GLOSSARY
Subsidy: an amount of money granted to people or business to keep the price low or competition going.
Mandate: official order to do something.
Provision: providing something for use.
Discriminatory: making or showing prejudice or unfair behavior toward people of a different race, sex, sexuality, or religion.
GOP: Grand Old Party. A different name for the Republican party
Congress: a national legislative body that is comprised of the Senate and House of Representatives.
Filibuster: a prolonged speech that stops or slows down the process of passing a law.
What are the key concepts of the Affordable Care Act?
Ever since former President Barack Obama passed the Affordable Care Act (ACA) there have been many changes to healthcare that has added more provisions like more subsidies, the individual mandate, and essential health benefits. Before the Affordable Care Act, individuals had to buy their own health insurance, but with the provisions of the ACA, David Manko, Gregory Mitchell, and Jonathan Salm who work at Rivkin Radler LLP Health Services Practice Group state, “The ACA created the individual and employer mandates, which require nearly every citizen to obtain health insurance, and employers with more than 50 full-time employees to offer healthcare coverage to all full-time employees and their dependents.” The mandates the ACA has created helped many employees have an easier time with getting coverage they need at a lower price. Getting the coverage for the health services people need is big deal, especially when the health conditions are seen as pre-existing conditions or are very expensive without coverage. And according to Jennifer Sneden from the Colorado Daily, for women, “Since the ACA, over 47 million women obtained access to health services that were previously denied or offered at extremely high co-pays.” The coverage of health services for women is included in the “essential health benefits” provision of the ACA, which is an important part because it covers all the basic health needs and extra in order to keep prices non-discriminatory for men and women and to include any emergency situations in a person’s health. The Affordable Care Act has covered more people since its enactment but many officials in the government are against the act, especially the GOP, or as they are also known more commonly as: Republicans, who are in the process of repealing it since President Trump has ordered an Executive Order.
What can Republicans do to repeal the Affordable Care Act? Can Democrats stop this?
Republicans have been against the ACA since day one and now that there is a Republican lead in both of the houses in Congress and Donald Trump as president it’s very possible that the government will repeal it. Right at the beginning of Donald Trump’s presidency he ordered an Executive Order to begin the repeal process of the ACA and according to Leandra Bernstein from her article on KCBY, Trump can successfully repeal most if not all of the ACA “because of the massive web of regulations and rules put in place through executive actions under President Barack Obama, there is actually quite a lot Trump can accomplish on his own in a short period of time.” Although the Executive Order can do a lot to repeal the ACA, there is another process which can help the repeal process possibly go faster if Republicans need it, called reconciliation. Partners and associates of Rivkin Radler LLP Health Services Practice Group, David Manko, Gregory Mitchell, and Jonathan Salm, stated that “Reconciliation allows federal budget bills to be approved in an expedited fashion; requiring only 51 votes in the Senate and allowing a maximum of 20 hours of debate, eliminating the threat of a Democratic filibuster.” With the Executive Order of Donald Trump, the repeal process is beginning which can affect many industries like hospitals, and it can also dramatically affect hospitals.
What does the repeal mean for hospitals and state budgets?
Hospitals and state budgets will have some dramatic spending changes if the ACA is repealed which can have either bad or good effects. A state that can be affected majorly by the repeal is New York because according to Kenneth Raske and Kenneth David from Modern Healthcare, “if New York reverted to pre-ACA Medicaid eligibility levels, its Medicaid spending would increase by nearly $2 billion in 2021. That amount would spike even higher if New York chose, post-repeal, to keep its ACA expansion population covered.” If spending by the state is estimated to rise that means insurance will cost more to the people of New York. If the price of insurance increases, then there is the risk of people not buying health insurance which could mean less income for hospitals. According to the same article by Kenneth David and Kenneth Raske, “The American Hospital Association estimates that stripping more than 22 million people of their health insurance would reduce hospitals’ net income by $165.8 billion over 10 years.” Although, the states and hospitals spending and income is estimated to change drastically, the most important impact of the repeal could be the loss of insurance to millions of people that can’t afford a spike in the cost of health insurance.
How will this repeal affect the American population?
Many Americans use the Affordable Care Act to be able to afford healthcare and if the repeal goes through at anytime, many Americans will lose their insurance because it will get too expensive. For example, Kenneth Raske and Kenneth Davis from Modern Healthcare say that “More than 22 million Americans, including hundreds of thousands in our home state of New York, could lose their health insurance if Obamacare is repealed without an appropriate replacement plan.” And this isn’t just in New York, millions of other people in different states will be affected as well. In MJ Lee’s article from CNN, Senate Minority Leader Chuck Schumer agrees with Davis and Raske as well because he says that “Millions of Americans would be kicked off their plans, out-of-pocket costs and deductibles for consumers would skyrocket, employer-based coverage for working families would be disrupted, and protections for people with pre-existing conditions, such as cancer, would be gutted. All while the wealthiest few get a tax cut.” Millions of Americans losing their health insurance is not good, so obviously the officials in Congress would have to implement replacement plans to cover people that can’t afford insurance without government help.
What new plans are proposed by the new Trump administration?
After repealing the ACA, Republicans will need to pass a new healthcare plan to cover the people that will most likely lose their health insurance because of a spike in prices and the removal of subsidies. In order for this to not happen, many Republicans are now proposing their own plans to replace the ACA. In CNN’s article by MJ Lee, it says that “Sens. Bill Cassidy of Louisiana and Susan Collins of Maine unveiled a bill that they are describing as an "Obamacare replacement plan." The duo is promising that the proposal would give more power to the states on health care policy, increase access to affordable insurance and help cover millions of Americans who are currently uninsured.” This “Obamacare replacement plan” is an example of how Republicans are proposing new plans that have less federal government control and more state control on if they want to keep the provisions of the ACA or not. Another replacement plan to the ACA is discussed in a Youtube video by the Youtube channel HealthTriage where Aaron Carroll talked about a new plan by House Speaker Paul Ryan called “A Better Way” plan which is very similar to Barack Obama’s Affordable Care Act because it keeps the business mandate, guaranteed issue, and uses subsidies, but they’re based on age and not income like in the ACA. Some of the differences are that older people would be charged five times more than younger people instead of three times more, the essential health benefits would be removed, and Medicaid would turn into a block grant program, which means that states have more freedom on how to spend money and on what. There are more replacements plans by other officials in government that have similar main points. After all, Republicans are trying to repeal the ACA, which they see as very expensive for most Americans and replace it with a cheaper plan that would still help families that need it.
To learn more about possible replacement plans to the ACA, go to the video below...
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