After breaking a promise to protect people with pre-existing conditions, a number of House Republicans voted for the American Health Care Act (AHCA) in part based on the Upton amendment. The Upton amendment added $8 billion to the AHCA in an attempt to lower premiums or out-of-pocket costs for people whose premiums are ratcheted up due to a pre-existing condition.
Discriminating against people with pre-existing conditions through higher premiums is prohibited under the Affordable Care Act (ACA). The AHCA allows states to remove this protection, and then attempts to remedy the situation by adding $8 billion through the Upton amendment.
A new analysis by the Congressional Budget Office (CBO) confirms that the AHCA, on net, would cut protections for people with pre-existing conditions. Specifically, CBO states, “less healthy people would face extremely high premiums, despite the additional funding that would be available.”
Upton’s investment is a fraction of the bill’s spending, according to CBO, on priorities such as tax breaks for insurance corporations, drug companies, and high-income people.
A comparison to other funding elements of the AHCA puts this vote-swaying provision in perspective. Upton’s investment is a fraction of the bill’s spending, according to CBO, on priorities such as tax breaks for insurance corporations, drug companies, and high-income people.
For every $1 the Upton amendment spends on people with pre-existing conditions, the bill spends:
- $4 on tax breaks for the pharmaceutical industry;
- $5 on tax breaks for health savings accounts that disproportionately benefit high-income people;
- $18 on tax breaks for the health insurance industry; and
- $29 on tax breaks for people with income above $200,000.
This reflects the overall choices that House Republicans made in this bill: provide hundreds of billions in tax breaks for the wealthy and corporations at the expense of people with pre-existing conditions, tax credits for people purchasing coverage in the individual market, and people with Medicaid.
It remains to be seen whether Senate Republicans will make the same choice.