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The GOP health bill is dead, but rising health care costs are still a huge problem

The GOP health bill is dead, but rising health care costs are still a huge problem

Picture of Mario Molina
File photo

The Affordable Care Act (ACA), also known as Obamacare, is far from perfect. Even so, it succeeded in halving the uninsured rate in California. In addition to providing access to care for millions of our state’s residents, increasing the number of individuals with insurance has far-reaching benefits for the state’s economy overall. The American Health Care Act (AHCA), which failed to win over enough Republican Congressmembers to pass the House last week, would have been a huge step back for our health care system and would have set off a ripple effect of negative impacts throughout California and the entire country if it had passed.

However, even though the bill was pulled, this does not mean that a plan to repeal and replace the ACA is dead. Nor does it mean that the issues simply dissipate. We still need to implement significant changes to stabilize the market in order for millions of Americans to continue  accessing affordable health care.

The AHCA would have simply shifted the financial burden from the federal government to the states. More than half of Medicaid beneficiaries are low-income children and a quarter of beneficiaries are aged, blind and disabled. These two populations account for 85 percent of the program’s expenditures, with the aged, blind and disabled accounting for the lion’s share of this spending. Industry experts agree that Medicaid is the most effective way to provide health coverage for low-income Americans, which makes the ongoing GOP effort to cut funding and roll back the Medicaid expansion quite troubling. Furthermore, the Republican plan called for switching the Medicaid payment system to per capita funding caps, which leaves states vulnerable with insufficient resources to deal with various contingencies, such as a health epidemic like Zika.

The problem isn’t limited to Medicaid. The latest GOP proposal would have abolished the individual mandate, which would have had a devastating effect on the individual marketplace as well. Without the mandate, a high percentage of young, healthy people would opt not to buy insurance, which in turn would damage the risk pools and drive up premiums. And even if premiums didn’t go up dramatically, the less generous tax credits replacing the subsidies would have made coverage out of reach for many consumers.

Take this example: The average Molina customer on Covered California is 41 years old and makes about $20,000 a year. Under the AHCA, he would have received a $3,000 tax credit, based on his age to help pay for a silver plan that costs $4,300 a year. That means the customer has to come up with almost $110 a month compared to about $20 a month owed under the ACA. For someone making $20,000 a year, that may not be affordable.

As a physician and CEO of Molina Healthcare, I have seen firsthand what happens when people do not have health insurance. The uninsured go to emergency rooms to get care. Emergency rooms become overcrowded. Hospitals’ rates of uncompensated care skyrocket. Smaller rural hospitals close, meaning many people will have to travel farther for care. And the hospitals that are able to stay in business pass along that cost to insurers, who pass along that cost to consumers in the form of increased premiums.

Our health care system remains in a crisis. Both the AHCA and the ACA only address the funding of health care and fail to tackle the troubling rate at which health care costs are rising. Rather than passing the burden back and forth between state and federal governments, we should be looking to control the high cost of drugs, integrate care for the chronically sick and use managed care to ensure access and control costs. If the goal is to insure more people and improve health outcomes, the debate we need to have moving forward should be about how to controlcosts. And that is not a partisan issue — it is common sense.

Lastly, rising costs are not just an issue for legislators or those who are currently eligible for government health care. This will have a negative impact on state budgets and programs, taxpayers, those who are covered by private health insurance and more. That is why people need to become interested, knowledgeable and then involved. How can we each make an impact? Call your senators and congressmen and let them hear your thoughts. This problem belongs to all of us — many people just may not realize it yet. 

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[Photo by David Goehring via Flickr.]

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