trumpcareThe American Health Care Act, better known as Trumpcare, is being billed as the Obamacare replacement we’ve all been waiting for.  However, the healthcare reform initiative has failed to move forward twice.  First, it gained some traction in late March but crashed and burned.  A revised version passed a House vote in May but didn’t get further.  Now, Trumpcare 2.0 has returned healthcare reform to the national conversation.  But the “new” version of the bill just suffered the same fate.

On June 27, Senate Majority Leader Mitch McConnell announced Congress was postponing the Trumpcare vote until after its July 4 recess.  The newly revised bill failed to gain enough support…again.  There’s staunch opposition from both liberals and conservatives.  Without 100% agreement within the Republican party, Trumpcare’s future is bleak.  The postponement is a last-ditch effort to compromise and make the bill passable.  Though AHCA is going to need some serious work to become an American reality.  Odds are that work won’t be complete in a week’s time.

While the bill’s future hangs in the balance, one thing is clear: Trumpcare is bad news.  It’s bad news for the estimated 22 million people who would lose coverage.  It’s bad news for the poor.  For the middle class.  For the disabled.  And especially bad for the LGBTQ community.

The Nitty Gritty on Trumpcare

As with any D.C. legislation, Trumpcare is a lengthy bill full of technicalities, stipulations, and verbose nonsense.  All of it needs to be pulled apart and dissected.  If you’re a glutton for punishment, you can read all 142 pages here.  But if you prefer the Cliff’s Notes, there are some troublesome highlights that should be on your radar.

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Medicaid changes

President Obama introduced a Medicaid expansion as part of the Affordable Care Act.  Formerly, only people making 100% of the federal poverty limit were covered.  ACA pushed that requirement to 138%, widening the net of coverage to include millions of Americans.  Trumpcare includes a provision that phases out the expansion completely by 2023.  Effectively, it forces people teetering between poverty and middle-class to find coverage through individual providers—something they couldn’t do prior to ACA.  

To add salt to the wound, Trumpcare would reduce the amount of federal funding states receive for Medicaid-related expenses.  And the bill would allow states to enforce work requirements for those seeking Medicaid.  This could erect a new roadblock for the unemployed and uninsured.

Tax credit adjustments

Tax credits are another hot topic in healthcare.  Under Obamacare, people making up to 400% of the federal poverty limit were eligible for tax credits.  Trumpcare not only lowers that cap to 350% but decreases the benefit as recipients age.  This means less money for all who receive tax credits but there’d be a disproportionate negative effect on the middle class.

Abortion cost restrictions

This is the provision that would defund Planned Parenthood.  Trumpcare would forbid the use of federal insurance funds for any healthcare plan or provider that covers abortion.  This means those women seeking abortions would have to pay out of pocket.  And Planned Parenthood would need to be privately funded.

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Other possible updates

Though not explicitly stated in this version of the bill, the idea of lifetime caps has been floating around the White House for most of June.  Currently, those covered under Obamacare can receive treatment for as long as they need.  Trumpcare could possibly be revised to impose lifetime caps.  This means that once a person hits their cap, their insurance company is no longer obligated to cover their medical costs.  This could be a deadly blow to the terminally ill.

Rolling Stone’s Tim Dickinson says Trumpcare operates on a “reverse Robin Hood logic”.  Just by assessing the major points, it seems like an accurate assessment. Though its negative impact on many Americans is clear, there are parts of this proposed bill that could harm those in our community.

The LGBTQ Community & Planned Parenthood

The rationale behind defunding Planned Parenthood is its menu of abortion services.  But the organization offers so much more.  

“Planned Parenthood was vital to my development as a young queer person. Their website was packed with information that wasn’t being discussed anywhere else,” writes Meg Cale of Dopes on the Road.  Planned Parenthood is one of the only places where LGBTQ youth can access inclusive sex education.  There’s a holistic focus that includes assistance in coming out, defining one’s gender identity, and coping mechanisms for families.  

Additionally, Planned Parenthood is the only large-scale health provider that offers easily accessible, transgender-specific services like hormone therapy.  It’s also a place for our community to receive knowledgeable, unbiased care.  Defunding it doesn’t just affect women’s health.  It severely limits our community’s access to healthcare and education.  

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Why LGBTQ People Need Medicaid

Medicaid is a vital resource for millions and covers everything from regular visits to emergency services to prescriptions.  It covers low-income Americans, a sect of the population that includes a large part of the LGBTQ community.  American Progress reports that 1 in every 5 gay and bisexual men lives in poverty.  The same report cites a Gallup poll which determines LGBTQ people are more likely to be uninsured than their straight counterparts.  Medicaid is the bridge to healthcare but without the expansion, many current recipients would lose coverage.  The original requirements exclude most childless adults.  Once Trumpcare reverts to pre-ACA guidelines, a huge part of our community could find themselves navigating the costly insurance market and becoming uninsured once again.

How Lifetime Caps Could Hurt Us

Lifetime caps are essentially an insurance company’s way to protect their long-term spending.  But they also serve as a punishment for those who have serious illnesses and higher medical expenses.  On one hand, lifetime caps aren’t a new thing.  There was a point in time when roughly half of Americans had a plan with a lifetime cap somewhere between $1-2 million.  Though most of us won’t reach these caps, ACA provided assurance we’d never have to worry about it.  And furthermore, those of us who needed more care could get it without piling up stacks of hospital bills.  It’s the latter group of us, mainly those taking HIV meds, who could suffer most.  

While lifetime caps aim to save the government, and the nation, some extra cash, they could leave many people out in the cold long before they’ve grown old.  Think about the cost of HIV meds and how quickly a person could blow through these limits at a young age.  Especially when people like Martin Shkreli are dramatically boosting the cost of life-saving drugs.  Then what? These LGBTQ Americans should pay for their meds out of pocket for the rest of their lives? No, this is not the answer.

Trumpcare is being disguised as an improvement that could benefit all Americans.  But the bill is chock full of legislation that could endanger millions and seriously damage our community’s health.  As of publication, the bill had stalled.  Let’s hope it stays that way.