# What happens to people on ACA if AHCA passes **URL:** \ **Category:** In My Humble Opinion\ **Created:** [March 24, 2017, 2:31pm UTC](https://boards.straightdope.com/t/what-happens-to-people-on-aca-if-ahca-passes/782910 "2017-03-24T14:31:11Z")\ **Posts on this page:** 11\ **Page:** 1
**Author:** ![enipla](https://avatars.discourse-cdn.com/v4/letter/e/54ee81/32.png) [@enipla](https://boards.straightdope.com/u/enipla)\ **Post date:** [March 24, 2017, 2:31pm UTC](https://boards.straightdope.com/t/what-happens-to-people-on-aca-if-ahca-passes/782910/1 "2017-03-24T14:31:11Z")
Not sure if this is GQ or IMHO. But, I’m confused. What will happen to people insured by ACA if AHCA passes? Do they all just loose their insurance and have to sign up for AHCA? ---
**Author:** ![Happy\_Lendervedder](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/happy_lendervedder/32/8488_2.png) [@Happy\_Lendervedder](https://boards.straightdope.com/u/Happy_Lendervedder)\ **Post date:** [March 24, 2017, 2:56pm UTC](https://boards.straightdope.com/t/what-happens-to-people-on-aca-if-ahca-passes/782910/2 "2017-03-24T14:56:23Z")
I’m not sure of the specifics in the bill (is anyone really?), but I think it would probably kick in once this year was over. People that bought plans on the Marketplace will keep them until the time comes they need to re-enroll. ---
**Author:** ![dolphinboy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dolphinboy/32/330_2.png) [@dolphinboy](https://boards.straightdope.com/u/dolphinboy)\ **Post date:** [March 24, 2017, 3:05pm UTC](https://boards.straightdope.com/t/what-happens-to-people-on-aca-if-ahca-passes/782910/3 "2017-03-24T15:05:10Z")
> [@Happy\_Lendervedder](#): > > I’m not sure of the specifics in the bill (is anyone really?), but I think it would probably kick in once this year was over. People that bought plans on the Marketplace will keep them until the time comes they need to re-enroll. That’s my understanding as of now. ---
**Author:** ![enipla](https://avatars.discourse-cdn.com/v4/letter/e/54ee81/32.png) [@enipla](https://boards.straightdope.com/u/enipla)\ **Post date:** [March 24, 2017, 3:21pm UTC](https://boards.straightdope.com/t/what-happens-to-people-on-aca-if-ahca-passes/782910/4 "2017-03-24T15:21:21Z")
And pre-existing conditions aren’t included in AHCA. Right? So millions will be further screwed. ---
**Author:** ![slash2k](https://avatars.discourse-cdn.com/v4/letter/s/439d5e/32.png) [@slash2k](https://boards.straightdope.com/u/slash2k)\ **Post date:** [March 24, 2017, 3:33pm UTC](https://boards.straightdope.com/t/what-happens-to-people-on-aca-if-ahca-passes/782910/5 "2017-03-24T15:33:13Z")
> [@enipla](#): > > And pre-existing conditions aren’t included in AHCA. Right? So millions will be further screwed. At least as of 3/20, the AHCA retained the prohibition on pre-existing conditions exclusion (see Kaiser Family Foundation for a [side-by-side comparison](http://kff.org/interactive/proposals-to-replace-the-affordable-care-act/)). However, it is by no means clear that in the absence of the individual mandate, very many insurers are going to want to offer coverage under those conditions, so you may still be screwed by market failure. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [March 24, 2017, 3:42pm UTC](https://boards.straightdope.com/t/what-happens-to-people-on-aca-if-ahca-passes/782910/6 "2017-03-24T15:42:39Z")
In reality, the AHCA is not a repeal of the ACA. It is just a series of tweaks to the existing law. It can only mess with funding issues like taxes, expenditures and subsidies. Changes to things like the required benefits may pass the house but in the senate they will get removed (or the bill must be passed by 60 votes). As **slash2k** , the mess with the ACA enough to force it to fail - which would probably mean no one will offer to sell insurance to individuals. ---
**Author:** ![Happy\_Lendervedder](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/happy_lendervedder/32/8488_2.png) [@Happy\_Lendervedder](https://boards.straightdope.com/u/Happy_Lendervedder)\ **Post date:** [March 24, 2017, 3:49pm UTC](https://boards.straightdope.com/t/what-happens-to-people-on-aca-if-ahca-passes/782910/7 "2017-03-24T15:49:20Z")
> [@enipla](#): > > And pre-existing conditions aren’t included in AHCA. Right? So millions will be further screwed. [Yes.](http://www.npr.org/sections/health-shots/2017/03/23/521220359/gop-health-bill-changes-could-kill-protections-for-people-with-preexisting-condi) > [@](#): > > When House Speaker Paul Ryan says he wants to repeal the Affordable Care Act so that people can buy insurance that’s right for them, and not something created in Washington, part of what he’s saying is that he wants to get rid of so-called essential health benefits. > > That’s a list of 10 general categories of medical care that all insurance policies are required to cover under the Affordable Care Act. > > Getting rid of that requirement, or trimming it, is central to the Republican strategy, because they say those benefits drive up insurance premiums so much that healthy people won’t buy coverage. > > But if Republicans repeal that list, they essentially renege on a promise they’ve repeated over and over to voters, that they will protect people with pre-existing medical conditions. > > “Protections for pre-existing conditions only work as long as plans have to cover the services you need because of your pre-existing condition,” says Rodney Whitlock, a vice president at the consulting group ML Strategies who was a Republican staffer on the Senate Finance Committee when the Affordable Care Act was passed. “By repealing [essential health benefits], a plan may no longer have to cover those services, making the protection potentially meaningless.” > > That’s because if insurance companies don’t have a list of medical services they have to include in their policies, they can sell stripped-down policies and then charge extra for specific types of coverage. > > This isn’t theoretical. ---
**Author:** ![SamuelA](https://avatars.discourse-cdn.com/v4/letter/s/c77e96/32.png) [@SamuelA](https://boards.straightdope.com/u/SamuelA)\ **Post date:** [March 24, 2017, 3:53pm UTC](https://boards.straightdope.com/t/what-happens-to-people-on-aca-if-ahca-passes/782910/8 "2017-03-24T15:53:37Z")
So the straight dope is, the ACA repeal would technically still require plans to cover pre-existing conditions. But you can have plans on the marketplace that don’t actually cover the 10 essential health services. I’m not even sure which ones on that critical list you can do without. Every single one listed can bankrupt you under the right circumstances and you won’t know if you need it until you do. A couple of them you can dispense with if you don’t have kids, but you’d only be subscribing to them if you buy an ACA plan for your kids, so you weren’t paying for them anyways. There’s the mental health treatment portion, but how much does that really save you…(and what happens if you do have a breakdown - you get sent to jail instead?) But if no plan on the marketplace in your state actually offers anything on the list at a price you can afford, essentially you don’t have coverage. ---
**Author:** ![Colibri](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/colibri/32/1841_2.png) [@Colibri](https://boards.straightdope.com/u/Colibri)\ **Post date:** [March 24, 2017, 4:18pm UTC](https://boards.straightdope.com/t/what-happens-to-people-on-aca-if-ahca-passes/782910/9 "2017-03-24T16:18:43Z")
> [@enipla](#): > > Not sure if this is GQ or IMHO. > [@enipla](#): > > So millions will be further screwed. [Moderating] It’s IMHO if you want to be able to state your opinions about it. Off to IMHO. Colibri General Questions Moderator ---
**Author:** ![SamuelA](https://avatars.discourse-cdn.com/v4/letter/s/c77e96/32.png) [@SamuelA](https://boards.straightdope.com/u/SamuelA)\ **Post date:** [March 24, 2017, 4:42pm UTC](https://boards.straightdope.com/t/what-happens-to-people-on-aca-if-ahca-passes/782910/10 "2017-03-24T16:42:37Z")
Well, now that opinions are allowed : I’m trying to think of an argument _for_ this repeal. This specific set of changes is really hard to defend. How does it _help anyone_ other than those who benefit from the lower taxes? Well, ok, the ones who benefit are a very small percentage of the population, but we shouldn’t tax them more because they make more than 200k a year? It’s discriminatory to tax em more because they are rich? They earned that money, by going to work in the morning? Except, uh. Well. It’s capital gains taxes, isn’t it? So it’s actually just taxing those who didn’t “go to work” directly, it’s investment gains on money they already have. It’s redistribution of wealth. You’re taking from the rich and giving to the poor (essential medical care so they may continue to live). That’s wrong. Because it’s socialism. And that’s evil because, umm, all those countries in Europe practice socialism and look how they turned out. I mean, they are great places to live, but we can’t do the same thing here because we let in too many black folks\* and hispanics and they will “take” from the system. (I shit you not, that’s the argument I’ve heard from my conservative acquaintances why we can’t just copy the same government policies they use in the nicer European countries. The argument is, Sweden or Norway can have that nice welfare state because it’s a monoculture of hard working white people. Which it mostly is. ) \*by purchasing their ancestors from slave merchants and hauling them over. ---
**Author:** ![SamuelA](https://avatars.discourse-cdn.com/v4/letter/s/c77e96/32.png) [@SamuelA](https://boards.straightdope.com/u/SamuelA)\ **Post date:** [March 24, 2017, 4:51pm UTC](https://boards.straightdope.com/t/what-happens-to-people-on-aca-if-ahca-passes/782910/11 "2017-03-24T16:51:25Z")
Another significant way to look at it is you can think of these changes as deregulation. They are reducing regulations on insurance companies and on individuals to buy insurance. Except, if they do that, it doesn’t mean pricing gets better, because the _supply_ of healthcare is still heavily restricted. The reason the suppliers can charge so much is that demand hugely exceeds supply, and only by negotiating as a block can the entities demanding healthcare force prices lower. And the supply of healthcare is hugely restricted by the government. You can’t practice medicine without a license provided by the government, that demands you have gotten in to a very finite number of slots in medical schools the government is heavily involved in, and then get into a very finite number of slots of residencies that are funded…by the government. You can’t buy a pill unless it was made by an entity authorized and given a monopoly by the government, or it’s a government authorized generic manufacturer, which there are few of, since the government makes it so expensive to get approval to make a generic. You can’t open a new hospital without a shit-ton of permits from the government which cost a fortune. And you then must hire your essential staff from that finite pool of licensed doctors and nurses, which the government has restricted to a trickle. So I’m just saying, if the Republicans really want to fix things, they need to open the floodgates on the supply side. You need to be able to import generics from manufacturers overseas, at least in countries with good regulations like Europe. Doctors licensed in other countries need to be able to just practice here without repeating residency. There needs to be no limit to the funding for residency slots. And so on.