How The New GOP Healthcare Bill Might Affect You The Most

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Despite the decision by Speaker Paul Ryan (or Donald Trump, depending on who you ask) to pull the House GOP health care bill vote in March, Republicans vowed to revisit the controversial legislation. Sure enough, between Trump’s strange intra-party threats and the MacArthur-Meadows Amendment to attract votes from detractors or undecideds, the American Health Care Act returned with a vengeance on Thursday, despite lacking a CBO score.

The vote to officially deliver on seven years’ worth of promises to repeal and replace the Affordable Care Act is scheduled for the early afternoon, and those keeping track of the whip counts believe it may pass and advance to the Senate.

Seeing as how, come Thursday evening, Trumpcare may be one step closer to becoming a reality, how might the convoluted bill’s key provisions affect Americans who currently depend upon Obamacare? Many of the protections included in former President Barack Obama’s key legislative output, be they original inclusions or later updates, are on the chopping block. Some, like the disputed individual mandate requiring all persons to obtain insurance or face a tax penalty, are more fiscal in nature. Others, like protections against higher premiums (or no coverage whatsoever) for those with pre-existing conditions, are more problematic.

If you have a pre-existing condition, you’re screwed

Aside from the individual mandate (and its equivalent for employers), one of the most debated attributes of Obamacare was its sweeping protections for people with pre-existing conditions. Before the ACA’s passage in 2010, insurance companies often charged higher premiums for persons with health issues that were determined to exist prior to the start of coverage. (That, or they didn’t offer coverage at all.) This was especially troublesome for patients undergoing cancer treatment, or receiving care pertaining to other long-term, life-threatening issues. According to Rep. Mo Brooks (R-Alabama), however, this is unfair to “those people who lead good lives,” are “healthy” and have “done the things to keep their bodies healthy” over time.

A late amendment added to the bill would significantly diminish these protections. It won’t, as the New York Times reports, completely do away with them, but will severely limit how persons with pre-existing conditions can gain, or afford, coverage. Per CNN, the most notable aspect of this amendment involves letting states apply for waivers that, if approved, would allow carriers to “set premiums based on enrollees’ medical backgrounds” and “sell plans that don’t include all the essential health benefits.”

And it gets worse. On Thursday morning, an important addendum surfaced that will impact some catastrophic illnesses. Not only will providers be able to charge exponentially higher premiums for anyone with a pre-existing condition, but the bill will allow employers to opt not to fully cover 10 “essential” benefits, including hospitalization, mental health services, maternity care, mental health services, prescription drugs, and pediatric services.

(Except for members of Congress, of course. They’ve already protected themselves from losing the most popular Obamacare benefits.)

You’re even more screwed if you’re a woman

The essential benefits required by Obamacare also include maternity care and pediatric care, both of which affect families and — more directly — women. While supporters stress the amendment’s optional waivers wouldn’t necessarily result in insurers suddenly dropping coverage for expectant mothers and women in general, the bill itself and the administration supporting it have done little to indicate otherwise. Health and Human Services Secretary Tom Price refused to directly answer questions about “gender ratings,” instead saying it was up to the states to determine whether or not insurers could charge women more for health services.

Not to mention survivors of sexual assault, whose immediate and long-lasting injuries were often considered pre-existing conditions, and therefore not covered before Obamacare. As a result of the new rollbacks, providers who obtain waivers could — if they wanted — no longer cover rape victims. In addition, $880 billion in planned cuts to Medicaid by 2020 would also affect expectant mothers, or women with children, who qualify for low-income assistance. Obamacare expanded the program greatly, but the House GOP wants to diminish these advances. And whether intentional or not, women would suffer greatly for it.

Younger and lower-income Americans will also suffer

Even if you fall under Brooks’ nearsighted assessment of “healthy” individuals, and aren’t a woman, Trumpcare will still affect you. Especially if you are young, fall into a lower-income tax bracket, or both. For unlike the ACA, which offers enrollees subsidies in the form of refundable tax credits based on income and coverage costs in their area, the AHCA will base these credits on age. In other words, younger Americans past the age of 26 (the latest they can remain on their parents’ insurance) with low-paying jobs will have to pay a higher premium.

These age-based credits will “range from $2,000 for 20-somethings to $4,000 for those in their early 60s,” with an income cap set at $75,000. Anyone earning that or higher would see lower credits, and persons earning $215,000 or more would no longer be eligible. What’s more, the higher taxes Obamacare imposed on wealthier Americans higher up in the tax bracket — which helped offset insurance costs for lower-income individuals and families — will be completely eviscerated by Trumpcare. That’s around $883 billion in total, which makes up a large chunk of the $1.34 trillion over the next decade estimated by the Congressional Budget Office in 2016.