Viewpoint: American Health Care Act unaffordable for too many

This week I will be in Washington, D.C., meeting with our Congressional delegation about the American Health Care Act (AHCA) and the impact it would have on all North Dakotans, especially those 50 and older.

Kathi Schwan, state president, AARP North Dakota

 This week I will be in Washington, D.C., meeting with our Congressional delegation about the American Health Care Act (AHCA) and the impact it would have on all North Dakotans, especially those 50 and older.

The legislation would dramatically increase costs for people over age 50 and those with pre-existing conditions.

Under the AHCA, insurance companies could charge older adults five times what other consumers pay for the same health insurance policy. It's an age tax. The bill also lets North Dakota lawmakers get a waiver that would give insurance companies the power to charge older adults even more.

People in their 50s and 60s would also be penalized through changes in the way health care tax credits are calculated. Under current law, the tax credits are determined by what your health insurance costs along with your ability to afford that coverage. Under the House bill, those factors are no longer considered, which would cut the tax credits by thousands of dollars for older adults.

If this bill becomes law, North Dakotans age 50 to 64 would have to dig a lot deeper into their pockets to pay for health insurance - for most, these premium increases would be unaffordable.


In North Dakota, the age tax and the reduced tax credit could increase the annual premium by as much as $3,688 for someone age 55 earning $25,000 a year. For someone age 64 earning the same amount, the premium increase could be as much as $7,076. Half of all North Dakotans ages 50-64 who buy insurance in the individual market have incomes of $30,500 or less a year.

But there is even more bad news. Under an amendment added to secure passage of the bill, states will be permitted to request waivers that would once again give power to insurers to charge higher premiums to people of any age with a pre-existing condition.

In North Dakota, 35 percent of the population age 50 to 64 - that's 50,626 people AHCA unaffordable for most older North Dakotans have a pre-existing condition. Under the AHCA, they could pay more than $25,000 a year in health insurance premiums.

AHCA supporters say it protects people with pre-existing conditions by allowing states to create "high-risk pools." But high-risk pools have a 25-year history of failure.

According to an analysis by AARP's Public Policy Institute, high-risk pools carry sky-high premiums and often inadequate coverage. The AHCA also cuts 25-percent out of the Medicaid program which would result in a massive cost shift to states. Medicaid is a vital safety net for millions of low-income adults and children with disabilities who rely on the program for health care and critical services on which disabled children and low-income seniors depend.

Finally, the AHCA would impact those who obtain health insurance through their employers or the individual market. It allows states to waive federal standards for minimum coverage, allowing insurers to sell less comprehensive coverage. It weakens the requirement that insurance companies must limit annual out-of- pocket costs such as deductibles and copays. And it would once again allow insurance companies to set caps on how much they would cover over a person's lifetime.

These are the issues I'll be talking about with our Congressional delegation and reasons the AHCA is opposed by not just AARP, but also doctors, hospitals, and consumer groups.

The Senate needs to start over and craft legislation that includes strong consumer protections, lower costs, improves quality, and provides affordable coverage to all Americans.


Kathi Schwan, West Fargo, is state president of American Association of Retired Persons.

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