The Republican contrived American Health Care Act would repeal the Affordable Care Act (Obamacare) which made great strides in making access to health insurance more affordable for millions of Americans and slowing the annual increases in premiums which had been rising at rates 3 to 5 times faster than inflation. Obamacare was designed to work within the for-profit health insurance industry, rather than do what every other industrialized nation does and offer universal health care. Some continued to complain that premiums and deductibles were too high, but rather than solve that problem, Republicans have sought to repeal Obamacare 60 times, going so far as to shut down the government in 2013 rather than accept a budget that provided for the subsidies that make health insurance affordable for tens of millions of Americans.

Trump has made it a defining issue to get repeal, no matter the damage or loss of health insurance which is quite literally a life-and-death issue. But the AHCA is more than just a matter of Trump’s ego, it is also about reducing taxes for the wealthiest – who are assessed a small surcharge to fund ACA – and crucial to Trump’s other massive giveaway to the wealthiest and corporations, his tax “plan.”

It’s remarkable that this act, which would completely rework health care, representing one-sixth of the US economy and impacting every single person, is being pushed through without any hearings, input from medical professionals or even health insurance companies, without scoring from the Congressional Budget Office as to its true cost or how many people would find health insurance unaffordable or inaccessible.

But Governor Andrew Cuomo spells out how AHCA would affect millions of New Yorkers, and specifically attacks an amendment foisted by two New York Republican Congressmen that exclusively targets New York:

“The Republican health care bill is an assault on women and an assault on New York. It would allow insurance companies to discriminate against Americans based on pre-existing conditions, force millions of New Yorkers to lose coverage, and slash Medicaid by hundreds of billions of dollars.

“As a direct result of the amendment introduced by Congressmen Faso and Collins, this provision alone would cut Medicaid funding for New York by $2.3 billion and cripple hospitals, nursing homes, and assisted living facilities across the state.

“Most disturbingly, this bill penalizes New Yorkers because we believe in reproductive rights and ensure by law that medically necessary abortions are covered by insurance carriers. I’m calling on all of New York’s Congressional delegation—Republican and Democrat alike—to stand up for New York values and vote against this terrible bill.”

The American Health Care Act will be disastrous for New York:

• The plan will leave 2.7 million New Yorkers without health care coverage
• It will cut $4.7 billion from the state’s Medicaid budget.
• It will put at risk 7 million people who rely on Medicaid services and other programs created under the Affordable Care Act
• And it threatens the entire New York State health care system, which serves 19.5 million New Yorkers.

The Collins/Faso amendment, which targets only New York, stops counties from paying a share of Medicaid. It would have a devastating effect on New Yorkers:

• It will cut $2.3 billion in Medicaid funding to the State. When added to the $4.7 billion cost of the ACHA over the next four years, the total cost to the State would rise to $6.9 billion
• Steep cuts would force New York State to increase taxes, slash coverage to millions of New Yorkers, or devastate health care providers:
  • Nursing Home payments would be cut by $401 million
  • Home care payments would be cut by $360 million
  • Hospital payments would be cut by $355 million

The bill punishes New York for its support for women’s reproductive rights by threatening to take away citizens’ access to tax credits that are intended to make health insurance more affordable:

• New York requires that all commercial insurance policies cover abortion services. In January, Governor Cuomo took new action to ensure that contraceptive drugs and devices are covered by commercial health insurance policies without co-pays, coinsurance, or deductibles
• The Republican health care bill would prohibit the use of tax credits to support the purchase of insurance plans that cover abortion services.
• As a result, the bill would effectively defund the Essential Plan, forcing 685,000 low-income people, half of whom are women, to lose their insurance and denying them $1.5 billion in tax credits.
• In addition, roughly 143,000 lower-income New Yorkers whose income is just above the threshold for the Essential Plan, half of whom are women, would be denied $400 million more in tax credits that help them afford insurance.

This bill also includes an amendment that will enable insurers to charge more for people with preexisting conditions in some states, rolling back a key achievement of the Affordable Care Act.

• In New York, 8.4 million people under the age of 65 have preexisting conditions.
• The MacArthur amendment would allow states to opt out of provisions that restrict providers from raising prices on people with preexisting conditions.
• Removing protections for people with pre-existing conditions will result in the sick paying high premiums and would force those who cannot afford it to lose coverage.
• The health plan would also permit states to charge older people more, which would also force people who cannot afford it to lose coverage.