HEALTH CARE INDUSTRY FEARS REPEAL
Health care industry groups warn of consequences to nixing ACA
Bipartisan groups warn the incoming Republican administration and Congress against repealing the Affordable Care Act without a clear plan to address the consequences.
washington» One by one, key health care industry groups are telling the incoming Republican administration and Congress that it’s not a good idea to repeal the 2010 health care law without clear plans to address the consequences.
Hospitals, insurers and actuaries — beancounters who make long-range economic estimates — weighed in and more interest groups are expected to share their views soon. The American Cancer Society Cancer Action Network reminded lawmakers that lives are at stake.
The concerns go beyond the obvious potential hardship for 20 million people covered by subsidized private insurance and expanded Medicaid under President Barack Obama’s signature law. Hospitals say a stand-alone repeal would cost them billions, compromising their ability to serve local communities. Insurers say Congress must be careful not to create even more uncertainty and instability. Actuaries worry that the mere promise of an eventual replacement won’t be enough to sustain the individual health insurance market.
And the anti-cancer network is concerned that protection for people with preexisting health conditions might be undermined or lost. Before the Affordable Care Act, it was common for insurers to deny coverage to people with a cancer diagnosis, even if successfully treated, or to charge them more. Also, uninsured people with cancer are more likely to be diagnosed late, when there’s less chance of a cure.
Republicans say they remain resolute in their determination to repeal “Obamacare,” but some also seem mindful of the potential political risks. The basic plan under GOP consideration involves repealing the health law next year, but delaying the effective date to allow Congress time to pass a replacement. That replacement presumably would do many of the things the Affordable Care Act does, such as subsidizing coverage and protecting people in poor health, but with less government regulation and without the unpopular “individual mandate” for most Americans to have coverage or risk fines.
However, replacement legislation that covers a comparable number of people would require billions in government financing and extensive regulations, a stumbling block for the most conservative Republicans.
President-elect Donald Trump promised to repeal “Obamacare,” but his ideas for a replacement plan were more talking points than an actual plan.
“Public opinion seems to be shifting,” said John Rother, president of the National Coalition on Health Care, an umbrella organization that includes doctors, businesses, unions, and religious groups. “It’s not clear when people say they want to ‘repeal,’ what they mean by that. It may mean they just want to get rid of the individual mandate.”
Industry groups are giving lawmakers plenty to consider:
• The two main hospital lobbies — the American Hospital Association and the Federation of American Hospitals — released studies indicating more than $200 billion in potential losses for their members if the health law is repealed without restoring funding cuts that were used to finance coverage expansion.
• America’s Health Insurance Plans, the biggest insurer lobby, said the new administration and Congress need to “send strong signals” that they’re willing to maintain the current market through at least Jan. 1, 2019.
• Perhaps the most sobering assessment comes from the American Academy of Actuaries, who unlike hospitals and insurers, don’t have a direct financial stake in the future of the health law. The group said delaying the effective date of a repeal while a replacement is worked out could create such uncertainty that it triggers a crisis for the individual health insurance market. That’s where people who don’t have job-based coverage can buy policies, including more than 10 million in government markets like HealthCare.gov and an estimated 9 million who purchase their plans independently.