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ACP: Repeal, Replacement of ACA Would Negatively Impact Health Care Industry

President-elect Donald J. Trump has pledged to “repeal and replace” the Affordable Care Act, and with a Republican-led Congress, he will most likely obtain enough votes to do so, a senior official with the ACP wrote in Annals of Internal Medicine.

“[Affordable Care Act (ACA)] repeal is complicated. Without a viable replacement, coverage for more than 20 million people will be disrupted,” Robert Doherty, BA, senior vice president for governmental affairs and public policy for the ACP, wrote. “More broadly, even talk of repeal is disruptive to the health care industry because planning and business decisions have assumed that the ACA would remain in place.”

According to Doherty, the Republican party will most likely use an approach called “repeal, delay and replace.” Using this approach would allow Trump and Congressional Republicans to avoid creating turmoil throughout the health care system and immediately disturbing care for millions of Americans, he wrote.

However, signing a “repeal, delay and replace” reconciliation bill into law would likely trigger most insurers to leave the ACA’s insurance markets by the end of 2017 due to uncertainty about the ACA’s replacement, he continued. Doherty cautioned that this could cause as many as 10 million Americans to suddenly lose their health care coverage in 2017, creating “a bigger political firestorm than when the ACA required approximately 4 million people to switch to a different plan in 2013.”

A replacement plan would be difficult to agree upon among Republicans because they are disjointed as to how to change or replace important elements of the ACA, such as the exchanges, subsidies, Medicaid expansion and rules prohibiting discrimination for pre-existing, he argued.

According to Doherty, Sarah Kliff, a veteran health care journalist, investigated seven potential conservative replacement plans and found that in general, such replacement plans “are better for younger, healthy people and worse for older, sicker people ... [and] offer less financial help to those who would use a lot of insurance. This will make their insurance subsidies significantly less expensive than Obamacare’s. Economic analyses estimate that these plans reduce the number of Americans with insurance coverage.”

A repeal of the ACA would mostly affect working class people, women with contraception coverage and individuals with pre-existing medical conditions, according to Doherty.

“Despite its flaws, the ACA has achieved a historic reduction in the uninsured rate in the United States, with more than nine out of 10 Americans having coverage and 22 million and counting getting their coverage from the ACA,” he concluded. “The consequences of ACA repeal are direct, real, and personal for many, and their voices need to be heard.” – by Alaina Tedesco

Disclosure: Doherty reported receiving personal fees from American Clinical and Climatological Association.