Indivisible Gainesville: Ted Yoho Fails With His Vote to Dismantle the ACA

TED YOHO FAILS WITH HIS VOTE TO DISMANTLE THE ACA

Indivisible Gainesville, a local group of nearly 2000 citizens, would like to express our dismay at Congressman Ted Yoho’s vote in favor of dismantling the Affordable Care Act (ACA). This decision will negatively impact millions of Americans. Despite broad constituent disapproval, many of our own members received a form letter from Mr. Yoho explaining his vote.

This letter was filled with misleading and inaccurate statements about the ACA and its proposed replacement so we decided Mr. Yoho’s work deserved to be graded. We invite everyone in Gainesville and the surrounding area to review Congressman Yoho’s justification for supporting the AHCA and our counter argument, so we are making his graded letter publicly available here on our blog. Please share our researched response widely, and help us to educate the Congressman on the importance of accurately estimating health care needs while assessing the impact of legislation to deliver this vital societal asset. Below, we highlight three of the most egregious falsehoods in the Congressman’s letter.

FALSEHOOD #1: “The healthcare system under the ACA is unsustainable” and “insurance companies are pulling out of the marketplace.”

TRUTH: The ACA is not failing; the truth is that 20.4 million people gained health insurance thanks to the ACA, a record drop in the uninsured rate in this country. This is in spite of constant efforts by the Republican Party at the federal and state levels to destroy the ACA through lawsuits and legislation. The Congressman himself introduced unproductive legislation this spring designed to relieve insurance companies of any penalty for failing to comply with the requirements of the ACA, blatantly undermining the ACA and removing requirements that promote the best interest of patients. In fact, a recent study by S&P Global Market Intelligence revealed that the existing healthcare market shows signs of continued improvement but cautioned that the path to stability can be disrupted by new rule changes such as those supported by Congressman Yoho.

FALSEHOOD #2: “The American Health Care Act (AHCA) contains important components of true healthcare reform.”

TRUTH: The AHCA would remove many of the benefits offered by the ACA. It would allow states to be granted waivers to drop requirements for essential health care so that people with preexisting conditions will once again be charged exorbitant premiums. In certain states, at least half of the insured between the ages of 50 and 64 have a preexisting condition for which they would be denied affordable coverage. Moreover, the AHCA would remove $834 billion from our Medicaid program and 23 million people would lose healthcare coverage altogether. We challenge the Congressman to explain to his constituents how an inability to pay premiums due to preexisting conditions or loss of coverage equates to responsible health care reform.

FALSEHOOD #3: The Congressman’s basic justification for the repeal and replacement of the ACA is that it hurts our economy. For example, he stated that “the law’s taxes and regulations hurt job-creators” and that the ACA’s “expansion of Medicaid and other federal subsidies propels our country more quickly into fiscal insolvency.”

TRUTH:  The private sector has not lost any jobs since the ACA was put into effect. In fact, because more people have access to healthcare, new jobs are being created in the healthcare industry. Moreover, one would assume from Congressman Yoho’s concern pertaining to the country’s fiscal insolvency that the AHCA would use cost savings to pay down our national debt. In reality, all of the money saved by removing coverage from so many Americans would result in a huge tax cut for the top 1% wealthiest individuals in our country, at the expense of basic healthcare for millions of Americans.

If Mr. Yoho is really interested in reforming the healthcare system in this country, we encourage him to work together with both Republicans and Democrats in Congress to fix the ACA. For example, the Medicaid gap could be closed by allowing for negotiations of drug prices, increasing the penalty offset for not being insured, and restricting insurers from opting out of the exchanges. These significant changes would increase the number of healthy insured individuals and thus lower the cost for everyone. These relatively simple reforms could receive strong bipartisan support and benefit all Americans. We ask the Congressman to act on the facts and negotiate in a transparent manner.

 


 

 

Indivisible response to Yoho AHCA letter



FOOTNOTES:

1. The first clause in this sentence is factually true: The 2010 Affordable Care Act (ACA) does need reforms, and may even benefit from a public option. But the second clause is entirely false: The proposed American Health Care Act (AHCA) reverses some of the most important parts of the ACA, allowing insurers, for instance, to significantly increase premiums for people with pre-existing conditions. The AHCA undermines the current health care system to provide a large tax cut to the top 1% wealthiest Americans, while millions of Americans lose their health insurance.

Harvard Business Review – Improve the Affordable Care Act, Don’t Repeal It: https://hbr.org/2016/11/improve-the-affordable-care-act-dont-repeal-it

2. This claim is inaccurate. It is based on the assumption that healthy people will opt out of paying health insurance premiums and instead pay the tax penalty, leaving insurers with only high-cost customers. Small changes, such as closing the Medicaid gap, can easily be made to the ACA to increase the number of healthy insureds, and to provide lower cost coverage to more people.

New York Times – Room For Debate:
https://www.nytimes.com/roomfordebate/2016/08/24/is-obamacare-sustainable/a-public-option-would-greatly-improve-obamacare

3. This sentence is misleading. While fewer people than projected bought insurance through the exchanges, more people than expected applied for Medicaid. Even when an insurer pulls out of the marketplace, a customer can still purchase higher priced unsubsidized insurance plans. Studies show that premiums are actually lower than they would have been without the ACA. And many insurers would remain in the exchanges if more states had chosen to expand Medicaid coverage under the ACA. Instead of fixing anything, the AHCA will increase premiums to the point where anyone with a pre-existing condition will not be able to afford insurance.

FactCheck.org – Obamacare Predictions:
http://www.factcheck.org/2017/03/cbos-obamacare-predictions-how-accurate/

Politifact Truth-O-Meter:
http://www.politifact.com/truth-o-meter/statements/2017/mar/12/mick-mulvaney/fact-checking-white-house-attack-nonpartisan-cbos-/

US News – Health Insurers Exit from Obamacare:
https://www.usnews.com/news/articles/2016-08-17/health-insurers-exit-from-obamacare-leaves-little-insurance-choice

LA Times – Obamacare Exchanges:
http://www.latimes.com/business/hiltzik/la-fi-hiltzik-obamacare-exchanges-20160805-snap-story.html

The Atlantic – Why Insurers are Leaving:
https://www.theatlantic.com/health/archive/2017/05/why-so-many-insurers-are-leaving-obamacare/526137/

4. This is demonstrably false. In fact, new jobs have been created in the healthcare industry because more people have access to healthcare under the ACA. Moreover, the private sector has not lost any jobs since the ACA was put into effect. Implementing the AHCA would cause a spike in unemployment, as underscored by a brand new study by George Washington University which estimates that Florida will lose 83,000 jobs and $8.6 billion from our state economy if the ACA is replaced with the AHCA.

Forbes – Obamacare NOT a Job Killer:
https://www.forbes.com/sites/dandiamond/2015/03/05/five-years-ago-they-called-obamacare-a-job-killer-heres-what-they-say-now/#25fcb7a63214

CNN – Healthcare Jobs:
http://money.cnn.com/2017/04/25/news/economy/health-care-jobs-trump-obamacare/index.html

Miami New Times – Repeal Would Cost Florida 83,000 jobs:
http://www.miaminewtimes.com/news/obamacare-repeal-bill-would-cost-florida-83000-jobs-cut-86-billion-from-economy-ahca-study-warns-9426646

5. Here, Representative Yoho is returning to one of his pet projects: the national debt. This topic is often used as a scare tactic to trick people into voting for austerity measures that only benefit the top 1% of Americans. Even if you accept Representative Yoho’s premise that the national debt is critical and that Medicaid causes more debt (which we do not), the AHCA does nothing to alleviate that debt. In fact, the money that AHCA takes out of Medicaid is used to give a massive tax cut to the wealthiest Americans. Where’s the “fiscal solvency” in that?

Business Insider – 19 Trillion Debt:
http://www.businessinsider.com/us-government-19-trillion-debt-not-a-problem-2016-4

NPR – National Debt For Beginners
http://www.npr.org/templates/story/story.php?storyId=99927343

The Week -Why America’s Gigantic National Debt is a Good Thing:
http://theweek.com/articles/618419/why-americas-gigantic-national-debt-good-thing

Wikipedia – United States Federal Government Credit Rating Downgrades:
https://en.wikipedia.org/wiki/United_States_federal_government_credit-rating_downgrades https://www.theatlantic.com/business/archive/2017/03/

6. There’s no indication that our healthcare system is collapsing, as claimed in Yoho’s letter. Republicans, including Representative Yoho, have been doing all they can do undermine the ACA since its enactment. In March 2017, Yoho introduced the “Holding Health Insurers Harmless Act” which freed insurers from the ACA requirements, undermining the entire structure of the program. The various parts of the ACA work together to create a sustainable healthcare system. By taking away the ability for the government to enforce the requirements of the ACA, Representative Yoho’s legislation helped break the system. And now he says it’s “broken.”

Congress.gov – 115th Congress Health Bill:
https://www.congress.gov/bill/115th-congress/house-bill/


7.
The primary difference between the two House versions of the AHCA is that the second version allows insurers to remove essential health benefits – benefits that were guaranteed under the ACA – so that while a person with a pre-existing condition could technically buy insurance, the plan they get could deny coverage for their specific condition, thereby rendering the plan useless. Representative Yoho and the House Freedom Caucus voted against the first version of the AHCA because they did not think it went far enough in removing guaranteed benefits. They subsequently passed the harsher second version, which removes essential health benefits from those with pre-existing conditions.

New York Times – Freedom Caucus Healthcare Pre-Existing Conditions:
https://www.nytimes.com/2017/04/04/upshot/freedom-caucus-health-care-pre-existing-conditions.html

8. The first clause is technically correct; the AHCA does not fully repeal the ACA. But what remains will be made less effective, or rendered completely dysfunctional. Representative Yoho also alludes to “state’s rights” and “personal freedom,” longtime GOP rhetorical crutches. Under the AHCA, you will have the “freedom” to pick any plan you want, but the plans will be so expensive that you won’t be able to afford them. Currently, the ACA gives you the freedom to pick healthcare options that you can actually afford. The “freedom” to choose healthcare coverage is essentially worthless if, in reality, you end up with no healthcare coverage at all.

9. The AHCA makes no real “reforms”. It simply removes many of the benefits from the ACA that Americans currently need to survive. The AHCA does undermine the current system by removing the individual mandate. But without penalties for compliance, employers will be able to take away health insurance from employees without repercussions. Furthermore, healthy individuals will have no incentive to buy insurance to offset the high costs for the disabled, elderly, or those with pre-existing conditions. This will result in fewer people with health care and higher premiums for many others.

10. A Health Savings Account (HSA) is an account whereby the money contributed is tax deductible when used for qualified medical expenses, and they can work well for people who already have money to put into an account to use solely for healthcare. But this change in no way makes healthcare more affordable for those who can’t do that. HSAs have not been shown to have a positive effect on access to health care for the average American.

Common Wealth Fund – Gains Under Proposal To Expand Health Savings Accounts
http://www.commonwealthfund.org/publications/blog/2017/apr/gains-under-proposal-to-expand-health-savings-accounts

11. By voting for the AHCA, Representative Yoho will allow millions of Americans to go without the health insurance they need. The non-partisan Congressional Budget Office has calculated that 23 million people will lose healthcare coverage if the AHCA becomes law. So while Mr. Yoho claims not to want anyone to lose coverage, his vote shows that he has other priorities, namely, cutting taxes for the wealthiest Americans, even if it means fewer people with affordable health insurance.

CBO.gov – Congressional Budget Office:
https://www.cbo.gov/publication/52486

12. This statement is entirely false, especially if you consider people with disabilities or the elderly to be those who “need it most”. Disabled students living in poverty will most likely not have access to care because the cuts the AHCA makes to Medicaid which will hurt public schools’ Special Education programs. At least 25 million adults aged 50-64 could be denied health coverage because of preexisting conditions if they seek to buy an individual plan, and this varies dramatically by state. In some states, at least half of those between ages 50 and 64 years have a preexisting condition for which they would be denied coverage.

New York Times – Medicaid and Special Education:
https://www.nytimes.com/2017/05/03/us/politics/health-bill-medicaid-special-education-affordable-care-act.html

AARP – Affordable Care Act Protects Millions of Older Adults:
http://www.aarp.org/ppi/info-2017/affordable-care-act-protects-millions-of-older-adults-with-pre-existing-conditions.html

13. This is entirely misleading information. While the AHCA says that an insurer cannot deny a person coverage because of a pre-existing condition, it also allows the insurers to increase premiums. The AHCA allows states to be granted waivers that result in no requirements for essential healthcare, and create high-risk pools, which have a bad history of death spirals, and are woefully underfunded in the ACHA bill that passed the House.

American Progress – House Plan Keeps High Risk Pools Afloat:
https://www.americanprogress.org/issues/healthcare/news/2017/05/02/431698/house-health-care-plan-not-enough-keep-high-risk-pools-afloat/

The Atlantic – To Be Sick Without Obamacare:
https://www.theatlantic.com/health/archive/2017/06/to-be-sick-without-obamacare/529317/


14.
The ACA was not designed to help members of Congress, as even before the ACA was passed members of Congress received Federal Employee Health Benefits. The ACA was designed to help those without health insurance to be able to afford it. McSally’s amendment and the ACHA will only dramatically cut Representative Yoho’s taxes. The McSally Amendment is simply a decoy intended to embellish this destructive legislation and distract from its actual ill effects.

SNOPES – Members Of Congress Healthcare:
http://www.snopes.com/members-congress-health-care/

Washington Post – MOCs And Their Aides Unlikely To Feel Impact:
https://www.washingtonpost.com/politics/members-of-congress-and-their-aides-wont-be-exempted-in-the-gop-health-care-plan-but-theyre-unlikely-to- feel-the-impact-much-anyway/

15. With regard to “free markets” and the healthcare industry, there already exists a free-market, whereby many Americans opt not to have health insurance and instead take the ACA tax penalty. Insurance by nature is different from other service industries, in that the incentives that other industries have to provide quality service do not exist in the same way for insurance. The “free-market” that Representative Yoho refers to usually means removing regulations that protect consumers from shady insurers. The AHCA might lead to cheaper policies for some healthy people, but for most Americans, it will result in less effective and more expensive coverage, or no coverage at all.

Forbes – There Is Never A Free Market In Healthcare:
https://www.forbes.com/sites/chrisladd/2017/03/07/there-is-never-a-free-market-in-health-care/

16. This is also not true, as evidenced by the history of Medicare and Medicaid. Australia’s universal system, for instance, is an example that even President Trump acknowledged provides better healthcare than we have here in the U.S. The ACA does not propose universal socialized health care, and yet has been, and continues to be, largely successful. A recent study demonstrates that the healthcare market shows signs of continued improvement, concluding that “2016 results and… enrollment so far in 2017 show that the ACA individual market is not in a death spiral.” The same study cautioned that the path to stability can be disrupted by new rule changes such as those supported by Republicans and Representative Yoho.

Washington Post – Trump Praises Australia’s Universal Healthcare System:
https://www.washingtonpost.com/news/post-politics/wp/2017/05/04/trump-praises-australias-universal-health-care-system

Global Credit Portal – ACA Individual Market Showed Progress In 2016:
https://www.globalcreditportal.com/ratingsdirect/

17. Here Representative Yoho insists that there are some people who really need government insurance, which is absolutely true, so he touts the benefits of Medicare and Medicaid. However, the AHCA would cut a devastating nearly $834 billion dollars from the Medicaid program. This would be a substantial loss in benefits for senior citizens and people with disabilities. Plus, earlier in this same letter, Mr. Yoho denigrated Medicaid, presenting the false argument that Medicaid is worsening the national debt to justify the extreme cuts under the AHCA. The AHCA will only hurt the people that Representative Yoho purports to believe should have government insurance.

The Hill – American Healthcare Act Undermines Medicare:
http://thehill.com/blogs/congress-blog/healthcare/335534-the-american-health-care-act-undermines-medicare

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