I am increasingly concerned that Congress may be about to make a historic mistake that could raise costs and degrade the quality of health care for countless Oregonians—all without seriously taking on any of the myriad problems in our health care system. Yesterday, I attended the release of a study from the State of Oregon that confirms many of my worst fears.
By now, nearly everyone will have heard about the American Health Care Act (AHCA), the GOP bill to repeal and replace the Affordable Care Act (ACA). OSPIRG has some very serious concerns about the bill. Among other things, we are worried that the bill will lead to huge increases in premium and out-of-pocket costs, and may even cause a wholesale collapse of the health insurance market in a scenario known as a “death spiral.” But until yesterday, we did not have specific data about the possible impacts on Oregon.
The new study shows not only that the AHCA will lead to nearly a half million Oregonians losing health coverage and a tripling of the state’s uninsured rate by 2023, and not only that the legislation could lead to over 23,000 jobs lost in the state—it also confirms what we suspected: The AHCA will lead to higher premiums and severely disrupt Oregon’s health insurance market. This kind of disruption will have serious consequences for countless Oregonians, not just those who take advantage of the ACA’s coverage programs.
Oregon’s health insurance market was already struggling, with big rate hikes for 2017 and some insurers pulling out of part or all of the state over the past couple of years, or even going out of business. Read our post-mortem on 2017 rate hikes and coverage options for more details. To remedy this situation, we’ve been calling for bold action to contain rising health care and prescription drug costs—the main drivers of rising premiums and out-of-pocket costs for consumers. But not only does the AHCA do nothing to address these problems, it seems poised to make them worse.
Aside from potentially tanking Oregon’s health insurance markets altogether, the AHCA may also short-circuit the state’s efforts to transform health care to contain costs and improve quality. Although there’s plenty more work to do, Oregon policymakers have been working for years to change the way health care is delivered and paid for in ways that reduce costs and improve health, e.g. by establishing the Coordinated Care Model in the Oregon Health Plan, or by working to hold health insurers accountable for cost containment and quality improvement. But the kind of chaos the AHCA could unleash would put that progress at risk.
If Oregon’s health care system goes into freefall for an extended period of time, possibly years, it’s likely that insurers and hospitals will jack up prices to compensate for the uncertain future of their industry, and will put up even more resistance to the kind of reforms needed to contain costs in the long run. The consequences for Oregon consumers could be disastrous.
Consumers urgently need a comprehensive solution to rising health care costs. The AHCA not only doesn’t get us there, it isn’t even a starting place for this important work. Oregonians can’t afford to go backward. Please join us in calling on Congress to put together a real plan to make health care work better for consumers.
 You can find the whole text of the AHCA here.