Weekly Column

The greatest problem facing our health care system is the ever growing cost of care. More and more Americans are unable to afford their health insurance premiums, leaving them with the choice of buying something they can’t afford or paying a penalty.  Premiums in Ohio have increased over 91% while deductibles are so high that even people who can afford health insurance can’t get quality care. How can going from $2,650 in 2013 to $5,065 in 2017 be an affordable choice for Ohioans? Sadly, those who can afford these skyrocketing premiums are left with lower quality care and patient outcomes. Nearly a third of insurers operating in Ohio’s exchanges exited in 2017, leaving 20 counties with only one insurer, creating monopolies rather than the competition our health care system needs.

The Affordable Care Act (Obamacare) attempted but failed to effectively address this major concern. Obamacare was unsustainable because it partly shifted to young customers the burden of subsidizing those who joined the pool already sick. The House solution, if adopted in the Senate, would go a long way toward letting individual premiums be fairly and attractively priced to these people.

From phone calls, meetings and letters I have heard two pieces of misinformation regarding the health care bill: One, that preexisting conditions are not covered in this legislation and two, that 24 million people will be left without coverage.

First, the American Healthcare Act (AHCA) preserves many important protections for patients and families. These include allowing young adults to remain on their parents’ insurance plan until age 26 and prohibiting insurers from denying coverage to individuals with pre-existing conditions. Pre-existing conditions are an understandably emotional issue, and families are scared of losing their plan and facing financial catastrophe. Most people with a pre-existing condition will not see any changes under the AHCA.

An individual with a pre-existing condition can only be charged more for their healthcare in the rare circumstance in which they live in a state that obtained a limited waiver from some of Obamacare’s mandates, purchase insurance in the individual market, and let their coverage lapse for more than 63 days after exiting an insurance plan. Even then, such a person can only be charged more for one year, and will have access to the $138 billion Patient and State Stability Fund, which is meant to lower the cost of their coverage. Americans who do not live in a state that obtained a waiver will not experience any change in their coverage, and individuals with employer- or government-provided coverage will not be charged more for their premiums, regardless of whether or not they maintain continuous coverage.

The second claim I’ve often heard is that 24 million people will lose their health care coverage, but these numbers don’t hold any weight under scrutiny. For example, the CBO projected that 11 million people would simply choose to not buy coverage now that they weren’t going to be taxed if they didn’t. Five million of these people do not have Medicaid coverage under the ACA and so they cannot lose it. The CBO also projected three million people would lose access to the employer coverage, similar to a projection it made for the ACA, which never materialized. An additional one million of these people would be helped by the Patient and State Stability Fund, leaving only four million people projected not to be covered. Even then, the CBO cannot take into account additional reforms and regulatory relief enacted by the executive branch.

As a businessman of 30 years who owned and operated various health care facilities, I saw first-hand the negative impact government-run health care has on patient care. I saw costs rise and the quality of care fall. AHCA is to save Americans from the collapsing law of the Affordable Care Act (ACA) that has crippled our families since its enactment. I will continue to move the process forward in helping American families get quality, affordable health insurance.