Affordable Care Act: To Repeal and Replace?

The Affordable Care Act or Obamacare was signed into law by President Obama in 2010 to give Americans better access to health insurance.  The idea behind it was to provide affordable healthcare for people who weren’t insured through their employers, offering subsidies for low-income Americans who couldn’t afford the premiums and deductibles.

The ACA, also allows people to stay on their parents’ plan until age 26 and prevents those with pre-existing health conditions from being shut out of insurance plans due to their risk level — two parts of the law that are popular.

Donald Trump made repealing Obamacare a cornerstone of his presidential campaign.  Now, Republican leadership in Congress is racing to repeal it.   Trump is promising a replacement plan but Republicans haven’t settled on one.

Over the weekend, Trump told the Washington Post he wanted to replace the ACA with “insurance for everyone . . . in a much simplified form – much less expensive and much better.”

Overshadowed by the politics surrounding the repeal and replacement of ‘Obamacare’ are the 23 million Americans who may see their insurance disappear with the repeal and no replacement.

There are other questions such as what happens to the expansion of Medicaid, how to pay for what’s popular in the ACA and what do the economics of healthcare look like without Obamacare?

Transforming Health reporter Ben Allen has been covering the effects of the ACA on Pennsylvanians for years and he joins us on Smart Talk Tuesday to discuss the implications of a repeal of Obamacare and what a replacement plan may look like.

You can be part of the discussion by emailing us at smarttalk@witf.org, post a comment to our facebook page, or follow our twitter feed at @SmartTalkWITF.

EMAILS

–  One person heara about tv advertising a product…they make an appointment to have something done to them.  It is so mundane.                    – Edward

–  Listening to the callers I thought of another idea, a hybrid.   Everyone is required to have health insurance, maybe by expanding medicare and then for secondary insurance individuals must choose their plan similar to the ACA.                                        – Ann

–  Before ACA I had affordable health care. Now if I could afford any plan, it wouldn’t be health care, it would be catastrophic coverage. When you pay exorbitant premiums and have a high deductible , you don’t go to the doctor because it’s not covered.          – Jeffrey

–  https://www.cms.gov/CCIIO/Resources/Files/Downloads/mlr-report-02-15-2013.pdf        – Dorothy, Carlisle

– Not insurance…there is a big difference…one you get a service to better health…the other is a piece of paper with no guarantees.                 – Edward

–  I’ve been listening to the program about repealing the ACA and I’d like to make a point regarding “winners and losers.” If I take into consideration the money I have paid in health care premiums versus the benefits I have gained from the health care system, I would be in the “loser” category. However, I do not consider myself a loser in the system just because of the fact that I have been healthy and haven’t needed to tap into my benefits very often.

This argument is a bit like saying that if you never had children, but had to pay school taxes, you have been on the losing side of the system, or if you have children, but they don’t have special needs, you lose out when your school district spends money on children whose education costs the district a lot more than that of other children who are more fortunate. When you pay home owners insurance and never had to make a claim because of damage from a fire or theft, are you a loser?

I feel blessed that I am healthy, my children were born without disabilities, I’ve never had to make an insurance claim for my home or car, etc. I am happy to pay into the system, not only because I feel that it’s my responsibility as a citizen, but also because I know that things can change in a heartbeat. I could suddenly be diagnosed with a disease that is expensive to treat, my home could burn down, or I could have a horrendous car accident.

Let’s advocate for a mentality that we’re all this together instead of each person for him/herself.                                                                                                      – Cindy, Carlisle

–  This is no resolution but rather a comparison.  We are all required to buy vehicle insurance even when we don’t use it.  It is there in case we are involved in an accident.  Property insurance is also required if one gets a mortgage.  Why can’t  health insurance be managed in a similar fashion?     – A

–  My four-year-old son had to go under anesthesia for 20 minutes to have a splinter removed from the bottom of his foot.  The cost was $12,000!!!

Thankfully the insurance that we get through my husbands employer covered most of it .

But come on $12,000 is outrageous- agree?!                       – Michelle

–  Prior to Obamacare, insurance costs were going up dramatically. Since Obamacare, Insurance costs have gone up anyway. How can you tell if insurance costs have gone up more or less than they would have increased without Obamacare?                                     – Lee, York

–  Please discuss profit margins of insurance companies with the recent increases in premiums. Also, CEO salaries of these companies.                                      – Diane

–  I am a strong supporter of the Affordable Care Act, but it frustrates me that these conversations of how we will pay for health insurance, but they often do not touch on the root causes of the high premiums. You cannot solve the premium problem without first finding a way to regulate the drug companies and health care costs.                                                          – Mary, York

–  I hear very little discussion about the effects of the loss of the benefits that Medicare recipients gained under the ACA.  How about the closing of the Donut Hole, the free Yearly Wellness Visit, and coverage of Preventative Services like mammograms and colonoscopies without a co-pay or deductible that MIGHT go away because they are part of the ACA.  Please talk about this.                      – Terry

–  1. Obamacare is having an adverse impact on individual health care and getting needed care. Despite having several well-care measures not mandatory in the PPACA rules, insureds are still not as quick to see their providers knowing they now have extremely high deductibles ($4,000+) AND coinsurance of $8,000 or more!

    2.  As discussed, we need TORT REFROM first so we can address the increasing costs of health care (insurance in general!)–don’t blame providers or insurance companies as they are doing what they have to in order to provide services and remain viable to pay claims!

 We need litigation reform first!                                            – Mike, Schaefferstown

–  If you are family of two, the credits are not available after reaching 62k in income. And yes, premium due go up based on age.                                        – L

– One very important issue that I have heard very little about has to do with the potential impact of the ACA on the treatment of individuals with Substance Use Disorder/Addiction. The ACA recognizes substance use disorder/addiction as a chronic disease like diabetes, for example, and as such, expects the insurance companies to pay for treatment at all stages of this debilitating chronic disease. According to the National Institute on Drug Abuse, addiction costs the US $700 billion dollars/year. Data show that early intervention and appropriate long term treatment strategies (like those in place for affected airline pilots and physicians) can greatly reduce relapse rates and promote recovery. This will be lost with the dismantling of the ACA and the costs in dollars and lives (now estimated at 10/day in PA due to drug overdose) will continue.                                                                                                               – Sue, Hershey

– What is the source for the lists Ben read this morning? Also, would you be able to put those lists or links to them on your website?                    – Dorothy, Carlisle

–  Scott Perry, Congressman from York, had an article in Sunday’s paper that stated in part, the following:

1) “. . . Obamacare gutted over $800 billion from Medicare to fund its massive new entitlement . . .”

2)  “. . . many of the architects of the health care law, including the Obama administration, have exempted themselves from its mandates.”

Are either of these statements accurate?                          – Lee, York