The proposed replacement for the Affordable Care Act, or “Obamacare,” was announced by Republicans on March 6. The new plan, called the American Health Care Act, has proven controversial among both Republicans and Democrats because of its cuts to Medicaid and its restructuring of taxes. While the ACA expanded Medicaid significantly, providing coverage to all living earning less than 138 percent of the federal poverty line, the AHCA plans to remove all federal funding for Medicaid’s expansion by 2020. Instead of the federal government paying for about 50 percent of states’ Medicaid expenses, as it currently does, states will be given a fixed amount of funding to spend on health care and insurance as they see fit.

The ACA also established government-run marketplaces where people could buy insurance and those earning less than 400 percent of the federal poverty line could receive tax credits to help pay for premiums. Under the plan proposed by Republicans, the amount received in tax credits would be based on age rather than income level or geographical location with the elderly getting more.

Though it is true that the AHCA would reduce the federal deficit by $337 billion dollars over the next decade, these savings would come at the expense of millions of Americans, who would no longer be able to afford health insurance. According to the Congressional Budget Office, these reforms will lead to an estimated 24 million people losing their insurance coverage by 2026, increasing the proportion of uninsured Americans from 10 to 19 percent of the population. Costs would go up for other Americans as well. For example, the yearly premiums of a 64-year-old earning $26,500 would rise from $1,700 under the ACA to $14,600 under the new plan.

These changes would be most harmful to rural Americans, many of whom voted for President Donald Trump, because they live in areas without competitive health care marketplaces that would encourage lower prices and provide more options. Much of this decrease will be the result of the decreased funding for Medicaid, which is expected to lose $880 billion in funding over the next 10 years. As a result, an estimated 15 million will lose their Medicaid coverage, or roughly 25 percent of people who currently benefit from the program.

Furthermore, the tax cuts proposed as part of the health care reform will disproportionately benefit the wealthiest Americans, while lower-income individuals and families lose coverage. The Tax Policy Center estimates that 40 percent of the bill’s tax cuts will benefit the wealthiest one percent of the country, who would save an average of 2.1 percent of their incomes, or $37,000 as a result. In contrast, those in the lowest income bracket will only receive an average tax cut of $150, equivalent to 0.9 percent of their income. Overall, the AHCA would create the largest benefits for the wealthiest Americans while causing millions of other Americans, especially those living on low incomes or in rural areas, to lose the health care coverage that they had gained under the ACA.

While the AHCA would reduce federal spending on health care, the distribution of the reduction in spending is unequal. The wealthy will benefit from significant tax cuts, but low-income Americans and those living in areas vulnerable to natural disasters will be forced to fend for themselves with less assistance from the government. These policy changes deprioritize the previous administration’s goals of increasing access to health care and cause the greatest harm to groups that are already disadvantaged.

This is an opinion article and does not reflect the views of The Tulane Hullabaloo. Madeline is a freshman at Newcomb-Tulane College. She can be reached at [email protected].