the individual market. Obamacare needs to be fixed so these Iowans can keep their coverage.

     The most widespread myth surrounding this bill pertains to pre-existing conditions. Those who prefer we do nothing – and keep the current collapsing system in place – claim that the AHCA will do away with protections for folks who have a pre-existing condition. This is simply not true. The AHCA explicitly states that NOTHING in this bill allows insurance companies to deny coverage to people with pre-existing conditions.

     If you are currently receiving coverage through the individual market, insurance companies CANNOT charge you more for a pre-existing condition under the AHCA. Only if you allow your coverage to lapse for more than two months could you be charged more for ONE year: a 30 percent surcharge for one year in states that do not apply for a waiver from some of Obamacare’s regulations, or one year of health based pricing in states that do receive a waiver. But even then, this bill sets aside nearly $140 billion to help states reduce those costs to patients who, through no fault of their own, have a pre-existing condition that costs more to cover.

     Another criticism of the AHCA is that 24 million people will “lose” their health insurance under this bill. This is highly misleading. The Congressional Budget Office (CBO) does estimate that millions of Americans will CHOOSE not to buy coverage under the AHCA because it eliminates Obamacare’s individual mandate that forced people to buy insurance or face a fine. That’s called free choice – not “losing” your insurance. 

     The CBO also estimated that millions fewer Americans would be covered by Medicaid. It is accurate that the AHCA rolls back Obamacare’s massive Medicaid expansion so states can focus resources on those who truly can’t help themselves, like children with special needs, but NOBODY currently on Medicaid will be kicked off. 

     I’ll be the first to admit that the AHCA is not perfect. There are good reforms that aren't in this bill that I would like to see but weren't included because of Senate reconciliation rules: buying insurance across state lines, allowing people to form groups to negotiate better insurance prices, and eliminating health insurance companies’ exemption from antitrust laws. 

     But this is government – often we need to compromise to fix a big problem like Obamacare’s collapse in Iowa. The AHCA is a step in the right direction. It moves us closer to a system where we help those who cannot take care of themselves, while others can afford their health insurance again.