Americans’ Top Four Healthcare Asks: Does the AHCA Deliver?

With contributions from Prabha Kannan, Bethany Klaene, and Mallory Salerno.

In the past month, C Space talked to dozens of American citizens across party lines and discovered that regardless of political beliefs, American share the same “Big Four” hopes for the future of healthcare. On March 6, the Republicans released their replacement for the Affordable Care Act, presenting a different view for the way forward with healthcare.

Did Republicans listen to what Americans asked for when it comes to healthcare? Does the American Health Care Act deliver on the “Big Four” of what Americans want? Let’s take a look.

  1. Don’t deny coverage for those with pre-existing conditions
    • “I feel parts of Obamacare are good – not being able to deny pre-existing conditions primarily.” –Somewhat conservative, 48
    • YES, BUT – Pre-existing conditions are covered…unless you go more than two months without health insurance.
  2. Don’t issue a fine/penalty if someone doesn’t get health insurance.
    • “Do not tax Americans with a penalty if they couldn’t get coverage. It should be their choice whether or not to get coverage and using gross income as how much a person can pay is totally unfair.” –Somewhat liberal, 34
    • YES, BUT –There is no direct fine or penalty for not having health insurance – but there is a 30% surcharge on premiums if you go more than 63 days without health insurance.
  3. Keep premiums and drug costs affordably low for all.
    • “[We need] Something more up to standards, something actually affordable, not just premiums but all out of pocket expenses.” –Somewhat conservative, 30
    • YES AND NO. The AHCA eliminates the need to provide standard plans and the ability to offer “skinnier,” less benefit-rich plans that will be less expensive for younger, healthier people. But it also allows insurance plans to charge their oldest enrollees up to five times as much as younger enrollees (up from 3x under the current law). Tax credits replace subsidies, on a sliding scale that increases with age, but do not replace the current subsidy value.
  4. Any replacement plan should be available immediately, without a lapse in coverage.
    • “There needs to be a solution on day 1 after it is repealed. This is coming from someone that hates Obamacare. The worst thing that can happen is if you repeal and don’t replace. The damage has already been done to most Americans and there is no going back. The best you can do is try to ease the burden that has been dumped on the majority of Americans.” –Somewhat conservative, 34
    • TO BE DETERMINED. The Republicans hope for approval by mid-April, 2017 – but time will tell. Conservative Republicans, House Democrats, and interest groups such as the AARP are already taking stands against the AHCA – a detailed debate lies ahead.

There’s so much more to it, but these are the “Big Four” we heard when it comes to Americans and healthcare. There are fewer than 35 weeks until 2018 open enrollment. Overhauling our healthcare system is not an easy task and there will be many tradeoffs and concessions along the way. By listening to consumers – citizens – together we can share the burden and create something sustainable: a system that delivers on American’s expectations, while reducing unnecessary pain points and restrictions for companies that operate in this space.

C Space will continue talking to consumers in the coming months to deeply understand how their feelings and perceptions of the changing healthcare landscape are evolving. Check back to see what they have to say.

All data for this piece from C Space sponsored research conducted in C Space’s HATCH community from January 20-30, 2017.

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