How will the Republican health care plan affect insurance coverage and costs if the Affordable Care Act replacement becomes law? We share stories of Americans likely to be affected, including a small business owner and her employees, and an unemployed auditor on Medicaid.
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But first: how the Republican bill could change insurance coverage and costs, if its core ideas become law.
Our team has traveled across the country to capture the stories and the voices of those who could be most impacted.
We have two of those profiles tonight.
We start with the perspective of a small business owner and her employees in Zanesville, Ohio. She say she hopes that a new law would offer cheaper insurance options with fewer required benefits. That's been the source of much debate today, and is a possible element in health care's next act.
KELLY MOORE, Vice President, GKM Auto Parts:
My name is Kelly Moore. And I am the vice president of GKM Auto Parts. We operate as a NAPA Auto Parts store.
Before the ACA, we offered full insurance, as far as meaning that we paid at that point 80 percent of the premium. The employees paid 20 percent of the premium. It covered not only their office cares and their medical and hospital, but also prescription drug plan.
DARIN LAWLER, Store Manager, GKM Auto Parts:
My name is Darin Lawler. I'm 51. I have been with the company for around seven years.
When I first got here, I had insurance for my family and I through the company, you know, relatively good insurance. We had health care, and we had dental. And it was affordable.
When the exchanges opened, and the Affordable Care Act came into play, every year, with the exception of one, my insurance went up double digits for the first time ever.
We had mandates imposed on everyone. And those mandates made us cover things that we wouldn't normally be necessarily involved in. Suddenly, we are having to cover things like pregnancy and other conditions that my folks may not need the coverage on.
And so because we're having to share that mandate with everyone, our coverage had to go up. We had to scale back our premium portion from 80 percent to 70 percent and then to 60 percent in order to afford it.
It got to the point for us as a company that it was no longer a benefit for the employees.
We were forced to go on our own, and it's — Affordable Care isn't very affordable. At this point right now, my family and I do not have insurance because of the act.
And we're actively searching, but we just have not come up with anything that we can afford at this point.
It was gut-wrenching to make that decision, to pull that trigger. I lost sleep. I did everything I could. I spent most of my time at my desk, not doing the other duties of my job, but rather trying to crunch numbers to find a way to offer that insurance benefit.
You could see it in her eyes. And she just — just kind of the way she talked. Just, it was upsetting to her. And, you know, it would be, because they have always — you know, that was one of the things… We had decent benefits here. And that was one of the things that they can't do for us anymore, and, you know, it was hard on her.
I hope that the government steps back a little more from the business of offering health care. I would like to see health care traded across state lines, the way we do auto insurance, the way we can get our business insurance. I would like to see fewer mandates on the program.
I would love to offer insurance again, when it becomes affordable.
Affordability is clearly a big issue in the debate over the health care replacement.
But so is the question of who's covered. The Republican bill would end the expansion of Medicaid over time, and would phase out government coverage for millions of people.
We visited a current Medicaid recipient in Shreveport, Louisiana, who got coverage because of the Affordable Care Act and is now worried about what may happen.
JULIA RAYE, Medicaid Expansion Patient:
My name is Julia Raye. I'm 50 years old, and I live in Shreveport, Louisiana.
I have been unemployed for about a year now, and I will be starting a new job in April at a nonprofit. And while I was unemployed, I have relied solely on Medicaid expansions, and for my health conditions with diabetes and seizures.
I am a chemist by degree, and I have worked for the CDC. I have worked for EPA. I have worked for FDA. And I never planned to not work, but then there have been situations in my life where the contractor, the job ended, and I needed insurance.
There was a time when I didn't have any health care coverage. I use two types of insulin, and I would take the needles. I would rinse them out with alcohol, and then I would reuse the needles. And I remember thinking, 'Am I getting the right dosage?'
Obamacare allowed me to get medicine for whatever illness it was I had. And, without it, I wouldn't be healthy enough to even have a job.
Medicaid has been frustrating at times. The issues are, in some cases, there might not be a doctor that takes Medicaid or that situation. But make no mistake. It is — it is a blessing to have Medicaid, and to be medically assisted by Medicaid.
As I hear the news about the changes in Medicaid for the future… I am very excited about my new job. But the job is, in all essence, a contract position. At some point in time, it may be that I — this job closes down, and I find myself needing insurance.
I am worried that, what happens if I have no income, and that puts me at a point where I need Medicaid again? I mean, at this point, do I take the medicine that I get now or that I get in the future, and do I, instead of taking all my medicine, do I take two of the three pills I'm supposed to take, and start stockpiling it, so that — you know, for a rainy day?
You know, people have stockpiles of food for possible war. Do I stockpile my medicine in case I don't have it?
I went to the hospital three times in one year with sugars above 600, because they were not — I wasn't taking the right medication. If you don't think that Medicaid is important, then you're signing my death sentence. If you're comfortable with that, then go right ahead.
We are going to have more of these profiles of how people could be impacted by the new health care plan in the days to come.
You can watch all of them on our website right now at pbs.org/newshour.