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Last week, on the seventh anniversary of the Affordable Care Act (ACA), leaders in the U.S. House of Representatives planned to hold a vote on legislation to repeal the ACA and affect the health care of tens of millions of Americans. Called the American Health Care Act (AHCA), the proposed law would have erased health coverage for 24 million people, according to Congressional Budget Office (CBO) estimates.
Low-income Americans ages 50 to 64 would have been among the hardest hit by changes in the AHCA. The law would have ended the expansion of Medicaid, allowed insurers to charge older enrollees even higher premiums, and provided less generous assistance to help people in the Marketplaces afford premiums and cost-sharing. It would have also made fundamental changes to Medicaid—cutting federal payments to the program through what is known as a per-capita cap. These cuts would have significantly harmed millions of older adults and people with disabilities who rely on both Medicare and Medicaid to cover vital long-term home health care and nursing home services, to help afford their Medicare costs, and more.
The stability of the Medicare program would have also been considerably impacted by the AHCA. CBO estimated that the law would have increased Medicare spending by $43 billion over ten years. The AHCA also would have eliminated an ACA provision that places a small additional Medicare payroll tax on the highest earners. According to the Kaiser Family Foundation and the Center on Budget and Policy Priorities, the elimination of this tax would have cut federal revenues by $117 billion between 2017 and 2016, placing a strain on the Medicare Part A trust fund, which is financed primarily through the payroll tax.
Ultimately, because of the hard work of concerned citizens across the country, the legislation was pulled and a vote never took place. Proposals like the AHCA undercut our core mission and violate our driving principles—to ensure older adults and people with disabilities are assured access to affordable, high-quality health care. The debate over health care is far from over, and the Medicare Rights Center and health advocates everywhere will be vigilant about future proposals coming out of Washington D.C.
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