Many healthcare consumers are not adopting a wait-and-see attitude.
They don’t plan to stand idly by while the U.S. Senate scrutinizes the healthcare reform bill sent to them early this month by the House of Representatives.
They are heading to doctors’ offices, clinics, and hospitals before whatever final version of the American Health Care Act (AHCA) becomes law, perhaps as early as next year.
They’re going in for mammograms, surgery, cancer screenings, and any other procedures they fear might not be covered under the Republican health plan.
“It’s very similar to people running to the store to buy bottled water and batteries before a hurricane,” Kurt Mosley, vice president of strategic alliances for Merritt Hawkins healthcare consultants, told Healthline.
The changes in coverage aren’t limited to people who buy their health insurance on the state marketplaces either.
Provisions now in the AHCA could allow companies to reduce the number of covered medical services, or drop their health insurance plans altogether.
For people with chronic conditions who need continuing care as well as medications, the concern runs even deeper.
“Now what? Just stop breathing?” wrote Susan Gray on Healthline’s Living with COPD Facebook page. “They might as well shoot us. At least it would be quicker.”
How coverage could change
Under the current edition of the AHCA, there are a number of ways a person’s health insurance coverage could change.
For starters, the Republican plan substantially reduces the amount of money available for subsidies to help people pay the premiums on policies they purchase in state marketplaces.
In addition, the plan allows insurance companies to charge older adults up to five times what they charge younger clients. The current maximum is triple the cost.
It also allows states to apply for a waiver to get rid of the tax penalty for people who don’t buy health insurance.
Another waiver would allow insurance companies to set up high-risk pools for consumers with preexisting conditions.
It’s not entirely clear what ailments would be included on that list of conditions, but in the past people have been denied coverage for high blood pressure and postpartum depression.
An article on Vice.com lists 57 potential ailments that could be considered preexisting conditions. They range from acne to anemia to caesarean section to ear infections to migraines.
The states could also ask to waive the current requirement under the Affordable Care Act (ACA) that insurance companies offer certain minimum “essential benefits” to their customers.
This could affect not only marketplace policies but also insurance coverage provided to employees by companies. That’s about half the people in the United States who are covered by health insurance.
Employees could also be asked to pay higher premiums or higher out-of-pocket costs for certain health services.
Companies with more than 50 employees would no longer face a fine if they didn’t provide health insurance to their workers.
And then there are the cuts to the Medicaid health programs for low-income individuals and families.
The Republican plan axes $880 billion in Medicaid funding over the next decade.
There are also potential cuts in funding to organizations such as Planned Parenthood and the Centers for Disease Control and Prevention (CDC). Those reductions could affect services such as birth control and vaccinations.
Experts say these changes are likely to cause some people to lose their health insurance, while other consumers discover certain services are no longer covered or they have to pay a lot more for the services that are under their policies.
“This is a can of worms, and I don’t know if they can put the lid back on,” said Mosley.
What people are doing
Many consumers are already operating on the assumption that as early as next year they will have more expensive premiums and/or insurance that doesn’t cover all the services it now does.
Deborah Nucatola, Hawaii medical director for Planned Parenthood of the Great Northwest, told Vice.com that she is already seeing the effects.
“In the past several months, there hasn’t been a day that goes by that I don’t come across a patient who is coming in for services for fear they are going to lose part or all of their healthcare,” she said.
Christy Valentine, of Valentine Medical Center in New Orleans, has seen similar concerns.
“Normally you have to convince people of the importance of something like a mammogram. Right now, they want everything — well visits, cancer screenings, immunizations,” she told Vice.com.
Mosley says he isn’t surprised.
He said when the ACA was approved, people were aware of what was coming.
“It’s different now,” he said. “This is the unknown.”
Mosley said it makes sense for people to have medical services performed before copayments and deductibles go up.
“It’s the smart thing to do,” he said. “Why not get it done while it’s still covered.”
Mosley noted that medical professionals will also be busier this year.
Anyone involved in any kind of screening or imaging will most likely see an increase in customers.
This includes not only primary care doctors but radiologists and X-ray technicians, as well as professionals who perform lung scans, colonoscopies, and mammograms.
Mosley added offices that provide birth control services or vaccinations will probably also get busier.
People who are going in for one-time procedures can take advantage of this period before the Republican health plan takes effect.
However, Mosley noted, people with chronic conditions like cancer, arthritis, and diabetes aren’t as fortunate. They are going to have to continue receiving care after the new health plan becomes law.
Many of those folks spoke out on Healthline Facebook pages when asked for their thoughts on the new Republican healthcare plan.
Some Facebook participants said they expect their health services to improve after Obamacare is replaced.
Others held out hope the Senate will rewrite the House plan.
But others are fearing the worst.
“Scared to death,” wrote Mariko Singleton on Healthline’s Living With Crohn’s Facebook page. “I won’t be able to afford my meds without insurance. It’s literally a death sentence.”
“I’m terrified,” added Allie Ochoa on the same Facebook page. “The thoughts literally running through my head are ‘How am I going to be able to pay for my medications?’”
“We are barely scraping by,” wrote Lovada Timothy on Healthline’s Living With Rheumatoid Arthritis Facebook page. “I don’t know what we will do if our premiums raise.”
On Healthline’s Living with Hypothyroidism Facebook page, Joyce Martin wrote that she and her husband both had surgeries last year because “this is exactly what I was afraid of.”
“Not knowing if we would continue to have any [insurance], we both got everything taken care of,” she said.
Now they are living in uncertainty.
“As of this year, we are paying less monthly with a huge deductible just in case anything happens. Yet knowing we could be uninsured at any moment,” she said.