Since Erin and I started this blog, we’ve tried to provide historical context for contemporary events. We’ve especially tried to examine the history of healthcare in the United States and if you missed any of those posts, simply use the healthcare tag on this post to find them.

Sometimes historical context isn’t enough. As the Senate prepares to vote on its version of repealing and replacing the Affordable Care Act, rather than look to the past, we need to look at what this bill will do to health insurance in this country. According to ThinkProgress, these are the main features of the bill:


Elimination of the individual and employer mandates.

Premium taxes based on age, income, and geography like Obamacare but, but with adjusted thresholds that disproportionately hurt older and poorer Americans:

Begins to cut Medicaid program expansion starting in 2021, with a three-year phase out. (This will not matter for 8 states with “trigger laws,” which terminate immediately once federal funds are affected.) And then cuts the rest of the budget’s program too.

Tax cuts for the wealthy by repealing Obamacare tax increases.

Cost sharing subsidies end in 2020, but could end earlier if the Trump Administration cuts them off.

States can still waive Obamacare regulations, such as essential benefits.

Planned Parenthood could face a one-year Medicaid funding freeze.

The long and short of it is, it’s a tax cut for the wealthiest Americans at the expense of poor Americans. The bill is especially devastating towards Medicaid, the federal program that provides services to the elderly, disabled (of all ages), veterans, and well, pretty much every American unless you’re as rich as Donald Trump. Under the Senate bill, the Federal government would no longer match payments to the states to cover the cost of healthcare for Americans. Rather states would receive a single pool of money and use it as they wish. In reality, this means that states will have to set caps on how much money they will spend on health care for individuals. So that those among us who need healthcare the most will not be able to afford it.

I’m not a health care expert and I can’t explain all the intricacies of this horrid, cruel bill. But I can point you to some places that can.

The Kaiser Family Foundation: They detailed breakdowns of the effects of the Senate bill and how it compares to the ACA and the AHCA.

This NPR chart does a good job of outlining the key features of the bill.

The good folks at Indivisible have a good breakdown of the impacts of this legislation state-by-state.

If after you’ve read these resources and think this is a good bill, then sit back, relax, and hope you never need to go to the doctor. Ever. If not, call your senators and tell them to vote no. Here’s the list.