GOOD

Here’s What Will Happen To Your Healthcare If The Affordable Care Act Is Repealed

Expect chaos—even if you get insurance through your job

Within days of Trump’s inauguration, Republicans swiftly laid the groundwork to “repeal and replace” the Affordable Care Act, nicknamed “Obamacare,” which provided health insurance to more than 20 million Americans. The public has responded with panic about pre-existing conditions and potential sticker shock, storming the offices and town halls of waffling representatives.


Yet the Republican-held Congress has already passed their stated January 27 deadline for deciding on a repeal option. “In two months, health plans have to file their rates for 2018 to be locked in and they have no idea if there’s even going to be an insurance market,” says Adam Beck, assistant professor of health insurance at The American College of Financial Services in Pennsylvania.

[quote position="left" is_quote="true"]I'm a 100 percent walking pre-existing condition.[/quote]

Despite mixed reviews, the ACA is still “the most comprehensive health care reform this country has seen in 150 years,” says Daniel Dawes, a Georgia attorney and author of 150 Years of Obamacare. Repealing it would undo significant protections for many, but will hurt the sickest and poorest Americans the most. But they won’t be the only ones affected.

The return of pre-existing conditions

“If you are low income and have a pre-existing condition or chronic health condition, I’m quite certain you will not have health insurance coverage a year from now, or it will be an all-consuming expense,” Beck says.

This alarms people like California mother Megan Dooley Fisher. Diagnosed in the early 2000s with rare autoimmune vasculitis, Behçet’s Disease, which causes ulcers in all the mucus membranes in your body as well as “migraines, debilitating joint pain,” and fatigue, she calls herself “a 100 percent walking pre-existing condition.” Pre-ACA, she worked under the table to keep her Medi-Cal, and went without insurance for several terrible years in which she slept 15 to 17 hours a day and could barely work. She relies upon a medication called Enbrel, which would cost her nearly $2,500 out-of-pocket and took years to find.

[quote position="right" is_quote="true"]Most people take the choice to stay alive.[/quote]

The idea of going without it “frustrates the hell out of me,” she says, because “it keeps me out of the hospital and consuming healthcare that other people could be using. If I get my medications, I can be a contributing member of society.” If the ACA is repealed, she says, “I’m terrified that I won’t be able to keep a roof over my head.”

Tough choices for freelancers and low-income Americans

Beck says we’ll see recurrences of this terrible choice between one’s livelihood and one’s life if the ACA is repealed. He calls it a “perverse incentive” to only make Medicaid available to people with disabilities or who are well below the poverty level, because “if you have to make the choice of working to make income to support yourself, but not have medical care, or stay alive and live off Medicaid, most people take the choice to stay alive.”

[quote position="left" is_quote="true"]We’re throwing the system into complete chaos. The market isn't going to know how to price anything.[/quote]

After losing her job through downsizing, Laura Kiesel, a freelance writer and editor, relies upon MassHealth, Massachusetts’ state Medicaid program, to treat degenerative disc disease, endometriosis of the uterus, and small fiber neuropathy, all of which have required surgery. She and her boyfriend have even put off marriage “indefinitely,” since his insurance policy “wouldn’t even come close to covering my vast medical needs.”

Kiesel emphasizes that Medicaid access is a disability rights issue. “Taking Medicaid away from us or forcing us onto other insurance programs which lack the services we require or to pay money we don’t have, condemns us to further pain and suffering, and in some cases, death.”

Shifts in employer-provided coverage

As for those who have insurance through their employers and don’t believe they will be affected by changes in the ACA, Dawes says that “before the ACA, 40 percent of the costs of the uninsured were being placed on the backs of those who were insured” in the form of higher premiums and deductibles. This “uncompensated care” as it’s called has seen significant drops under the ACA, but will rise again if it is repealed. In fact, the costs of repeal are projected to be as high as $350 billion through 2027.

“This time, we’re not going back to the system we had pre-ACA. We’re now throwing the system into complete chaos,” Beck adds. Repeal will have an impact on even large group insurance plans, he says, “because the market isn’t going to know how to price anything.” He sees a return of annual limits on particular medical conditions, and an increase in medical bankruptcy.

[quote position="full" is_quote="true"]‘Repeal and replace’ is a really catchy slogan around election time but it’s not the same as legislative language.[/quote]

Not to mention that the ACA provides preventative services benefits for everyone “at no-cost sharing,” Dawes says. “Whether you have employer health care insurance, or through the individual market, or through Medicaid, your insurance company or plan is required to be sure that you are not being charged for those benefits. … That is a huge deal.”

“I think a lot of people are going to die,” Beck states bluntly.

Here’s what you can do

So what can people do in the face of losing their insurance? Dawes says some can turn to community health centers, where services are often provided on a sliding scale. A handful of new apps allow you to get basic prescriptions without a doctor, and Beck says nonprofits and charities may be able to offer temporary assistance or discounts in medications or services, but aren’t meant for long term care. Some states already have medical exchanges in place, like California and Massachusetts, but more states do not.

Beck has hope that “the Trump administration and Congress are going to find that saying ‘hashtag repeal-and-replace’ is a really catchy slogan around election time, but it’s not the same as legislative language. It’s a lot harder to get consensus to reach 218 votes around an actual bill.”

Dawes takes a little comfort that every time Republicans introduce a repeal and replacement bill, “it seems they are getting more moderate and taking a middle-ground approach.” He hopes the moderate Republicans—those “who know this would be a huge tragedy”—will win out.

Health
via Real Time with Bill Maher / YouTube and The Late Late Show with James Corden / YouTube

A controversial editorial on America's obesity epidemic and healthcare by comedian Bill Maher on his HBO show "Real Time" inspired a thoughtful, and funny, response by James Cordon. It also made for a great debate about healthcare that Americans are avoiding.

At the end of the September 6th episode of "Real Time, " Maher turned to the camera for his usual editorial and discussed how obesity is a huge part of the healthcare debate that no one is having.

"At Next Thursday's debate, one of the candidates has to say, 'The problem with our healthcare system is Americans eat shit and too much of it.' All the candidates will mention their health plans but no one will bring up the key factor: the citizens don't lift a finger to help," Maher said sternly.

Keep Reading Show less
Politics

There is no shortage of proposals from the, um, what's the word for it… huge, group of Democratic presidential candidates this year. But one may stand out from the pack as being not just bold but also necessary; during a CNN town hall about climate change Andrew Yang proposed a "green amendment" to the constitution.

Keep Reading Show less
test
Me Too Kit

The creator of the Me Too kit — an at home rape kit that has yet to hit the market — has come under fire as sexual assault advocates argue the kit is dangerous and misleading for women.

The kit is marketed as "the first ever at home kit for commercial use," according to the company's website. "Your experience. Your kit. Your story. Your life. Your choice. Every survivor has a story, every survivor has a voice." Customers will soon be able order one of the DIY kits in order to collect evidence "within the confines of the survivor's chosen place of safety" after an assault.

"With MeToo Kit, we are able to collect DNA samples and other tissues, which upon testing can provide the necessary time-sensitive evidence required in a court of law to identify a sexual predator's involvement with sexual assault," according to the website.

Keep Reading Show less
Health

Villagers rejoice as they receive the first vaccines ever delivered via drone in the Congo

The area's topography makes transporting medicines a treacherous task.

Photo by Henry Sempangi Senyule

When we discuss barriers to healthcare in the developed world, affordability is commonly the biggest concern. But for some in the developing world, physical distance and topography can be the difference between life and death.

Widjifake, a hard-to-reach village in northwestern Democratic Republic of Congo (DRC) with a population of 6,500, struggles with having consistent access to healthcare supplies due to the Congo River and its winding tributaries.

It can take up to three hours for vehicles carrying supplies to reach the village.

Keep Reading Show less
Health
via Keith Boykin / Twitter

Fox News and President Trump seem like they may be headed for a breakup. "Fox is a lot different than it used to be," Trump told reporters in August after one of the network's polls found him trailing for Democrats in the 2020 election.

"There's something going on at Fox, I'll tell you right now. And I'm not happy with it," he continued.

Some Fox anchors have hit back at the president over his criticisms. "Well, first of all, Mr. President, we don't work for you," Neil Cavuto said on the air. "I don't work for you. My job is to cover you, not fawn over you or rip you, just report on you."

Keep Reading Show less
Politics