First, Do No Harm
“Primum non nocere” is a Latin phrase that means “First, do no harm.” It was easier for me to grasp the meaning of this simple phrase when a teacher posed it this way, “given an existing problem, it may be better not to do something, or even to do nothing, than to risk causing more harm than good."
I’ve thought about that phrase a great deal since March when the American Health Care Act of 2017 (AHCA) passed the U.S. House of Representatives and was reminded again Thursday of it as I quickly scanned the Senate’s version of “repeal and replace” of the Accountable Care Act (ACA), which is called the Better Care Reconciliation Act of 2017 (BCRA).
Either replacement version has considerable implications for individuals who have health coverage through the ACA’s individual health insurance marketplace.
The older you are, the more you’re going to pay. Currently, age rating has the oldest consumer (age 64 prior to going on Medicare) paying three times more than the youngest. Both the AHCA and the BCRA , change that so the 64 year-old will pay five times more than the youngest.
A 60-year-old in Minnehaha County would be charged $18,070 a year for a silver ($2800 deductible) plan under the AHCA or BCRA compared to $13,450 for the same plan under the ACA. All three proposals offer a tax credit to help with the cost of these premiums.
Tax credits impact what you pay for premiums. Tax credits impact the ability of working class individuals, farmers and early retirees to afford premiums. That 60-year-old Minnehaha County resident earning $20,000 in 2020 would see his annual premium costs increase in 2020. For a silver ($2,800 deductible) plan, under the ACA he would pay $960 or 5 percent of his income, under the AHCA $14,070 or 71 percent of his income and under the BCRA $4,780 or 24 percent of his income.
To discover your impact under each proposal, go to the Kaiser Family Foundation’s interactive county maps.
With each, you will be able to compare the ACA to the House’s proposal and the Senate’s proposal for South Dakota — county by county — and see the impact these changes would have on you, your neighbors and family members getting health insurance in the individual market.
What Can You Do?
1) If you are concerned about affording your health care coverage, please call your Senators.
Senator John Thune
Sioux Falls office – 605-334-9596
Senator Mike Rounds
Sioux Falls office – 605-336-0486
We need to stabilize the individual market and get it right. Our residents who purchase coverage in the individual market need affordable health care coverage with plans that cover their needs when they are sick or injured and provide them incentives to prevent chronic conditions and stay healthy.
2) If you have coverage, keep it. If you need coverage, get it.
If the AHCA is signed into law, it will permit health plans, at a minimum, to impose additional premium increases for those that do not hold continuous health care coverage. The BCRA addresses continuous coverage by requiring a six month waiting period for individual market coverage if you had a break in coverage of more than 63 days in the last twelve months. Either bill reinforces the importance of carrying health insurance because when you need it, it may not be available or it may cost you more. So please, get and stay covered.