The American Health Care Act leaves more unanswered questions than it answers.

In reviewing the bill any American who is not an attorney wonders exactly what is this bill saying. The bill mentions the law, the section, and modifies the existing sections by inserting a change. The reader is thinking this is changing Affordable Care Act / Obamacare, but in closer observation is not the Affordable Care Act of 2010 (ACA) but instead these changes is in the Social Security Law of 1935.

The ACA did not change Medicaid, instead just expanded the existing coverage to include uninsured individuals whom did not qualified for ACA and needed coverage. There was NO CHANGE to the Medicaid coverage that helps the poor families, handicapped, or retirees who can hardly live on social security.

Therefore, the American Health Care Act is focus on changing Medicaid that affects all Americans not just the uninsured. As opposed to ACA, who focus on the uninsured not everyone on Medicaid.

This presents a serious problem since the caps create savings of billions of dollars comes from reduction of benefits from the most vulnerable of our society, the poor, handicapped, and retirees who cannot exist without Medicaid.

The uninsured that was added due to the expansion returns back to having no coverage and is awarded to the State to offer all uninsured some form of coverage under a private insurance solution. Medicaid expansion itself on a State level has never worked.

It is clear that the Medicaid of the past is altered forever and the states now control the outcome of its own citizen’s healthcare under private insurance. We revert back to Medicaid and Medicare with private insurance for everyone at regulation of the state not the federal government. This is how it was prior to ACA. Where private insurer does not have to be transparent and the filing of premium rates are proprietary information and does not need to be disclosed at insurers discretion. There is no accountability or transparency by the insurance industry necessary or refunds in premiums required.

The idea of choice to save money brings back the Ala Carte menu of plans where you can purchase affordable plans with exclusions of benefits and capitations in the amount of benefits received. So the term unlimited appears to now change forever.

The guaranteed coverage is now based on continuity of coverage that reminds me of COBRA, which was always the most expensive insurance and very few would purchase to continue coverage. Base on this simple fact, Americans who cannot afford to continue to pay for healthcare, when in need, must again purchase insurance but now will have to pay 30% penalty in order to have insurance again. This increase premium remains with you defeating the purpose of affordable healthcare.

Another solution is the offer of HSA as the premier benefit, which in reality only benefits the higher income employees under a salary arrangement. The hourly employee would find it difficult to pay the healthcare premium in addition to an HSA. This has been the biggest drawback to the use of HSA, which usually is associated with higher deductibles.

In summary, the American Health Care Act is just a return to business as usual for the insurance industry prior to the ACA 2010 with the exception of the modification of Medicaid that the ACA 2010 only expanded, never altered or change existing benefits. The choice of plans are Ala Carte plan menu of exclusions of benefits to make it more affordable. The guaranteed coverage is based on continuity in benefits not a straight guaranteed. And the only assistance to the working middle class is a tax credit for participating. This is not the change Americans need, at the expense of the most vulnerable by changing the social security law that has withstood the test of time.