Bad Medicine: How Trumpcare Hurts College Students

By Rachel Greenberg

On May 4th, conservative lawmakers passed the AHCA, the health care plan that President Trump proposed as his replacement to President Obama’s Affordable Care Act. For the past few weeks, thirteen male Senators have been crafting the Senate version of the bill in secret, preventing the public and other members of Congress from debating and scrutinizing the bill.

Finally, they released their version of the bill last Thursday, June 22, entitled the Better Care Reconciliation Act, and it is just as bad as the House version. The plan eliminates the individual mandate, replaces income-based tax credits with age-based ones, cut taxes for individuals earning high incomes, rolls back Medicaid expansion, and gives states the opportunity to waive out of certain requirements. According to the report from the non-partisan Congressional Budget Office (CBO), the bill would leave 22 million more people without health insurance.

The Better Care Reconciliation Act will impact millions of Americans, and college students are a particularly vulnerable population. Here is a guide to explain how the new health care plan would impact college students.

  1. Staying on parents’ insurance: It’s important to know that the AHCA has kept the provision from the Affordable Care Act that allows individuals to stay on their parents’ insurance until they’re 26. If you have been on your parents’ network, you can continue to do so.
  2. Employer mandate: The AHCA removes the provision that forces companies with 50 or more employees to provide them with health insurance. For students who get insurance through their job, they could lose access if their employer chooses to drop their coverage, because they will no longer be legally obligated to provide it.
  3. Individual mandate: The new health care plan removes the individual mandate, which requires all individuals to get healthcare, taxing a small fine on those who don’t. This may seem like a positive component, but the House plan replaces the individual mandate provision by mandating that if coverage is interrupted for over 63 days, insurers can charge a 30% penalty over their premium for one year, and the Senate plan penalizes individuals who go without health insurance to wait six months before their coverage would begin.

Instead of encouraging Americans to purchase insurance, this mandate punishes people who are facing lapses in their insurance because of employment change or other forces. If you are a young, healthy person, and therefore are thinking of not purchasing insurance, that decision impacts the lives of sick people whose insurance costs can only be kept down by the admittance of healthy people into the pool.

Supporters of the AHCA boast that it expands options and access by lowering premiums. This is true, but only because it is too expensive for elderly, sick people, so it forces them out of the insurance pool. In effect, it makes it more affordable for young, healthy people to purchase insurance, at the cost of those who need it most.

  1. Reproductive Health Care: Conservative legislators have been trying to “defund” Planned Parenthood for years. Even though the Hyde Amendment prohibits any federal funding to be used for abortions, the AHCA pulls all federal dollars currently going towards Planned Parenthood for one year, unless its hundreds of clinics stop providing abortions. Federal funding for the organization makes up about 30% of its budget. PP provides 2.4 million patients with care, and is the largest women’s health care provider in the country.

Additionally, access to birth control could be severely cut. States can opt to receive a per capita cap on federal Medicaid funding per enrollee, in which case states would still be responsible for covering contraception, but the federal government would stop providing the 90% subsidy for those services. So, states may be forced to limit the range of birth control options for Medicaid beneficiaries. This would cut the more expensive (read: effective) options, like IUDs. States can also opt to receive a federal Medicaid block grant, in which the federal government would only require coverage of contraception for women with disabilities. States who choose this option could severely restrict coverage for family planning services.

  1. Preexisting Conditions: Under the Affordable Care Act, insurance providers were prohibited from refusing care or charging higher premiums for an individual with preexisting medical conditions. Trumpcare makes it possible for providers to charge higher premiums or offer plans that exclude coverage for preexisting conditions. In most cases, this includes sexually transmitted infections and mental health issues, which makes sexual assault survivors particularly vulnerable. Before the ACA, receiving counseling after an assault sometimes led victims to losing their insurance, and the new bill could create the same problems. The list of preexisting conditions is exhaustingly long, and it seems to essentially target women: it includes pregnancy and childbirth, breast and cervical cancer, depression, eating disorders, and medical treatment related to domestic and sexual violence.

In a continued effort to rush the health care decision, Mitch McConnell originally planned to hold the vote on the Better Care Reconciliation Act this week. However, after a handful of Senators have announced their opposition to the bill, McConnell decided to push the vote off until after the 4th of July recess. Progressive legislators are standing in opposition to this bill, and while some conservative legislators have announced that they would not be able to vote in its favor in its current form, none have pledged to vote no on it.

In order to defeat this catastrophe of a bill, at least three conservatives need to be convinced to oppose it. We must stand up together—as feminists, as college students, and as Americans—and speak out because for many, it’s truly a matter of life or death.

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