The GOP's Dangerous ACA Repeal Plan Would Threaten Health Security for Millions of Americans
ACA BY THE NUMBERS:
- 20 million previously uninsured Americans now have access to affordable health care
- 95 percent of America's children are now covered with health insurance
- Up to 129 million Americans with pre-existing conditions now have protection and health security
- 55 million seniors and people with disabilities enrolled in the Medicare program now receive free preventive services, such as cancer screenings and wellness visits
- 2.3 million young adults have benefited from the ACA's provision allowing children up to the age of 26 to stay on their parents' insurance plans
- 15.7 million more people have Medicaid coverage
- Over 11 million Medicare beneficiaries have saved more than $23 billion thanks to the ACA's closure of the prescription drug donut hole
- Every woman benefits from the fact that being a woman is no longer treated as a pre-existing condition and women no longer are being charged more than men for the same coverage
IN THE NEWS:
…This "repeal and delay" strategy may appear to be a reasonable way to minimize the negative effects of transitioning off Obamacare. It is not. The plan would represent a reckless act of congressional malpractice , threatening the well-being of millions of Americans. The threat of such a policy disaster down the road would have immediate and negative effects on the health insurance market.
Health-care experts and industry groups are sounding the alarm with increasing urgency. They worry, first, that Congress will schedule much of the law to expire in a few years and then fail to agree on a replacement. There is plenty of evidence that lawmakers would not be able to unite behind an alternative. Republicans already have spent years trying to agree on a preferred plan, without success. Meanwhile, strategies based on putting a metaphorical gun to Congress's head generally fail to force action, as the "sequestration" gambit failed to produce bipartisan budget compromise.
…The American Academy of Actuaries sent a letter to congressional leaders Wednesday explaining that the uncertainty of repeal and delay would cause insurers to "reconsider their participation in the market and some may choose to exit in the near term." That would cause "severe market disruption and loss of coverage." Not in three years — now.
Repealing Obamacare is a bad idea.
…Hospitals, insurers and actuaries — bean-counters who make long-range economic estimates — have weighed in, and more interest groups are expected to make their views known soon. Representing patients, the American Cancer Society Cancer Action Network reminded lawmakers that lives are at stake.
The concerns go beyond the obvious potential hardship for the 20 million people covered by subsidized private insurance and expanded Medicaid under President Barack Obama's signature law.
…And the anti-cancer network is concerned that protection for people with pre-existing health conditions might be undermined or lost. Before the Affordable Care Act, it was common for insurers to deny coverage to people with a cancer diagnosis, even if successfully treated, or to charge them more. Also, uninsured people with cancer are more likely to be diagnosed late, when there's less chance of a cure.
…In the meantime, key senior groups say they will be on high alert for anything that reduces health benefits to older Americans or raises the cost of health care. The ACA provided substantial Medicare supports, including new free preventive health services and the phased reduction of drug prices in Part D prescription plans.
"If the Affordable Care Act goes through the appeal process in a very short time, you should be concerned about the solvency of Medicare immediately," says Max Richtman, head of the National Committee to Preserve Social Security and Medicare. "You should be worried about the loss of preventive services. And you should be concerned about the rise in out-of-pocket drug prices."
David Certner, a legislative expert with AARP, said the lack of specifics in Republican calls to repeal Obamacare were of great concern, as are proposals by House Speaker Paul Ryan to provide Medicare enrollees with premium-support payments, or vouchers, and let them buy health insurance in the private market.
The nation's hospital industry warned President-elect Donald Trump and congressional leaders on Tuesday that repealing the Affordable Care Act could cost hospitals $165 billion by the middle of the next decade and trigger "an unprecedented public health crisis."
… Charles N. "Chip" Kahn III, president of FAH, a for-profit group, said the amount of money that hospitals could lose under a repeal of the Affordable Care Act was "unsettling."
Joann Anderson, president of Southeastern Health, a financially fragile rural hospital in Lumberton, N.C., one of that state's most economically depressed areas, said the prospect of repealing the health law without a replacement to keep people insured is "gut-wrenching. .?.?. We cannot take additional cuts."
… Borrowing from Congressional Budget Office estimates, the study says a similar repeal would cause an additional 22 million people to be uninsured by 2026. By then, it predicts, hospitals would lose $165 billion as a result — and $102 billion more unless the government reverses payment cuts the law made to hospitals that treat many uninsured patients.
…Since 2010, the rate of uninsured people in Florida dropped from 21.3 percent to 13.3 percent last year, according to the U.S. Department of Health and Human Services, which tracks how Obamacare has changed the number of uninsured people from state to state.
…Within a year [of repealing the individual mandate], the institute's researchers predict, deterioration in the markets will add more than 4 million people to the ranks of the uninsured. And it will only be a matter of time, the researchers warn, before most if not all carriers exit the markets altogether ? rather than stick around and try to insure a population so weighted toward people in poor health that it's impossible to cover costs.
… Among other things, the researchers found, the vast majority would be from families with at least one household member who is working. A similar percentage would be people without a college degree.
… The Kaiser Family Foundation used data from two large government surveys as well as manuals from insurance companies to arrive at their conclusions. If the pre-existing protections were to be repealed, then 52 million people under the age of 65 would have difficulty getting private coverage, the analysis concluded. The data do not include the number of people who may not be denied because of their condition but who might have had to pay more before Obamacare. Others may have had particular medications denied, such as those used to treat HIV, arthritis or diabetes.
The analysis also found that in some states – Alabama, Arkansas, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee and West Virginia – roughly 30 percent of adults under age 65 have pre-existing conditions. Florida and California have the highest number of people with pre-existing conditions, at 3.1 million and 4.5 million, respectively.
…Tulare County, some of which is represented by [Rep. Kevin] McCarthy, had the state's highest level of Medi-Cal enrollment, 55 percent of its residents, on Jan. 1. The county's two other congressional members are also Republicans. And in fact, most of the rural Central Valley counties with high rates are represented by Republicans.
Were Obamacare – and its financing – to disappear, as McCarthy suggests, California would face a gigantic dilemma on the fate of its 3.8 million optional Medi-Cal enrollees.
The Department of Finance says that during the current fiscal year, their coverage is costing $16.17 billion, 95 percent coming from the feds.
Were that to disappear, California would either have to tell 3.8 million people they are no longer covered – hitting those Republican-represented rural counties the hardest – or cough up more than $15 billion a year to maintain coverage.
To put that in perspective, it's roughly what the state spends on all of its colleges and universities and more than it spends on prisons. It would be twice what's raised by an extra income tax on the state's highest income residents, which voters just extended for an additional 12 years.
…The Empire Center, a fiscal watchdog group, is trying to figure out what would happen if Trump and Congress do make big changes to President Barack Obama's Affordable Care Act. Empire Center health policy analyst Bill Hammond said the state budget could end up with a very large deficit, as high as $2.7 billion.
"My finding is that New York potentially could be hurt more by Obamacare repeal than any other state except California," Hammond said. "This is because we have a really large Medicaid program."
And the state's Medicaid program greatly expanded under Obamacare. States were given the option of expanding their Medicaid programs to enroll more people into the health care exchanges, to those earning up to 138 percent of the federal poverty level. The federal government, for now, pays the entire cost.
The Wolf administration warns that health coverage for nearly 700,000 Pennsylvanians is in jeopardy if President-elect Donald Trump and Republicans make good on promises to repeal the Affordable Care Act.
That's sounding alarm bells because of the impact on those people who got coverage when the state expanded Medicaid last year, as well as rural hospitals.
"It would be a disaster," if the government stopped paying for the Medicaid expansion, said state Rep. Gene DiGirolamo, R-Bucks.
…Hospitals forced to treat thousands of patients who have no insurance and cannot afford to pay their medical bills would be devastated.
"I really believe you would see hospitals close," DiGirolamo said.
While hospitals warn about a large-scale impact of repealing the Affordable Care Act, DiGirolamo said it could devastate families, too.
"This serves people who are working but are making minimum wage. These are people we should be insuring," he said. "This is not a partisan issue, this is something that has been working for people in all our (legislative) districts."
The Urban Institute research shows that in Ohio, more than 960,000 children and adults would lose coverage.
…Joan Alker, executive director of the Center for Children and Families at Georgetown University, says there is a lot of misinformation about who would be most impacted by a repeal of the ACA. She explains it's not just those who are low-income.
"Eighty-two percent of those losing coverage would be in working families," she points out. "The majority of those are non-Hispanic whites and 80 percent of the adults becoming uninsured would not have college degrees."
…The report shows that over a 10-year period, Ohio would lose $48 billion in federal funding to meet the health needs of its residents.