Almost nothing you have just said is accurate. First of all, the AHCA still had subsidies, just less effective ones. But the AHCA would still have “forced others to pay for the subsidies.”
The only people in the United States that pay the full cost for their insurance without receiving any sort of tax break or other government assistance are people on the individual market that do not qualify for subsidies. This is a very small group. The vast majority of people getting insurance on the individual market qualify for subsidies. And the only way costs would have been brought down for anybody else (other than the wealthy people who would’ve received huge tax cuts with the AHCA) would have been because the AHCA gave subsidies to even more people. This would have been a great idea if the subsidies were anywhere near adequate, but they aren’t. The number of people that 1) did not qualify for a subsidy before but do now, 2) could not afford coverage before, 3) would get an adequate subsidy to be able to afford insurance now, and 4) would actually use the subsidy to buy insurance rather than choosing to go uninsured, is vanishingly small. It is true that the people who do not qualify for subsidies now and are looking for insurance on the individual market in areas with extremely high health care costs are suffering right now because the ACA did not fix the individual insurance market for them. But the AHCA barely provided any help to them (and, in many cases, could have made things worse) while inflicting significant pain on millions of others who are at an even higher risk and less able to handle it.
Overall, prices would not be brought down. There were no cost controls in this bill. Again, the only thing that would have brought costs down for anyone is if they now qualified for a subsidy, but that does nothing to bring the total cost of health care down. Fewer people buying health care would not bring prices down for everyone else. It would bring them up because the people less likely to buy care are the people who do not think they need it (young, healthy people), while older, sicker people (people who use more care and are more expensive to provide health care for) would be sure to buy insurance to save themselves money. Of course, the AHCA’s solution to this was to make insurance completely unaffordable for elderly people on the individual market, which is why the CBO says premiums would go down on average in the AHCA even though premiums would not go down adjusted for age. Premiums would go down on aveage because older people would be priced out of the market altogether, and older people are charged more. But, on an individual level, prices would still go up, largely because of healthier people choosing to go uninsured, which would likely have more than given back whatever gains in the healthy-sick mix the AHCA would have made by pricing out so many older people.
As for the ACA collapsing, that is not the case. The CBO just confirmed it in their AHCA analysis. To be sure, there are some places, particularly rural areas, where health care is still too expensive and there are only one or two insurers willing to offer coverage. That does not mean collapse, and even if it did, it would be isolated to certain areas, with the vast majority of the country unaffected. But, even in those areas, collapse is unlikely under the ACA, and it would have been more likely under the AHCA than the ACA.
This is because the subsidies in the AHCA were not tied to local costs, making them completely insufficient for these areas where high prices could cause a collapse (even though more people would have qualified for subsidies, the subsidies would have become practically useless because they were dwarfed in comparison to costs). With subsidies that are not be enough to make insurance affordable, fewer people would be able to sign up for insurance, and insurers would have little incentive to serve those areas and less ability to do so profitably. So for all those areas you hear about that only have one or two insurers, the AHCA would have made it more likely that they would end up with zero.
On the other hand, ACA subsidies vary based on local costs, so the consumers are still able to afford insurance even when health care costs are rising, creating a larger market for insurers to offer coverage in these expensive areas than there would have been under the AHCA. Because consumers getting subsidies are mostly insulated from premium increases, insurers, especially if they are the only insurer in the area, can feel free to raise premiums as much as they need to to remain profitable in that area. This is a big reason why “ACA collapse” is unlikely even in struggling, high-cost areas where it may be possible: the ACA still allows insurers to be profitable while still allowing the vast majority of consumers to afford coverage. This was not the case under the AHCA.
It should be noted that, although collapse is unlikely in these areas, the high cost of care is still a huge problem for anyone in the individual market that does not qualify for a subsidy. Insurance remains completely unaffordable for many of them, but the AHCA would not really have improved the situation. More must be done to bring down costs in these areas and/or extend subsidies to more people. Again the AHCA did not have cost controls, and the subsidies were inadequate, so it was not a solution to the big policy problems people have with the ACA. What it was a solution for was the fact that wealthy taxpayers who were on the hook for the large subsidies in these areas. There is an ideological argument for helping them, but even if this is the goal (rather than sound policy being the goal), it can be done in a way that doesn’t take coverage away from millions of people.
Furthermore, the AHCA would have risked collapse even in areas where ACA exchanges are working well. Though the CBO initially said that markets would be stable under either the ACA or the AHCA, this was before essential health benefits were removed from the bill. Though the CBO found that a weak subsidy and a weak penalty would still be enough for a stable market, those weaknesses plus the addition of junk insurance is a recipe for disaster. Suddenly, healthy people have a choice of ultra-cheap but inadequate plans, and many will choose them, while sick people will choose the more generous plans they need. But without enough healthy people in the generous plans, the generous plans get more and more expensive until nobody can afford them. Then even all the sick people have to buy the inadequate plans, which raises the price of those plans and/or makes insurers remove whatever useful benefits they did cover, until everyone is paying more money for coverage that is getting worse and worse.
As for people dying, it’s obvious, and it inevitably follows from a bill that makes our health care system worse in so many ways. Fewer people receiving health care, especially when so many of those people are from at-risk populations like the elderly and the poor, means more preventable deaths. More and more people buying junk insurance that doesn’t actually cover what they will need if they ever get sick means more preventable deaths. It’s unavoidable. But, if you want research/doctors groups/sources to back it up, here you go:
If 24 million people lose insurance, we'll see more than 24,000 extra deaths per year.www.vox.com
Now that President Trump is in the Oval Office, thousands of American lives that were previously protected by…www.washingtonpost.com
The ACA is not perfect. It could be made much better if our political leaders would work in good faith to try to improve it. But the AHCA took almost every problem the ACA has and made it worse, and it took many of the problems the ACA solved and made them problems again. The AHCA was indefensible on its merits, which is why most stakeholder advocacy groups and virtually every policy expert left, right, and center opposed it, with many of whom expressing astonishment at the level of incompetence that went into its crafting. All supporters had, and all you gave me, were misleading ideological talking points that were not backed up by evidence and were devised to support objectives that had absolutely nothing to do with improving American health care.