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Health Care Proposal Built on Inequality

Epitomizes separate and unequal

Marjorie Innocent | 7/5/2017, 2:34 p.m.
Our representatives are on the brink of instating a health care plan that epitomizes separate and unequal. Thirteen U.S. Senators ...

In 1954, Thurgood Marshall and a team of NAACP attorneys argued the landmark civil rights case, Brown v. Board, before the Supreme Court. They demonstrated to the Justices that segregated schools violated the Fourteenth Amendment's Equal Protection Clause -- that separate was and would always be unequal.

Our representatives are on the brink of instating a health care plan that epitomizes separate and unequal. Thirteen U.S. Senators -- all white men -- sat behind closed doors in Washington, D.C. and crafted a replacement to the Affordable Care Act.

Their proposed bill, the Better Care Reconciliation Act, based off of the House's American Health Care Act, would only benefit people like themselves -- healthy, wealthy white men -- and quarantine the rest of the country into the confines of high cost, low quality health care.

The Senate's inequitable protection plan would disproportionately hurt the sick, the poor, the elderly, women, and people of color. It would make healthcare more expensive for seniors and people who are already sick, increase out-of-pocket costs for doctor's visits, slash subsidies to help low-income people pay for health insurance, and cut Medicaid support to states by three-quarters of a trillion dollars.

In more than 20 years as a health and social policy professional, I have witnessed the dire consequences of African Americans living without health care, and I have watched the ACA repair some of the most egregious inequities in our health care system. If the Senate bill passes, the impact will be devastating, and, in many cases, lethal.

The current version of the Senate's health care plan is projected to cause some 22 million people to lose their coverage by 2026, including 15 million next year. It also proposes to cut more than $772 billion from the Medicaid program over ten years and phase out additional funding for its expansion. At the same time, the bill proposes tax cuts of $700 billion that will largely benefit high-income individuals and big businesses -- especially profiting the top one percent of earners. In effect, cuts to Medicaid for the poor and to premium subsidies for low-income people will serve to refund the rich.

The plan grants several allowances to states that hold the potential for serious harm. It permits states to opt out of providing essential health benefits that made coverage under the ACA more comprehensive, such as maternity and mental health care. States that opt out of providing these essential benefits would receive their share of $112 billion over 10 years to help offset the states' cost for covering those who need care most and likely set up high-risk insurance groupings. This provision would incentivize states to mark up the cost of coverage for people with certain needs, ostracizing them to their own costly risk pool.

But the sick are not the only ones that the Senate plan puts at risk: under the new bill, low-income families and individuals would also be significantly hurt by the cuts to Medicaid. Proposed changes to Medicaid would make it more likely that states will reduce much-needed services or cut back enrollment. The resulting increased cost of care would be hurtful to elderly Americans, most of whom experience a decline in income, but they would be especially crippling to African-American seniors, who experience poverty at twice the rate of their white counterparts.