In early May, the American Health Care Act (ACHA) made its way out of the U.S. House of Representatives by a very tight vote. The bill, now under consideration by the Senate, made it through thanks to two critical amendments that garnered the support of key California Republicans.
The Congressional Budget Office (CBO) has now confirmed what we long knew: The amendments made a bad bill worse, not better. There was, indeed, no valid excuse for supporting the AHCA.
This bill is troubling. If passed, the CBO estimates 23 million people would lose health insurance by 2026, with low-income and elderly Americans hit the hardest. Insurance companies could charge more to persons with pre-existing conditions, and states could cut vital health benefits.
The latest CBO analysis further confirms that the AHCA would put millions in jeopardy, and that the amendments introduced by Rep. Tom MacArthur, R-N.J., and Rep. Fred Upton, R-Mich., championed by Republican House members as the reason they supported the bill, did little to change its projected devastating impact.
Here in Los Angeles County, we’ve spoken regularly with Rep. Steve Knight, R-Santa Clarita, our area’s only Republican representative, on the impact of the Affordable Care Act (ACA) on his district, and the potential effects of replacing the ACA with the proposed AHCA.
More than 80,000 people in Knight’s district currently benefit from the ACA, with close to 21,000 enrolled in Covered California and almost 60,000 adults newly covered as part of the Medi-Cal expansion. These people could all lose coverage under the AHCA.
The ACA’s massive expansions in coverage allowed community providers to dramatically expand access to care.
The Antelope Valley Community Clinic, for example, opened in 2010, the year the ACA was passed. In just five years, the clinic went from providing 12,000 patient visits and 25 employees to 100,000 visits and 235 employees. Thanks to the ACA, the clinic expanded its facilities and became a one-stop shop for physical, mental and oral health needs for the underserved in the High Desert.
Antelope Valley residents can finally access comprehensive preventive services that keep them healthy and productive in society. If patients lose coverage under the AHCA, the clinic would be forced to choose between scaling back services or laying off staff. This would cost taxpayers more in the long run, as the newly uninsured would delay care and rely on the emergency room when they experience an avoidable health emergency.
In addition to the impact on the clinics, the broader community would suffer under a repeal of the ACA. Health care is a major employment sector in Los Angeles, and health care comprises the bulk of our middle-skill job growth.
Congressman Knight has been very responsive to the clinics, hospitals, health plans and community partners in the district. Yet he ultimately supported the AHCA. He believed the Upton and MacArthur amendments would mitigate the impact of the bill on those with preexisting conditions.
Unfortunately, the CBO has debunked that myth, and it’s time for our legislators to look at the real impact of the bill.
There is no denying that these cuts are a serious attack on our nation’s healthcare system and will have a devastating impact on the most vulnerable among us, including children, women, seniors, people with disabilities, and low-middle class families.
As the Senate produces its version of the bill, in light of the analysis by the CBO it’s our hope that Knight and other House Republicans will reconsider their support for any bill that reduces coverage, disadvantages the sick, and leaves their communities worse off.
Louise McCarthy is president and CEO of the Community Clinic Association of Los Angeles County. James A. Cook is CEO and founder of the Antelope Valley Community Clinic. This column originally appeared in the Los Angeles Daily News.