Keep healthcare coverage personal

For most Americans, the health insurance that covers them and their families is a life vest that keeps them—and their loved ones—safe when they need it most. 

Today, a record number of Americans have access to that life vest. The U.S. uninsured rate currently stands at a historic low of 8.9 percent, a sign of the impact of the 2010 passage of the Affordable Care Act (ACA) and other efforts, including the Children’s Health Insurance Program, first established in 1997. However, following the House of Representatives’ passage of the American Health Care Act (AHCA), the future of Americans’ health security is uncertain. As all eyes turn to the Senate’s health care debate, it’s more important than ever that we don’t lose the ACA’s vision of providing comprehensive, meaningful coverage to millions of Americans.

{mosads}With that in mind, it’s absolutely essential that we preserve the coverage and benefits for the 23 million Americans expected to lose insurance under the AHCA—including 14 million individuals with Medicaid. Future Medicaid policies should preserve adequate funding, benefits and eligibility provided under current law.

While the bill does address medical costs for patients with pre-existing conditions, it does so by allowing states to opt out of ACA requirements that prohibit insurers from charging individuals higher premiums based on their health status. The AHCA would also set up funds for states to establish high-risk pools that would subsidize premiums for individuals with high healthcare needs. Unfortunately, high-risk pools implemented in the past have been underfunded, leading to high premiums and long waiting lists. And early signs suggest that the money earmarked for high-risk pools in total will be far less than what is required to avoid the pitfalls that have undermined high-risk pools in the past.

Equally important, states also can opt out of mandating that insurers cover 10 essential benefits, including emergency services, hospitalization, prescription drugs, and preventive care. In doing so, the AHCA would indirectly allow insurers to ‘race to the bottom’ with insurance benefits, potentially leaving unsuspecting patients unable to afford necessary medications or services that they need to stay healthy but that are not covered.

But that’s not all. While the AHCA’s potential impacts on coverage are too many to list, they also threaten the current ban on annual and lifetime spending caps and bring an end to the ACA’s ‘community rating’ provisions that outlaw discrimination based on age, gender and health status, just to name a few. Taken together, these changes mean that many Americans who need healthcare the most will have a very difficult time affording coverage.

From the 2010 implementation of the ACA to this spring’s AHCA deliberations, we’ve all learned that crafting national healthcare legislation is immensely complicated. But no matter what happens over the next few months, it’s imperative that the bill’s intention and integrity be fair and just, and does not discriminate against any one American—sick or in perfect health—by prohibiting them from purchasing and securing meaningful coverage.

John Meigs, Jr., MD, FAAFP, is president of the American Academy of Family Physicians and a family physician in Centreville, Ala.

The views expressed by this author are their own and are not the views of The Hill.