Republican repeal plans may jeopardize thousands of lives saved annually through Affordable Care Act marketplace insurance for vulnerable Americans.
If the Affordable Care Act were repealed, approximately 29 million would lose access to health care coverage and costs would increase for all. According to estimates by the Congressional Budget Office.
What?s the current alternative?
Many states have their own rules regarding Special Enrollment Periods (SEPs), though most only allow people to enroll through their exchange (though some allow off-exchange enrollment as well). Under Obama administration policies, some SEPs for people losing subsidy eligibility were subject to an audit program which kept applications pending until documentation could be provided by insurers and received.
Also available exclusively through exchanges is a new Special Enrollment Period for people who gain a dependent, as it only applies to those whose income doesn’t surpass 150% of poverty and who qualify for premium subsidies in the marketplace. Furthermore, this SEP only exists as it’s intended to cover those left without coverage as a result of rule changes that made benchmark plans premium-free for households earning up to 150 percent of poverty.
The Affordable Care Act (ACA)
PPACA — commonly referred to as Obamacare — is the landmark healthcare legislation passed by Congress and signed into law by President Barack Obama in March 2010. Key provisions include mandating employers provide health insurance to employees, creating state-based exchanges where individuals can purchase major medical plans at discounted prices, expanding Medicaid eligibility for lower-income families, prohibiting annual or lifetime limits on coverage and cancelling or revoking policies, as well as prohibiting cancellation or revoking policies at will.
The Affordable Care Act has faced multiple hurdles since its implementation. Legal attacks to its core benefits were made public in 2014. Since then, the Supreme Court has agreed to hear King v Burwell. This case challenges federal subsidies designed to assist low and moderate income Americans afford insurance on government marketplaces; with Justice Ginsburg retiring and Amy Coney Barrett’s nomination by Trump administration as her replacement this case could become a crucial test of constitutionality of ACA.
The Patient Protection and Affordable Care Act (PPACA)
The Affordable Care Act, also known as Obamacare, has made healthcare accessible and more cost-effective for all Americans while simultaneously protecting consumers against discrimination based on preexisting conditions and lifetime or annual limits on benefits; eliminating copayments or fees associated with preventive services; and mandating that plans spend at least 80%-85% of premium funds on actual healthcare services.
This legislation gives patients greater autonomy in choosing their doctors and hospitals, gives states the option of expanding Medicaid, provides tax credits to small businesses, creates a Patient-Centered Outcomes Research Institute and establishes Accountable Care Organizations for Medicare beneficiaries with complex chronic or behavioral health needs, while making it easier for people to start businesses, take time off to raise families or retire when desired.
Due to the Affordable Care Act (ACA), more people are attending work more regularly and spending less on uncompensated care – helping strengthen our economy and create jobs at a time when unemployment remains elevated.
The American Health Care Act (AHCA)
The American Health Care Act (AHCA) would offer numerous tax breaks for wealthy Americans while repealing several existing taxes: 40% excise tax on high-end employer-sponsored plans; 10% tanning bed tax and 2.3% medical device manufacturer tax would all be repealed; additionally it suspends $500,000 annual executive compensation limit and eliminates Medicare payroll tax on income exceeding $250,000 for individuals.
This bill removes penalties that required employers to provide coverage, while also imposing a fee on individuals who go more than two months without insurance (63 days technically). Furthermore, it allows states to receive waivers from essential health benefit requirements within the Affordable Care Act and alters how premium tax credits are calculated.
It also establishes a fund to aid insurance markets and foster marketplace participation through state-based reinsurance programs, while creating an “invisible risk sharing” program in which insurers identify enrollees with high cost conditions and transfer them into a federal pool that would cover claims exceeding certain thresholds.
