Why the American Health Care Act is Doomed to Fail

Recently the House passed the American Health Care Act (AHCA) in an attempt to “repeal and replace” the Affordable Care Act (ACA). While most people feel the ACA is fatally flawed, there is great debate about what is needed to fix the healthcare system and many believe the GOP’s proposal falls far short of any true repair. In fact, in a survey released by CNN today (May 31, 2017), only 8% of those surveyed believe the Senate should pass the bill as is.

What changes is the ACHA bringing to the healthcare system?

  • Age, as opposed to other factors such as income, geography, and smoking status, will play more of a role in determining how much an individual will pay for a premium.
  • In 2020, federal funds into the state Medicaid programs will be capped on a per-enrollee basis.
  • After 2019, cost-sharing reductions for low income patients with certain insurances will be eliminated.
  • After 2018, federal funding will be eliminated for the Prevention and Public Health Fund.
  • Funding for community health centers will be increased.

The entire extensive list of changes can be found here: https://www.congress.gov/bill/115th-congress/house-bill/1628.

When the ACA was passed, one of its major goals was to get every American covered with health insurance. While more Americans were covered than ever before, healthcare was still unaffordable to many due to rapidly rising premiums and high deductibles. The changes proposed under the AHCA do little to address this and in fact, some experts predict that 23 million people will lose their insurance if the AHCA is passed.

Medical Bankruptcies Are a U.S. Phenomenon

In the U.S., healthcare costs represent the biggest expenditure in our economy. We are the only country in the world in which patients file bankruptcy due to medical expenses. In fact, many people who file medical bankruptcy are in fact covered with health insurance at the time their medical expenses were incurred.

While the Senate, and general public, debates the AHCA, we are still being faced with a dysfunctional healthcare system in which many patients cannot afford to purchase the medications they need. Other patients self-ration their own care due to the high deductibles. Yes, uninsured patients tax the system financially, but is insurance with a plan that doesn’t cover much truly helping? It seems like the run-away costs of healthcare were rather pushed onto the American people to pay rather than examining where the flaws lie.

Examining the AHCA, it seems like the undertaking is mere political posturing. Federal dollars are being reallocated. Whether you are Democrat or Republican, you are not going to devise a bill that fixes what is wrong with the U.S. healthcare system unless you uproot the causes of the dysfunction. And while the politicians try to one-up each other in the healthcare system poker game, real patients are suffering and dying. Our leaders, across the aisle, are failing us and the system continues to fissure. Politicians can debate the AHCA all day long, but they are on the wrong road to real reform.

  • Linda Girgis, MD, FAAFP

    Linda Girgis, MD, FAAFP, is Owner of Girgis Family Medicine LLC. Currently affiliated with St. Peter’s University Hospital and Raritan Bay Hospital, Linda also writes for Sermo, Physician’s Weekly, the Library of Medicine, and others.


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