The AHCA Is Delivering Something Other Than Healthcare
Written by Jim Davidson
On May 4, the House voted 217 to 213 in favor of the American Health Care Act (AHCA) which will “repeal and replace Obamacare.” The Senate is currently drafting an alternate bill to replace the Affordable Care Act (ACA).
The House bill has many moving parts but key are eliminations of taxes and penalties, the replacement of income-based subsidies with age-based tax credits, and significant reductions to funding of Medicaid. It also provides options for states to seek waivers of coverage and pre- existing condition mandates. The Congressional Budget Office (CBO) estimates the net effect will be an additional 23m Americans without insurance and that the deficit will be reduced a cumulative $119B over the next 10 years.
Is the AHCA good or bad for business?
This AHCA is bad for Americans and bad for American businesses. Like the ACA it seeks to replace, it does little to address the underlying causes of extraordinarily high total healthcare spend in the United States, now near 18% of GDP. In fact, the CBO’s projected $119B savings may sound significant, but compared to the almost $40T total which we will spend (public and private) over the next 10 years, this number is only about 1/3rd of 1% of the total, i.e., almost $0 when considered in context.
So, if the AHCA will nearly double the ranks of the uninsured while simultaneously delivering negligible savings, what’s the debate all about? Critics will reasonably point out it’s really about transferring burden from the wealthy back to poor. However, that criticism, while justifiable, is perhaps a bit too cynical and ultimately lacks an understanding of what truly drives supporters of the AHCA.
The AHCA seeks to provide more personal choice and individual responsibility. A key objective is to eliminate the personal mandate, allowing an individual to choose to go without insurance, without the burden of the ACA’s tax penalty. And, the bill heavily relies on the expected benefit of the “free market” to drive competition up, and prices down, through individuals doing their homework and utilizing high-deductible plans. These aspects are highly consistent and aligned with conservative values.
Thus, the key to understanding the motives of the supporters of the AHCA is to realize the bill is not providing health care at all. Instead, it is providing “liberty”, or rather a narrow form of economic freedom. Such freedom is at the core of the values of many Americans, steeped in the “Life, Liberty, and the Pursuit of Happiness” narrative which underlies our collective consciousness.
Unfortunately, what the supporters of the AHCA legislation do not realize is that increasingly Americans have a far richer definition of “freedom”. Beyond narrow economic freedoms, modern Americans understand that true freedom is, as Nobel Prize winning economist Amartya Sen would say: “The freedom to live lives they have reason to value”. This conception of freedom includes providing people true educational opportunity, secure retirement, and comprehensive health.
What is Medicare For All?
Health in this context includes not only the absence of sickness, but also the freedom from the possibility of financial hardship, be it the sudden liability to cover a $10k deductible due to a single-family car accident or freedom from bankruptcy in the case of an unfortunate chronic condition. This freedom also includes the peace of mind of knowing your fellow citizens are also unburdened by these eventualities, our seniors are taken care of with dignity, and our children are fully inoculated and able to afford the life savings medicines they need. These are the sorts of freedoms our developed nation peers enjoy with their comprehensive, publicly funded single- payer health care systems. True healthcare reform would provide these freedoms to Americans. HR676, the “Medicare For All” act would be such a reform.
A Medicare-for-All system would expand healthcare coverage to all Americans and reduce costs for individuals and businesses. It would also remove the administrative burden associated with providing healthcare as an employee benefit. This would provide real freedoms to individuals by allowing them to select any doctor or hospital and to employers by reducing the time and costs associated with these benefits.
Business leaders can take action on healthcare reform today. If you’re interested in learning more about the business benefits of Medicare-for-All, add your voice to the movement of business leaders calling for real freedom on healthcare by joining Business Leaders Transforming Healthcare, an initiative led by the American Sustainable Business Council.