In the early morning hours of Thursday January 12, Senate Republicans passed a budget resolution designed to help them dismantle the Affordable Care Act. The resolution passed with a 51-48 vote, and follows the same model as the budget resolution, which originally helped structure ObamaCare. Although the Senate passed the resolution, it will still be several weeks before the House of Representatives votes.
President Obama signed the Affordable Care Act into law on March 23, 2010. Its main purpose was to provide millions of uninsured with health insurance and to expand Medicaid. The law required insurance companies to charge the same rates regardless of sex or preexisting conditions, as well as cover a certain list of conditions. There was an individual mandate requiring that a person have insurance, or pay a penalty. It also required full coverage of preventative care for women, including contraceptives. Although the law was signed in 2010, the healthcare website did not launch until October 2013 with Healthcare.gov. The website rollout was rocky, with the site crashing and failing to properly operate. There were also concerns that the “affordable” healthcare was not so affordable, especially with premiums rising 22 percent overall. Even with all its problems, the Affordable Care Act achieved its main goal, by allowing more than 20 million people to receive health insurance.
“The main criticism of ObamaCare comes from the private health insurance exchange.”
Opponents of the individual mandate of the Affordable Care Act filed a lawsuit challenging its constitutionality. In National Federation of Independent Businesses v. Sebelius, the Supreme Court of the United States made a 5-4 ruling, stating that the individual mandate was a Constitutional exercise of the congressional taxing power. In 2013, there was a shutdown of the federal government, when congressional republicans refused to fund anything unless the mandate applied to employers was delayed. In response, President Obama delayed the mandate by one year. The main criticism of ObamaCare comes from the private health insurance exchange. Many of the plans are very expensive, with extremely high deductibles, adding to the cost.
Republicans now have control of Congress and the Presidency, and have been very vocal about plans to repeal and replace the Affordable Care Act, even before passing the resolution. Congressional Leaders want to reduce the cost of the healthcare program to the federal government, and believe in a more market-based system. During the Presidential election, now-President Donald Trump promised insurance for everyone, but never proposed a solid replacement plan to ObamaCare. Republicans have wanted to replace ObamaCare since it was passed in 2010, but still have no concrete plan in place.
“Healthcare and prescription costs are already very high, and in the event of a repeal, these costs will rise uncontrollably.”
One thing is certain: nothing is certain about the future of healthcare. President Trump and Congress seem to be on different pages, both offering different timetables for when the healthcare repeal should happen. President Trump stated that the repeal and replace plan should happen quickly and simultaneously, but the Republican congress is only starting the repeal process. Congressional leaders say it could take months or even years to have a substantial replacement plan. The majority of Republican leaders want to have the repeal process completed by the end of January, but others want to postpone the vote until March, giving them time to formulate a replacement plan.
“For those who suffer from preexisting conditions, such as cancer or asthma, getting health insurance can be a nightmare.”
There are several issues that would arise from repealing the Affordable Care Act without first introducing a replacement. Healthcare and prescription costs are already very high, and in the event of a repeal, these costs will rise uncontrollably. Millions of people have relied on ObamaCare to provide them with insurance they might not be able to afford otherwise. Women have had access to free annual exams and birth control, leading to our nations lowest abortion rate in decades. If Republicans successfully repeal the Affordable Care Act, women may go back to paying out of pocket for birth control and annual exams.
For those who suffer from preexisting conditions, such as cancer or asthma, getting health insurance can be a nightmare. The Affordable Care Act made it possible to them to get insurance without being turned away, and without paying more than anyone else. An estimated 27 percent of adults under the age of 65 suffer from some type of preexisting condition that made them uninsurable prior to ObamaCare. Many who suffer from preexisting conditions are concerned that a replacement will not protect them, and fear they will be uninsured during the gap period.
People who currently have help paying health insurance through the ObamaCare subsidies are concerned about what a repeal means for their futures. For example, North Carolina resident Alison Koehler found she was not making enough money to afford insurance, but made too much for Medicaid. She was ale to obtain insurance thanks to the subsidies.
“Under the Affordable Care Act, Medicaid is a joint state and federal program, but during the repeal and replace process, Republicans plan to give full control of Medicaid to the states.”
Currently, parents can keep their children on their health insurance until the age of 26. This is helpful for those young people who are in school, or who have jobs that may not provide health insurance. The Affordable Care Act made that possible, and if that portion is repealed, parents can only have kids on their insurance plans until the age of 22. This would leave millions of young people uninsured, simply due to their age.
Under the Affordable Care Act, Medicaid is a joint state and federal program, but during the repeal and replace process, Republicans plan to give full control of Medicaid to the states. Instead of being jointly funded, it would turn Medicaid into a block grant program, meaning the government would give states a certain amount of money for Medicaid, for them to distribute however they see fit. It is unknown whether Congress will tell states to cut back on their Medicaid eligibility, but it certainly could happen, which would leave a large group without healthcare.
As one of his first acts as President, Donald Trump signed an executive order, which directed federal agencies to minimize economic burdens of ObamaCare. The order also tells agencies to waive, defer, or delay imposing any provisions that impose fiscal penalties. This means that if you do not have health insurance, there is more discretion in whether you will be required to pay the penalty. President Trump has been vocal about replacing the Affordable Care Act, so there could be more executive orders in the future. The next month will be telling on where the future of healthcare is headed.