The American Health Care Act will affect you, even if you're insured through your employer

Republicans may be eliminating a provision that prevents terrible insurance plans from being inflicted on everyone

By Matthew Rozsa

Staff Writer

Published May 4, 2017 1:42PM (EDT)

Paul Ryan   (AP/J. Scott Applewhite)
Paul Ryan (AP/J. Scott Applewhite)

Trumpcare 2.0 is the latest terrible bill being pushed by President Donald Trump and the House Republican Party as their substitute for the Affordable Care Act (known as Obamacare), and a new report illustrates just how bad the bill might really be.

There is a provision in the current Republican bill that would permit insurers in states that waive specific regulations from the Affordable Care Act to not cover the 10 essential health benefits established under that act, according to a report by The Wall Street Journal. The Affordable Care Act prohibits employers from either limiting the amount of care they'll cover each year or limiting how much of the 10 essential benefits they'll provide over the course of a lifetime.

Because President Barack Obama allowed employers, however, to use another state's policies regarding essential benefits if they disliked those from their own state (an inconsequential matter as long as those benefits were nationally standardized), the new bill would let large corporations select essential benefit requirements from states that waive certain regulations.

In short: Even if you live in a state where all 10 essential health benefits are supposed to be covered, your employer could apply the standards from a state that limits lifetime coverage of essential benefits and permits skyrocketing out-of-pocket costs.

Health care policy experts interviewed by the Journal were split as to whether large employers would actually act on this. Larry Levitt, a senior vice president at the Kaiser Family Foundation, said, "The real question is, would employers do this? Many wouldn’t. Many employers offer quality benefits to attract employees. But employers are always looking for ways to lower costs."

By contrast, Andy Slavitt — who worked as acting administrator of the Centers for Medicare and Medicaid Services when Barack Obama was president — described the provision as "a backdoor way to gut employer plans, too."

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By Matthew Rozsa

Matthew Rozsa is a staff writer at Salon. He received a Master's Degree in History from Rutgers-Newark in 2012 and was awarded a science journalism fellowship from the Metcalf Institute in 2022.

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