Almost everyone will be affected to some degree. Seniors on Medicare may face increased payments, and the return of the “donut hole” will make prescription drugs more expensive. Free preventive care, such as contraceptives, mammograms, colonoscopies and cholesterol tests, may also disappear.
The medical community has responded, albeit somewhat weakly. The American Medical Association wrote an open letter to Congress urging lawmakers to reveal specifics about how they would replace the ACA before they repeal it.
The American College of Physicians, the American Congress of Obstetrics and Gynecology, the American Academy of Pediatrics and the American Academy of Family Physicians, collectively representing close to 400,000 physicians, have sent a joint letter to congressional leaders urging Congress not to increase the number of uninsured Americans and to ensure that a viable safety net remains.4
In a somewhat stronger statement, the ACP sent a letter separately to the Senate, imploring them to vote “No” on the budget resolution that would start the process of repealing the ACA in order to avert the “chaos” that would result in insurance markets and to prevent millions from becoming uninsured.5
Republicans often talk about keeping the best parts of the ACA and fixing the worst. They deem the “best parts” to be coverage through parents’ insurance until age 26 and not being denied insurance based on preexisting conditions. However, it remains to be seen how they will keep these parts without having everyone chip in to pay for them. Although no consensus exists, Republicans have tossed about phrases such as “association health plans,” “tax credits for consumers” and “high-risk pools,” while Democrats have tried to reinforce the ways in which the ACA has been successful.2
Paul Waldman, American columnist and regular contributor to The Week, summarized the problem clearly: “We don’t yet know for sure what the Republican ‘replacement’ for the ACA is going to be, because they don’t know themselves. What we do know is that when you repeal the law, a lot of people are going to lose a great deal — in money, in security and even in their lives. It’s something we shouldn’t forget when Republicans assure us of how terrific everything’s going to be once they’re done.”6
Hopefully, our government will take a step back from their determination to repeal the ACA and look at the potential harm repeal could do to many of America’s most vulnerable citizens. If Trump wants to make American’s health better, he will have to put aside his personal feelings and present solid plans for change before erasing what is working now. This is not an easy problem and there are no easy solutions. While the “ACA has not been perfect, it has resulted in the lowest uninsured rate ever and has aided in providing accessible, high quality and cost-effective care to all types of patients.”5
It doesn’t sound like a repeal of the ACA is needed to me.
1. The New York Times Editorial Staff. “Republicans Are Courting Disaster on Health Care.” The New York Times. Updated January 4, 2017. Available at: http://www.nytimes.com/2017/01/04/opinion/republicans-are-courting-disaster-on-health-care.html?action=click&pgtype=Homepage&clickSource=story-heading&module=opinion-c-col-left-region®ion=opinion-c-col-left-region&WT.nav=opinion-c-col-left-region. Accessed January 5, 2017.
2. Pear, R. “Republicans’ 4-Step Plan to Repeal the Affordable Care Act.” The New York Times. Updated January 4, 2017. Available at: http://www.nytimes.com/2017/01/04/us/affordable-care-act-congress-repeal-plan.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region®ion=top-news&WT.nav=top-news. Accessed January 5, 2017.
3. “Cummings Issues Response to Republican Plan to Repeal ACA” [press release]. Washington, DC: Committee on Oversight and Government Reform; December 7, 2016.
4. “Four Leading Medical Organizations Urge Congress to Protect Patients’ Access to Health Care” [press release]. Washington, DC: American Congress of Obstetrics and Gynecology; January 2, 2017.
5. “American College of Physicians Asks Senate to Oppose Repealing Affordable Care Act” [press release]. Washington, DC: American College of Physicians; January 3, 2017.
6. Waldman, P. “Who Loses When Republicans Repeal ObamaCare? Almost Everybody.” The Week. Updated January 5, 2017. Available at: http://theweek.com/articles/671002/who-loses-when-republicans-repeal-obamacare-almost-everybody. Accessed January 5, 2017.