The American Health Care Act (AHCA) Stinks

Health care was on my Watch List of things likely to get worse with a Trump administration. Yes, he promised the exact opposite, and his supporters may have believed that, but it was a con. Hang on—you’re about to get really screwed. And so are a lot of others. It’s not too late: call your representative in the House and urge that person not to vote to approve it (they are pushing for a vote on Thursday).


The American Health Care Act (AHCA; summarized here) is almost universally despised, left and right, but Paul Ryan wants to ram it through fast and kick the grenade to the Senate. It screws over a phenomenal number of people. The Congressional Budget Office (CBO) estimates that 14 million will lose their health insurance in its first year, and that 24 million will lose it in ten years. That’s sure a lot of sick people likely to die younger. Why? So we can give a huge tax cut to wealthier people: “The current health-care proposal is about rationing care to fund tax cuts for the U.S.’s highest earners.”. So far, not a single Democrat has supported it, and a lot of Republicans recognize it for a train wreck, too.

The American Medical Association (AMA), the American Association of Retired People (AARP), and the American Hospital Association (AHA) all oppose it.  A long list of conservatives and conservative groups also think it’s bad.

Trump voters are going to be especially hard hit by this act if it is passed. In fact, it is positively punitive to Republicans (red states, rural areas, and older people are particularly hard hit). Alaska is likely to be the hardest hit, but the list is long (see where your state falls).

Snap out of it, folks. Contact your representative in the House and let them know your thoughts. And if it passes (on Thursday or whenever they think they’ve strong-armed enough votes), pick up the phone and start talking to your Senators.

Can’t be that bad? I’ve waited to see what’s in the last-minute revisions, and the answer is yeah, it can be and it is. The last-minute revisions have not solved the major problems with the bill, and are mostly trying to make it more palatable to Tea Party conservatives.

Here’s an update from Vox, with a nice passage:

“Republicans have been promising the literal opposite of the bill they are trying to pass. Trump swore he’d oppose Medicaid cuts — but this law has more than $800 billion of them. He said everyone would be covered — but the CBO estimates this bill will push up the ranks of the uninsured by 24 million people. Republicans everywhere said they would replace Obamacare with a plan that ensured more competition, lower premiums and deductibles, and an end to skyrocketing annual increases — but this bill will have the opposite effect for most of those affected.”

Angry yet?

Update 24 March: Thank goodness that bill failed. What a total piece of crap to choose to go to the wall over. Thanks to all who called their representatives to urge them not to support it. Now the finger pointing and blame game has begun, but the problem fundamentally is that it was really bad legislation almost universally disliked. I’d argue that the Republicans are much better off having not passed it, given how bad the outcomes would be for Rs, but that’s not how it’s being interpreted. Decent summaries here and here. Good section from the latter in the NYT:

“In the end, Republican leaders doomed the bill by agreeing to eliminate federal standards for the minimum benefits that must be provided by certain health insurance policies…“This provision is so cartoonishly malicious that I can picture someone twirling their mustache as they drafted it in their secret capitol lair last night,” said Representative Jim McGovern, Democrat of Massachusetts. “This back-room deal will kill the requirement for insurance companies to offer essential health benefits such as emergency services, maternity care, mental health care, substance addiction treatment, pediatric services, prescription drugs and many other basic essential services.””

So not only was the aim to kick 24 million off of health insurance (and give wealthy people large tax cuts), but also to water down the definition of what health insurance actually covers to mean little for actual health. Good riddance, AHCA/Trumpcare. Now let’s hope folks in Congress have the sense to work together to fix the problems (which Rs have knowingly made worse) with the Affordable Care Act.