Who’ll lose health care after ACA repeal?

Later this month, Republicans in Congress plan to repeal large portions of the Affordable Care Act (ACA), aka Obamacare. The consequences for the health and financial security of tens of millions of Americans will be severe. Who’ll lose health care after the ACA is repealed? In a post-Obamacare world, access to care will be in jeopardy for tens of millions of working Americans whose employers don’t offer them coverage as well as for non-working Americans between jobs, unemployed or with pre-existing conditions.

While the ACA did little if anything to restrain the growing cost of health care, it required that health insurers both provide coverage to anyone wishing to buy it and cover essential benefits. It also put a cap on insurer profits and administrative costs. Once Republicans repeal the ACA, there’s every reason to expect that insurers will once again 1) refuse to cover people with pre-existing conditions or charge them unaffordable premiums, 2) sell plans offering inadequate health coverage, and 3) take greater profits, raising premiums, copays and/or deductibles.

In a post-Obamacare world, comprehensive health insurance will be unaffordable or unavailable to a large portion of non-elderly Americans. The Kaiser Family Foundation projects that 27 percent of people under 65 have pre-existing conditions that would lead health insurers to deny them coverage. In 11 states, three in ten nonelderly Americans will not be able to buy health insurance. Those states are West Virginia (36%), Mississippi (34%), Kentucky (33%), Alabama (33%), Arkansas (32%), Tennessee (32%), Oklahoma (31%), Louisiana (30%), Missouri (30%), Indiana (30%) and Kansas (30%).

Pre-Obamacare, 52 million Americans could not buy health insurance because of their pre-existing conditions. And, millions more Americans were underinsured, with inadequate coverage to meet their health care needs if they developed costly or complex conditions.

A new report from the Urban Institute projects that 58.7 million Americans will be uninsured by 2019, more than double the number of uninsured today, 28.9 million. In 2019 alone, the federal government will spend $109 billion less on health care.

• About 9.3 million people will lose the government subsidies the ACA offers and will no longer be able to afford coverage.
• Nearly 13 million people will lose Medicaid or coverage through CHIP, the Children’s Health Insurance Program.
• Many employers will stop covering their workers once they are no longer required to do so.

And, while Republicans are saying that they may keep the ACA subsidies in place until they pass a replacement plan, it’s more than likely that a large number of health insurers will stop offering coverage in 2018.  Insurers will fear attracting too many people with costly conditions once Republicans repeal the ACA’s mandate that most everyone have health insurance.

The full consequences of the ACA repeal for people with Medicare are less clear but not good. The ACA extended the life of the Medicare Trust Fund 12 years. It also reduced Medicare Part D prescription drug costs. Moreover, once the ACA is repealed, Medicare premiums are likely to rise as more people under 65 go without coverage and forego needed care before becoming Medicare eligible.

The smartest and most cost-effective solution to this brewing health care crisis would be to expand Medicare to everyone in America, a solution most Americans support. In the meantime, please sign this petition to tell Congress: Hands off Medicare.

Here’s more from Just Care:

• What’s the Medicare premium in 2017?
• Republicans’ new year’s resolution: Destroy Medicare