The marketplace, a source of ongoing political contention, offers subsidies based on a sliding scale of income. If passed, the repeal-and-replace bill will swap subsidies for tax credits based on almost entirely age, not income.
On Tuesday, outside a medical office building on Swann Avenue in Tampa, U.S. Representative Kathy Castor (D-Tampa) called the Republican proposal a “reverse Robin Hood” that benefits the wealthy and threatens the financial stability of millions of working-class Floridians, including the 1.7 million with marketplace insurance.
“Affordable insurance that filled a huge void in the State of Florida is going to go away. That means a lot of folks will be thrown back into the individual market that often times can be a very, very expensive place,” Castor said.
The Energy and Commerce Committee will spent some of the week marking up the bill, which House Speaker Paul Ryan wants the House to pass in the next three weeks—even if there is mounting criticism and doubt on both sides of the aisle over the plan.
Castor, who who is a vice ranking member of that committee, says there have been no hearings to discuss the substance of the bill and the rushed deadline could jeopardize informed decision-making.
“My Republican friends would have us vote on it without understanding what it does to the uninsured, without understanding the cost because the Congressional Budget Office has not had time to analyze the impacts,” said Castor.
Rather than push to repeal and replace the ACA, Castor wants Republicans and Democrats to work on improving it.
“I’m hopeful that this proposal that rips coverage away will crash and burn so that we can get back together and work on something that is much more constructive,” she said.
Meanwhile, some folks with preexisting conditions feel relief that, if passed, the Republican bill would maintain the ACA policy prohibiting insurance companies from refusing to cover people with preexisting conditions.
Of course, this operates under the assumption that folks do not have a lapse in coverage. Losing employer coverage or no longer being able to afford premiums could bring a 30% increase in healthcare costs to some individuals.
Speaking alongside Congresswoman Castor was 31-year-old Joe Nammour, who has multiple sclerosis. After his diagnosis, he was initially denied insurance because of his condition.
Nammour credits the ACA for his access to healthcare coverage and his family’s ability to afford it.
“The ACA has given us the ability to not be discriminated against based on a preexisting condition," he said. "We’re very grateful for what the ACA has provided us. It seems like they’re going to continue to cover that. Thankfully we’re not on the exchange, we’re on the private plan. But my heart breaks for those like us who are on the exchange plans because they could lose the exchange coverage, and then what’s going to happen to them?”
Many implications of the new plan remain unclear. The GOP has provided no estimates on cost or how many people would gain or lose insurance.
This article appears in Mar 2-9, 2017.