Trumpcare lacking as replacement


I am writing concerning the Affordable Care Act (Obamacare) repeal bill, called the American Health Care Act or Trumpcare introduced by Republican congressional leadership and supported by President Trump. I hope residents of New Hampshire educate themselves about this legislation and let Trump know that it isn’t good for them, the state or the country, and it is not what he promised he was going to provide.

There are many parts of this legislation that are concerning and will remove programs that are now in effect. the areas relating to proposed changes in tax policy, financial help for lower income individuals and families, and termination of the expanded Medicaid program are the most concerning.

This legislation proposes to end the taxes that were imposed on very wealthy individuals and profits made by medical companies. These taxes funded subsidies that reduced premiums for low income and middle income families. The tax benefit to these high earners can be as much as $50,000 a year. I don’t see how reducing taxes on the wealthiest part of our population will help improve health care insurance programs. It will increase the budget deficit which Republicans believe is too high.

Second, the program provides limited tax credits as an alternative funding mechanism. My concern is that the proposed tax credits are based on age, not income as the subsidies were, and are so low ($2,000-$4,000) that it will leave most individuals with higher premium costs than before. It also allows insurance companies to increase premiums more for older individuals. How does this make insurance more affordable?

Lastly, by ending the expanded Medicaid program this legislation will make it more difficult for lower income people in our state and country to obtain insurance and regular medical care. Specifically, many people trying to obtain treatment for drug and opioid issues will not be able to afford treatment due to a lack of insurance. How is that helping our state when we have one of the highest death rates for opioid overdoses in the country?

President Trump stated in an interview on January 17, 2017 that “We’re going to have insurance for everybody,” “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” ” can expect to have great health care. It will be in a much simplified form. Much less expensive and much better,” he said.

Now as President he is proposing a plan that will cost more, insure fewer people and somehow that is ‘better.’ None of the proposals in this legislation will insure more people, reduce the cost of insurance or is better. We need to improve the current system not replace it with something less available and effective. We need to hold the President to what he promised not what the Republican Party wants to do.

Richard B Friedman, MD