The AHCA was written to solve a crisis that doesn’t exist and accordingly accepts sacrifices it doesn’t need to ( Q1,2018). It’s akin to a doctor who wants to amputate a patient’s leg, a reasonable solution if gangrene has set in, but disastrous in case of a botched diagnosis. Everyone will face the specter of getting priced of health insurance altogether if they lose coverage. For them this is functionally a mandate, except instead of a financial penalty the AHCA punishes them by withholding access to care. I think one of the somewhat surprising elements of the bill was the fact that they kept in the essential health benefits, the ten classes of benefits that need to be covered just because it’s covered doesn’t mean that you’re going to be able to afford them. For the people who have coverage, meaning they are in an insurance plan, what is the extent of the out of pocket exposure they have to get the care they need. As it turns out, studies showing better health outcomes for those with insurance looked at individuals having private insurance. On the other hand, multiple studies, assessing the effect of the Medicaid expansion, found no improvement in health outcomes for those on Medicaid.  In fact, other investigations have found worse outcomes for those with Medicaid as compared to those with no insurance at all.


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