President Trump and other Republicans want to overturn the Affordable Care Act (ACA). This seem especially worrisome since Republicans have not offered an alternative. Consequences for quite a few American were mentioned in my previous post (Repeal ACA now and maybe replace later ).
In addition to the 20-23 million Americans who would lose their medical insurance mentioned in that post there are other consequences. Under the ACA, Medicaid was expanded to include more low income people if the state agreed. These people would become uninsured.
Pre-existing health conditions
The Centers for Medicare & Medicaid Services put it this way:
According to a new analysis by the Department of Health and Human Services, 50 to 129 million (19 to 50 percent of) non-elderly Americans have some type of pre-existing health condition. Up to one in five non-elderly Americans with a pre-existing condition – 25 million individuals – is uninsured. Under the Affordable Care Act, starting in 2014, these Americans cannot be denied coverage, be charged significantly higher premiums, be subjected to an extended waiting period, or have their benefits curtailed by insurance companies.
As many as 82 million Americans with employer-based coverage have a pre-existing condition, ranging from life-threatening illnesses like cancer to chronic conditions like diabetes, asthma, or heart disease. Without the Affordable Care Act, such conditions limit the ability to obtain affordable health insurance if they become self-employed, take a job with a company that does not offer coverage, or experience a change in life circumstance, such as divorce, retirement, or moving to a different state. Older Americans between ages 55 and 64 are at particular risk: 48 to 86 percent of people in that age bracket have some type of pre-existing condition. And 15 to 30 percent of people in perfectly good health today are likely to develop a pre-existing condition over the next eight years, severely limiting their choices without the protections of the Affordable Care Act.
Medicare
From the Kaiser Family Foundation :
How would ACA repeal affect the solvency of the Medicare Hospital Insurance trust fund?
Fully repealing the ACA would accelerate the projected insolvency of the Medicare Hospital Insurance (HI) trust fund, out of which Part A benefits are paid. This would result from higher spending for Part A services due to higher payments to Part A service providers (such as hospitals) and Medicare Advantage plans for services provided under Part A, along with reduced revenues, if the additional 0.9 percent payroll tax on high earners is repealed. As a result, Medicare would not be able to fulfill its obligation to pay for all Part A-covered benefits within a shorter period of time if the ACA is repealed than if the law is retained.
Does it seem right to throw millions off medical insurance during a pandemic? What about unintended consequences?