To the editor:

Healthcare is expensive, and as a society we are struggling with how to keep the largest number of people healthy with the least amount of money. Since 2010, the Affordable Care Act (ACA) has been our nation’s attempt to address both of these issues. It imposed taxes on pharmaceutical, medical device, and health insurance companies to fund health insurance subsidies. It also created a market for people to buy their own insurance if they do not get it from an employer. The ACA has seen both successes and failures: 13 million more people have health insurance under the law, mostly those with lower incomes. However, insurance premiums for people on the individual market have been rising, and some health insurers have left the individual market.

Republicans in the U.S. House of Representatives have recently introduced a bill to replace the ACA, called the American Health Care Act. The full text of this bill is available at Readthebill.gop. Some provisions of Obamacare are kept: children can stay on their parents’ plan until age 26, and coverage for preexisting conditions is maintained. However, there are some significant differences. People are not required to purchase health insurance. The ACA taxes used to pay for health insurance subsidies are eliminated. The Republican bill provides subsidies, but they are based only on age and not income.

This bill has real consequences. An analysis by the Kaiser Family Foundation estimates that, for example, a 60-year-old in Brown County, MN, making $50,000 per year will see $7570 less in support per year via tax credits under the new bill than under the ACA, while a 60-year-old making $100,000 per year will get $1,500 more. To put that into context, slightly less than half of workers in Brown County make less than $50,000 per year, and 16 percent make more than $100,000. In addition, the new bill allows insurance companies to charge our older citizens five times more than our younger ones, compared to three times more under the ACA.

Medicaid (called Medical Assistance in Minnesota) was also expanded in many states, including Minnesota, under Obamacare. Medicaid distributes federal money to states, which then use that money to provide healthcare to our poorest people, especially children, pregnant women, and the elderly. The new healthcare bill would eliminate this expansion and fundamentally change the way Medicare provides aid. It would base the amount of aid on the number of people enrolled, not on the cost of care. The Kaiser Family Foundation estimates this could cause almost 1000 people to lose Medical Assistance in Brown County alone, unless Minnesota finds a way to make up the difference.

Unfortunately, the number of people with health insurance will decrease under the GOP proposal. For this reason, the American Medical Association, the American Hospital Association, the American Nurses Association and the AARP oppose the plan. Those who support the bill argue that it will lower health insurance costs by increasing competition. I encourage you to inform yourself about this plan and decide whether it is in your, and your neighbors’, best interests. In addition to the link to the bill text above, much of the information here is drawn from the Kaiser Family Foundation at kkf.org/health-reform.

Nate Groebner, MD

New Ulm