Can Obamacare Be Repealed Without a Replacement?

Can Obamacare Be Repealed Without a Replacement?

Many experts, insurance regulators, and state leaders from both parties have voiced concern that an outright repeal of the ACA without its replacement would upheave health insurance markets and have serious repercussions for coverage, access to quality care, the economy and society as a whole.

What is the ACA?

The Affordable Care Act (ACA) makes health insurance more accessible and cost-effective through consumer protections, regulations, subsidies, taxes and exchanges. Furthermore, it encourages innovative approaches to medical care delivery and payment.

The Affordable Care Act prohibits insurers from discriminating against people with preexisting conditions and ensures all plans cover preventive care. Furthermore, premium increases each year must not exceed an amount set aside by law for medical care and improvement projects each year.

Before the Affordable Care Act was in place, many people with preexisting conditions were either denied health coverage or faced high premiums – in many instances either going without coverage altogether or visiting emergency rooms when medical assistance was needed.

The Affordable Care Act also increased Medicaid enrollment to include more people with low incomes. Furthermore, new taxes on medical devices and pharmaceuticals as well as limits to deductions for wealthy individuals have helped cover its provisions and reduce uninsured Americans while slowing overall growth of health care spending in America.

What are the main components of the ACA?

The Affordable Care Act requires health insurance providers to cover essential benefits, and prohibits them from charging those with preexisting conditions higher premiums or excluding them from coverage altogether. Furthermore, the ACA prohibits lifetime and annual limits imposed by insurers on how much coverage will be offered.

This law creates state or multistate-based insurance exchanges where individuals and small businesses can purchase affordable individual market coverage, expand Medicaid eligibility to cover more low-income adults, and make available premium tax credits to assist moderate-income families afford health insurance coverage.

The Affordable Care Act includes an individual mandate requiring most Americans to have health insurance or face penalties, and also mandates employers offer health coverage or pay fines. Republicans have attempted to remove this requirement but federal courts have blocked such efforts and it remains in effect today.

How does the ACA work?

The Affordable Care Act aims to reduce the number of uninsured Americans by expanding private health insurance coverage, offering federal subsidies for some individuals and families, encouraging states to expand Medicaid programs and creating rules on insurers that prevent them from discriminating against or dropping patients, as well as accepting all applicants with preexisting conditions.

KFF research indicates that, despite efforts by the Trump Administration to repeal and replace Obamacare, it remains law. Most Americans across party lines agree it is important for certain aspects of ACA such as guaranteed issue and community rating to remain in place.

The Affordable Care Act has significantly lowered healthcare costs and expanded access to coverage for millions of Americans, but Congress and the Trump Administration’s attempts at obstruction have hindered its progress towards its goals.

What are the main problems with the ACA?

The Affordable Care Act’s individual market has seen sharp premium increases, higher deductibles, and limited provider networks due to insurers trying to adapt to an older and sicker risk pool it entails. This has caused younger and healthier Americans to decline to join exchange plans and absorb losses caused by overcharging older and sicker enrollees.

Trump administration’s decision to cut cost-sharing subsidies has caused additional uncertainty on the individual market. Without them, premiums may skyrocket causing more insurers to leave and discouraging younger and healthier people from entering.

Even with its flaws, most Americans support keeping the Affordable Care Act’s core provisions intact. A July 2019 KFF Health Tracking Poll revealed that majorities across party lines as well as independents say it is very important to keep in place certain aspects of ACA such as guaranteed issue provision and community rating, among others. Furthermore, most people oppose repeal of its employer mandate/work requirements provisions.

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About the Author: Raymond Donovan