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North Carolina Community Health Center Association Concerned About Impact of the AHCA

Wednesday, May 10, 2017

North Carolina Community Health Center Association Concerned About Impact of the American Health Care Act on Vulnerable Populations and People with Preexisting Conditions


On May 4th, the American Health Care Act (AHCA) passed the U.S. House of Representatives by a slim margin (217-213). This bill would replace the Affordable Care Act (ACA, or, Obamacare). The bill now heads to the U.S. Senate where its future is uncertain. For now, the ACA remains the law of the land. Consumers’ current insurance coverage is not affected by the House vote. Consumers should continue to pay their premiums and use their health insurance.

The NC Community Health Center Association (NCCHCA) supports federal efforts to reduce the cost of health insurance coverage for all Americans, improve the quality of healthcare, and increase access to healthcare services. However, NCCHCA believes the AHCA – in its current form – will decrease access to health care and increase costs for Community Health Center patients and other North Carolinians who are medically underserved or who contend with preexisting health conditions.


American Health Care Act (HR 1628) Estimated Impacts

24 million more uninsured Americans by 2026.

$880 billion decrease in Medicaid funding to states by 2026.

Eliminates Medicaid expansion for adults with low incomes by 2020.

Raises premium costs for adults ages 50 and older.

Decreases financial help for people with low incomes buying Marketplace health insurance

North Carolina Marketplace plan costs increase $5,260 on average.

Allows states to:

  • Let insurers charge people higher premiums based on pre-existing conditions if there is a lapse in coverage
  • Put people with pre-existing conditions into high-risk pools where they could face more expensive and less comprehensive coverage.  The $8 billion over 5 years for the high-risk pool support to states is woefully inadequate.  It is estimated that NC alone would need $1 – 1.5 billion annually for a high-risk pool.  This plan puts an unbearable burden on states and consumers.
  • Eliminate essential health benefits. Insurance companies would no longer have to include coverage for these 10 essential health benefits: emergency room visits, outpatient care, in-hospital coverage (like surgery), pregnancy, maternity and prenatal care, behavioral health care, some prescription drugs, and more.

Allows employers to:

  • Increase employee out of pocket costs
  • Place lifetime limits on how much employer insurance coverage pays for the aforementioned essential health benefits
  • The 91% of North Carolina Community Health Center patients with incomes below 200% of the federal poverty level (income less than $24,120/year for an individual), will have less access to insurance coverage and health care services.
  • The 26% of Medicaid patients served by NC Community Health Centers risk losing this coverage or seeing a decrease in the services available to them through Medicaid.

The NC Community Health Center Association hopes the U.S. Senate will wait until the Congressional Budget Office scores the bill before taking it up.  We also encourage senators to use the components of the Affordable Care Act that are working effectively, or need reasonable modification as the basis for developing their version of the bill.  We urge the Senate to craft a health care bill that it focuses on decreasing disparities in access to health care services and health insurance coverage for the medically underserved, people with low incomes, and people with preexisting health conditions.

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