The U.S. House of Representatives could vote as early as Friday on the latest version of the American Health Care Act (AHCA). The latest changes to the bill do nothing to remedy its most harmful consequences: An estimated 24 million fewer people with health insurance, hundreds of billions of dollars in cuts to the Medicaid program and higher out-of-pocket costs for people who buy policies in the individual insurance marketplace.

The proposed amendment makes this bad bill even worse for Louisianans by gutting key consumer protections and eliminating basic coverage requirements for health plans. It would let insurers charge more for people who are old or sick and take America back to the days when people could be denied coverage because they had a pre-existing condition like cancer or diabetes.

This is how the AHCA would affect Louisiana:

1. The bill would make coverage less accessible and affordable.

– It would introduce new barriers to care by reducing the amount of financial assistance available to help low-income consumers pay for coverage.

– The premium tax credit for Louisiana consumers would decrease by an average of $3,013 compared to the current law.

2. The bill would increase out-of-pocket costs while eliminating many of the Affordable Care Act’s benefits and consumer protections.

– It would repeal actuarial value requirements, which would result in many consumers paying more for less.

3. The bill would make deep cuts to Medicaid and would cap federal funding for the program – which would result in reduced access to coverage and benefits and shift costs to the states.

– It would effectively end Medicaid expansion by winding down its funding after 2020. More than 417,000 Louisianans have gained coverage through the expansion since July 1.

– It would create per-capita caps for Medicaid, which would shift healthcare costs from the federal government to Louisiana. Estimates show that Louisiana would have to spend an additional $10 billion over the next decade to replace lost federal funding under the proposed per-capita caps.

The Congressional Budget Office estimated the original AHCA would result in 24 million fewer people having health insurance, and that federal spending on Medicaid would be cut by $880 billion over a decade.

Now, the “MacArthur” amendment, authored by Rep. Thomas MacArthur of New Jersey, proposes to eliminate popular consumer protections and could further increase the number of people that would be uninsured under the bill. Specifically, the proposed amendments would:

1. Roll back key pre-existing conditions protections. Just like before the Affordable Care Act, discrimination based on pre-existing conditions would be allowed except in states that chose to prohibit it.

2. Roll back nationwide standards that require plans to cover services like mental health and substance use treatment and maternity care, and that prohibit lifetime and annual limits.

Even more so than the original legislation, the amended AHCA would be a major step backward for Louisianans and would worsen the state’s already dire budget situation.