A Health Care Bill By Trump, For Trump

Photos from the White House party celebrating passage of the health care repeal bill in the House paint a clear picture of what support for this legislation looks like. Mainly, it comes from wealthy men inside the Washington beltway who are deeply insulated from the realities faced by the majority of Americans.

President Trump and Members of Congress celebrate passage of health care repeal in the House of Representatives

The reason the repeal bill is widely disliked among women, rural Americans, and anyone who doesn’t spend more time golfing than working is fairly straight forward: It will make health care cost more for less coverage and fewer protections. The reason for its support among wealthy Americans can be summed up just as easily: All of the savings go to high-earning individuals and insurance executives.

The GOP health care repeal doesn’t just dismantle health care for millions of Americans, it actively targets programs and protections that the men attending this past Thursday’s TrumpCare celebration will likely never have to rely on.

For women, the impact of TrumpCare will be disastrous. Take for example the fact that under TrumpCare, pregnancy can be labeled as a “pre-existing condition” that allows insurance companies to spike your premiums. While the Affordable Care Act (ACA) prohibited insurance groups from raising rates on women in need of maternity and childbirth care, the repeal bill allows states to opt-out of those protections. The new bill gives insurance companies the go-ahead to price women out of health care coverage when they need it most.

But pregnancy is only one of the pre-existing conditions that insurance companies may use under TrumpCare to charge women more. Lupus, depression, eating disorders, and other conditions that affect more women than men are also on the list.

To make things worse, the GOP health care repeal eliminates essential benefits requirements, allowing insurance companies to provide plans that fail to cover health care options women need. Under the ACA, insurance companies were required to cover essential services like maternity care, mammograms, and pediatric services. But if TrumpCare is signed into law, plans may drop coverage for these critical services, in addition to those as necessary as hospitalization, pediatric care, and prescription drugs.

Based on TrumpCare’s complete failure to address women’s health needs, it should not come as a surprise that only 13 percent of women support the proposed health care repeal.

For rural Americans, TrumpCare will mean more hospital closures and the loss of local health services. Already, our rural areas face a health crisis due to the increasing cost of uncompensated care for low-income, rural Americans. In Alabama, the crisis has had visible impact on communities statewide, with ten hospitals closing over the past six years. As a matter of fact, almost 80 percent of rural hospital closures since 2010 have happened in states that didn’t expand Medicaid under the ACA.

I believe our current health care debate is a chance to address the shrinking availability of rural care, but TrumpCare squanders that opportunity and does just the opposite. In fact, estimates suggest that the Republican repeal legislation would increase the cost of uncompensated care for Alabama hospitals by a whopping $97 million dollars. That could force the remaining rural hospitals in my state to close their doors for good.

As a woman and as an African American born and raised in rural Alabama, I know first-hand the challenges my constituents face in the health care market.

Take it from Will Ferniany, CEO of the University of Alabama at Birmingham (UAB) health system, which runs the largest hospital in my state. “The AHCA will hurt Alabama hospitals,” Ferniany wrote about the GOP health care repeal. “Bad debt will increase from more uninsured, and future Medicaid funding will be reduced.”

Numbers from the Kaiser Family Foundation tell a similar story. According to their analysis, my constituents in Jefferson County will face premiums more than $1,400 higher on average than they did under the ACA. In the end, these high costs will translate into more uninsured Alabamians and more uncompensated care for Alabama’s health providers.

In exchange for eliminating and rationing care for women, rural Americans, and families in need, the GOP health care repeal bill funds a massive tax cut for the wealthiest households. The bill eliminates a Medicaid surtax on income above $200,000 per year, a threshold which less than one percent of my constituents meet. The legislation also immediately repeals a 3.8 percent investment income tax, which generally applies to the highest income households in the country.

In my congressional district, the median income for a family of four is $34,000, a demographic that won’t see any relief under TrumpCare. Instead, Republicans have crafted legislation that benefits people like President Trump and his friends.

As a woman and as an African American born and raised in rural Alabama, I know first-hand the challenges my constituents face in the health care market. I know that their wellbeing and their access to health care isn’t a cost we can decide to cut, but a right that we have an obligation to protect.

No one deserves to pay more for health because of their gender or because of where they live. No family should have to decide whether pediatric care or maternity care is in the budget. I have always said that the Affordable Care Act is not a perfect bill, and I remain committed to lowering costs and strengthening coverage for all Americans. But TrumpCare takes our health care system in the opposite direction.

For America’s women, our rural communities, low-income families, and the hundreds of millions of Americans who don’t fall into the same tax bracket as President Trump, we have to do better. The health of our country depends on it.

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