What the AHCA Could Mean For Iowans

Mar 16, 2017

A new plan for health care in America, the American Health Care Act (AHCA), which is currently being debated by Congress, would replace the Affordable Care Act (ACA).

According to the new Congressional Budget Office (CBO) report, this plan has the potential to make many changes to health care policies in America. While it reduces the federal deficit by $337 billion over 10 years, it's also estimated to leave 24 million Americans uninsured by 2026.

During this River to River interview, host Ben Kieffer talks with Pete Damiano, Director of the University of Iowa Public Policy Center, about how the new plan could affect Iowans. 

Reaction to the CBO report. 

The CBO report is reflecting what many who study health policy would have expected because of the types of changes that have been discussed both during the campaign and in some of the previous Republican proposals that have come through in the last few years. If you’re going to try to reduce the federal role in health care and health care spending, you’re going to end up, logically, with having more people who are uninsured, underinsured, and pushing more of the costs onto states’ local governments and individuals, and I think that’s pretty much what the CBO report said.

What would be the biggest differences for Iowans?

There’s obviously a big difference in priorities between the Affordable Care Act and the American Health Care Act… In terms of trying to cover the uninsured, with the Affordable Care Act we’ve covered approximately 20 million people with health insurance coverage, and have declined the number of uninsured in the country to the lowest point it’s been basically in recorded time. With this plan, over the next ten years, it is estimated the number of uninsured would go back up to similar number of what it was, any maybe even slightly more than what it was prior to 2010 when the ACA was passed and really prior to 2014, when a number of the key provisions of the ACA kicked in.

How could this affect poor or disabled Iowans?

About 150-170,000 people in Iowa gained coverage through the Medicaid expansion, they won’t necessarily automatically loose coverage, that’s to be determined, but the state won’t get the same amount of money that they did for those people.

In the end, who benefits and who’s put at a disadvantage under the new proposal?

In general, if you are younger, healthier, or wealthier—because all of the payment side, if you will—how the ACA was financed, all of those are going to go away and most of those were relatively small taxes on wealthier people. So there’s going to be a big cost shift to both younger, healthier folks and the wealthy, and then the older adults [who are] pre-Medicare, especially those with a health condition, their costs are going to go way up.