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There is really no one who will escape the disastrous effects of Trumpcare if it passes. If you've got a pre-existing condition, you're screwed. If you're on Medicare, you're not safe, either. If you're a child, it's potentially catastrophic. If you have insurance through your employer, you're sunk, too. You might feel shielded because you live in a blue state, with a Democratic governor or legislature, and you think the waivers for states that would make the Affordable Care Act's provisions protecting people with pre-existing conditions won't be taken by your lawmakers.
But that's probably not how it's going to work, say most experts, refuting the claim made by Republicans like Rep. Tom Cole (R-OK) who told people not to get worked up, because the governors would save people from this shitty proposed law.
But in interviews with Mother Jones, health care experts warn that Cole is wrong: If the GOP bill becomes law, many states will indeed eliminate preexisting-condition protections and/or at least some of Obamacare’s requirements that insurance plans cover a range of standard treatments, including maternity care and mental health. And it wouldn’t just be states that voted for President Donald Trump. Under the GOP bill, even progressive states might have to take drastic measures to prevent their health insurance markets from exploding. […]
Experts say states would likely face enormous pressure to adopt at least some of the waiver options. In part, that would arise from insurance company lobbying; the industry spent tens of millions lobbying at the federal level in 2016 alone. But the basic market dynamics created by the GOP bill would play a role as well, potentially creating an industry death spiral if states refuse to allow price discrimination based on health conditions. "Insurers would be putting pressure on states, saying, 'We can't operate in this market. We won't participate at all unless you start rolling back these protections,'" says says Edwin Park, vice president for health policy at the liberal-leaning Center on Budget and Policy Priorities.
Insurance companies would face an immediate crunch if the Republican bill became law. The legislation ends Obamacare's individual mandate this year, removing a major incentive for healthy people to buy insurance. The bill also reduces the amount of money the government offers in subsidies to help lower-income people pay their premiums. With less help from the government, healthy people would have even more reason not to buy insurance.
Don't let Senate Republicans do it. Call your Republican senator/s through the Capitol switchboard, 202-224-3121 and at their local offices. Tell them you won't forget how they're selling you out.
Fewer healthy people in the marketplace, fewer people to subsidize the sick ones and there's your death spiral Republicans keep trying—unsuccessfully—to pin on Obamacare. Insurance companies won't be able to afford to do business in states where they have to take all comers, not when the healthy people aren't showing up and paying their premiums. They will lobby very hard for states to take the waivers and they have plenty of sway. And, by the way, this doesn’t just affect people on Obamacare—we’re talking about the essential health benefits for everyone.
The Senate bill, or at least as much as has been leaked about it, isn't any better than the House bill in this regards. Republicans claim that these waivers aren't really repealing the most popular part of Obamacare, the part that gives everyone the assurance that they're aren't going to have to go broke and declare bankruptcy because of a bad diagnosis. That peace of mind will be a thing of the past if this bill passes. It's going to put the insurance companies back in charge—the real death panels who get to decide who gets treatment and who doesn't.