Exit Obamacare?

Pennsylvanians should think hard about what they stand to lose

This presidential election season has diverted attention from many issues that really matter to people and their families. A perfect example is what each candidate actually proposes to do about health care and health insurance if elected Nov. 8.

For Pennsylvanians concerned about their health care and access to stable, affordable health insurance, a great deal is at stake. Nearly a half-million people have been enrolled in the state’s Affordable Care Act plan, called Marketplace. And Pennsylvania has received more than $34 million in grants to help make health care accessible to everyone in the commonwealth.

But, even as tens of thousands continue to enroll in Marketplace, new challenges have been identified, including rising out-ofpocket costs and, in some areas, difficulty finding a primary-care doctor.

There are essentially two ways being offered to deal with these concerns.

Donald Trump calls for repeal of the Affordable Care Act, also known as Obamacare, and “starting over.” Hillary Clinton intends to fix the ACA and build on it.

Put aside the rhetoric and think of what Pennsylvanians have to lose if Obamacare is eliminated. Here are just a few things that would happen:

• Insurance companies again could deny coverage to people with pre-existing conditions. Before ACA, this was a nightmare scenario. Imagine being unable to buy insurance coverage at all just because you have a medical condition such as diabetes, asthma, cancer or heart disease! You may even have someone in your family who was once denied coverage for these reasons. ACA has eliminated that fear.

• Insurance companies again could set arbitrary limits on annual or lifetime payouts for coverage, leaving people with serious medical conditions to face exorbitant out-of-pocket costs for hospital and specialty care, or to simply not get services they urgently need.

• Young people no longer would be assured of staying on their parents’ health insurance policies until they turn 26. Prior to the ACA, many young people just starting out in their careers found health insurance out of reach. More than 2 million young Americans have enjoyed excellent health insurance coverage because of the ACA.

• Charges again could be applied for a myriad of services that help identify or prevent health conditions. Benefits that Obamacare requires to be covered with no out-of-pocket payments include colonoscopies to detect colon cancer, Pap smears, mammograms, well-child care and flu shots. At least 1 million citizens of Pennsylvania take advantage of these services.

• Gone would be incentives to encourage primarycare doctors to settle and practice in Pennsylvania. Between 200 and 300 doctors already have responded to Obamacare enticements that eventually will make it easier for people to find qualified doctors wherever they live in the state.

There’s more. Obamacare is lowering prescription costs for senior citizens and providing funds to expand community centers and other programs that benefit Pennsylvanians from one end of the state to the other.

So the question is, why tear down something that is making such a positive difference in people’s lives?

Mr. Trump’s tough talk about turning his back on real health care benefits would amount to a giant step backward for all those Pennsylvanians who want decent health insurance coverage that can’t be taken away for a preexisting health condition or be arbitrarily limited by insurance companies.

The replacement for Obamacare Mr. Trump proposes is a hodgepodge of random and untested ideas that would once again put insurance companies back in the driver’s seat, such as allowing them to compete across state boundaries. Repealing the ACA would immediately result in loss of coverage for as many as 20 million Americans, including those 500,000 in Pennsylvania. Dropping federal subsidies for low- and middle-income families would make private insurance premiums unaffordable for all but the well-to-do.

Ms. Clinton would safeguard the ACA’s hard-won benefits for you and your family. She is deeply aware of the continuing challenges of access and cost that remain to be addressed under the program — accentuated by the big premium hikes recently announced. She has vowed to fix the problems. And she has the intelligence, insight and experience to do what she’s promised.