East End healthcare pros give mixed opinions on American Health Care Act

In the wake of Congress narrowly approving the American Health Care Act Thursday — replacing the Affordable Care Act, better known as “Obamacare” — local reaction from insurance and healthcare professionals was varied. 

And the U.S. Senate has yet to vote on the issue, so changes to the plan being pushed by Republican President Donald Trump are possible before anything becomes final.

Congressman Lee Zeldin (R-Shirley) was one of 217 Republicans to vote in support of the plan, which was approved by just one vote.

“Almost everyone agrees that our current system is deeply flawed,” Mr. Zeldin said in a statement Thursday. “For example, just yesterday, Iowa’s last major insurer through the ACA, Medica, threatened to remove itself unless something is done to stabilize the markets. Imagine no option at all for an entire state? None! There are too many other examples of how this law is deeply flawed.”

Mr. Zeldin said the American Health Care Act “provides relief from billions of dollars of crushing taxes and mandates enacted under the ACA.”

But what about the more than 20 million Americans who became insured under Obamacare?

“It has the potential to leave a significant number of people without insurance,” said Paul Connor, president and CEO of Eastern Long Island Hospital in Greenport. “I think this Congressional Budget Office quoted 24 million and that’s a big number. One of a hospital’s primary legislative issues is to try to get health insurance coverage for folks. This does the opposite of that, we feel.”

Mr. Connor said the American Hospital Association, the American Medical Association, the American Nurses Association and the AARP have all come out in opposition to the AHCA.

Among the changes in the new plan would be the repeal of a requirement that employers with more than 50 full-time equivalent employees offer their staff coverage and another requirement that most people obtain health insurance or pay a penalty, according to the Congressional Budget Office.

The AHCA also reduces Medicaid payments to states, and while it continues to allow people with pre-existing medical conditions to obtain coverage, it bases the rate of coverage for those people on the rate of risk the insurer will cover, Mr. Connor said.

So while a person may be eligible for coverage, they might not be able to afford it. Mr. Connor said the AHCA would provide $8 billion nationwide for pre-existing conditions, which he said is “woefully inadequate.”

“We want to make healthcare affordable, but over the last few years with Obamacare, some of these deductibles have made it unaffordable for a lot of people,” said Dr. Agostino Cervone, president of the medical staff at Peconic Bay Medical Center, who was speaking for himself and not the hospital.

He said the highest deductible he’s seen was about $1,200 per year and that was usually a young person or young family who would normally pay out of pocket.

Dr. Cervone said he thinks patients were making out better under Obamacare because it enabled them to go to a doctor and avoid putting off conditions until they get worse.

“If they didn’t have insurance, they wouldn’t visit a doctor because it would cost them extra money,” he said.

Overall, though, he said it’s too early to say if the AHCA would be better or worse.

Dr. Cervone recalled when Obamacare was first passed and “Republicans were saying people are going to die. Now the Republican plan has been submitted and Democrats are saying people are going to die.”

Anthony Cardona of Cardona & Company, a Water Mill-based insurance agency, said he doesn’t expect things to shift dramatically.

“My take [on AHCA] so far is that — not trying to get political on either side — there’s not going to be a whole lot of changes,” he said.

The problem is with the health care in general, Mr. Cardona added.

“At the end of the day, the cost of healthcare in this country is about $3 trillion, which comes out to about $9,500 per year per person,” he said. “Where is this money going to come from?”

Mr. Zeldin said there are “outright lies attacking this legislation,” such as a social media claim that 310,000 residents in his district would lose their healthcare coverage under the AHCA.

“The bill protects people with pre-existing conditions and gives states greater flexibility to lower premiums and stabilize the insurance market,” he said in his statement.

The Congressional Budget Office and the Joint Committee on Taxation estimate that enacting the AHA would reduce federal deficits by $337 billion over the 2017-2026 period.

But it also estimates that  14 million more people would be uninsured under the legislation than under current law by 2018, and that this number would rise to 21 million in 2020 and then to 24 million in 2026.

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