NPR examines the differences between the Affordable Care Act and the American Health Care Act in terms of insurance markets, individual mandate, guaranteed coverage and insurance subsidies.
KELLY MCEVERS, HOST:
Health care, repeal and replace, ACA, AHCA – what does it all mean and how does it affect you? We’re going to spend some time talking about that, about what’s still the law of the land — and that’s the Affordable Care Act — and how that compares to what House Republicans passed yesterday. . Here’s how House Speaker Paul Ryan describes US health care law.
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PAUL RYAN: It makes health care more affordable. He takes care of our most vulnerable. And that transfers power back from Washington to the states and, more importantly, to you, the patient.
MCEVERS: And let’s be clear. This bill does not yet have the force of law. He still has to go through the Senate where he is likely to change a bit. But people still have a lot of questions. And we’re going to hear from people across the country in a few minutes. But first, let’s discuss the differences between the Affordable Care Act and the American Health Care Act with Alison Kodjak. She covers health for NPR’s science office. Salvation.
ALISON KODJAK, BYLINE: Hello, Kelly.
MCEVERS: Let’s talk about the content of this bill first.
KODJAK: The main point of difference is that under the Affordable Care Act or Obamacare, everyone is required to have insurance or else they have to pay a penalty. Obamacare also offers quite generous grants to help low-income people pay their premiums and also reduce some of their costs like deductibles.
In the Republican bill, there is no such requirement. People don’t need to have insurance. If they don’t have insurance and want to buy it back later, they will have to pay a penalty. But they don’t need to have insurance every year. And there are smaller grants to help pay for insurance for most people.
MCEVERS: So smaller grants – doesn’t that mean fewer people will buy?
KODJAK: Well, the Republicans are saying their bill lowers the premiums, it will cost less, so more people can get insurance. That’s partly because they let insurance companies charge people five times more if they’re older than younger. Thus, prices for younger and healthy people may drop.
MCEVERS: What about the quality? I mean we hear from people who are concerned that their insurance just isn’t as good.
KOJAK: Yes. It’s been a big deal, and it’s been the subject of a lot of debate here in Washington. Under Obamacare, there are many protections for consumers. Insurance companies have to cover a lot of things including mental health, prescription drugs, maternity care. And it is necessary to cover people with pre-existing conditions at no additional cost. And there are no lifetime limits on coverage, no annual limits.
Under the new bill, states are allowed to opt out of most of these protections. So if you live in a state that has these waivers and you get sick, you may end up in what’s called a high-risk pool, a separate insurance plan for people with illnesses that cost a lot of money. expensive to cover.
MCEVERS: And what about the poor? I mean, this new bill includes cuts to Medicaid, the program that benefits the poor. Is it correct?
KOJAK: Yes. And that’s also a big change. Under Obamacare, Medicaid was extended to people slightly above the poverty line. This bill reverses most of that expansion and also cuts Medicaid spending by nearly $800 billion over 10 years. So there could be a lot of changes in what is covered by Medicaid if this bill becomes law.
MCEVERS: NPR’s Alison Kodjak, thank you very much.
KODJAK: Thank you, Kelly.
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