Republicans in Congress have ceremoniously voted to repeal the Affordable Care Act (ACA) over sixty times in the past seven years without ever proposing a replacement…until now. Republicans’ repeal legislation, which they plan to push through without any public debate, takes the affordable and the care out of the ACA. As a result: average workers, women, senior citizens, middle class families and those with pre-existing conditions are the clear losers.
It’s important to remember why healthcare reform was a priority in 2009: at the time, insurance premiums were rising well beyond inflation; Americans were being thrown off or denied health care because of pre-existing conditions; and medical expenses were the number one cause of personal bankruptcy in the United States. In the 2008 presidential election, health care affordability was a key priority for most voters.
Republicans, who have vowed to repeal the ACA since its passage, maintain that cost is their primary concern. Yet their proposal dismantles the ACA’s revenue- and cost-savings provisions while maintaining many of the expensive benefits; this creates an unsustainable system that is likely to drive insurance rates way up.
Republicans plan to eliminate both the individual and employer mandates, both of which have contributed to the ACA’s stability and affordability. Without the individual mandate, there is no incentive for young, healthy people to purchase insurance. This results in a pool made up of aging individuals with pre-existing conditions¬and, inevitably, higher premiums.
Removing the employer mandate, means large companies no longer have to offer coverage to full-time workers. It’s estimated that over one million Americans had acquired insurance through this provision.
The Republicans’ retention of certain ACA provisions means higher premiums; yet they offer no solutions, as the ACA did, to sufficiently address rising costs. Plus, older Americans will pay much more and anyone who allows their plan to lapse will pay excessive fees once they resume coverage.
The repeal allows people with disposable income to put substantially more money into Health Savings Accounts (HSAs). This is great for someone like me who is looking for a possible tax incentive; but for a family saving for college or just trying to get by, this caveat offers no benefit. For a healthy person, an HSA can be a great way to save for future health issues. For someone with a chronic illness, HSA funds can be quickly depleted.
Republicans will cut the subsidies that have allowed ten million Americans to afford coverage. Their proposal relies on tax credits that do little for those who earn little and does not go far enough to cover rising insurance costs. Under the republican plan, most Americans will see a significant decrease in subsidies, making it all the more difficult to afford comprehensive coverage.
The repeal plan would defund Planned Parenthood, eliminating essential health services for men and women, including cancer screenings, family planning, and treatment for sexually transmitted diseases.
Defunding Planned Parenthood would also severely limit low-income women’s access to contraception. The republican plan further targets women’s reproductive rights by prohibiting tax credits for private health insurance that includes coverage of legal abortions. These provisions would essentially eliminate a woman’s freedom of choice.
The fate of Medicaid, under this plan, is especially alarming. If Republicans decide to eliminate the Medicaid expansion (as some conservatives are proposing), millions would lose access to healthcare. At the very least, the plan would place federal caps on Medicaid spending, shifting the burden, over time, to the states.
There are many unanswered questions. Republicans want to fast-track their repeal plan with zero input from stakeholders and the public. In comparison, the ACA benefited from over 180 public meetings and hearings in Congress, plus hundreds of local town halls across the country.
Health care affects us all. It’s an issue far too important for the public to not be fully involved; people should have more input and influence than the special interests that too often sway the decisions of our political representatives. We need an open and transparent debate¬not one held behind closed doors.
Please call Representatives Lou Barletta and Tom Marino and demand ample opportunity for public input. Demand they host town halls before they vote on this bill.
Nicole Faraguna lives in Herndon and is a co-founder of the Susquehanna Valley Progressives.