With Donald Trump now America's 45th president and the Republicans firmly in control of Congress, efforts to "repeal and replace" the Affordable Care Act, also known as "Obamacare," have now ramped up.
Congressional Republicans have been much more vocal about their desire to repeal the law than about what they'll offer to replace it. Trump, however — perhaps anticipating the political ramifications of taking healthcare away from 20 million individuals who have insurance through the ACA — has vowed that "everyone will be covered" under an unspecified new arrangement.
Rep. La Shawn K. Ford (8th) is concerned about the impact the full repeal of the law would have on his district and says that communities like Austin, West Garfield Park and North Lawndale would be among the hardest hit.
Those areas house many residents who have pre-existing conditions and don't make enough to afford private insurance without the benefit of subsidies and other government mechanisms designed to make healthcare accessible for the poor.
"In Austin there are many people with diabetes and asthma," said Ford. "Under ACA, they can obtain affordable coverage either through the Medicaid expansion or from the exchanges. A repeal will make it nearly impossible for these individuals to find coverage because insurers won't cover them and underemployment prevents them from getting insurance through their employers."
Many Republican leaders have asserted that a full repeal of the law will have little negative impact on the economy and that getting rid of it would amount to just dismantling another obstacle in the way of job creation.
The facts, however, do not support this claim.
Forbes.com recently reported that a full repeal of the law, implemented without an adequate replacement, would cost more than 2.5 million jobs. This is because the law has allowed patients who wouldn't be able to afford coverage to become active participants in the marketplace, allowing hospitals to hire more nurses, physicians and technicians. If the law is repealed, many of these jobs will be lost.
The Congressional Budget Office reports that a repeal of the law would blow a $353 billion hole in the deficit over the next 10 years.
Seniors collecting Medicare would also be greatly affected. There is a prevision in the law that closes the "doughnut hole" for prescription drugs. This provision allows seniors to pay less for their medicines in contrast to the previous method of offering beneficiaries' coverage up to a certain dollar amount, and then none until high-dollar coverage provisions kicked in.
This is not to say that the ACA is a perfect system. There are many testimonies of people who have bought plans through ACA that are overly complex and that have high deductibles and spotty coverage — problems that have improved over time.
Two other valid criticisms of the ACA are that President Barack Obama broke his promise that "if patients liked their doctors, they can keep their doctor," which turned out not to be true as not every health provider accepted every plan. Patients are also justifiably frustrated with the spike in premiums, which have increased at a slower pace, but are still burdening families looking to pay for insurance.
But these are issues that can be remedied without a full-scale repeal. Indeed, according to a recent Rasmussen poll, 56 percent of Americans want the law improved "piece by piece" — not eliminated. Only 23 percent of those polled say that they want it completely repealed.
"That's the way government works," said Ford. "No law is perfect when it first passes, that's why we make amendments to improve them. Do you know what the country would be like if we just repealed every law that wasn't perfect? It would be absolute chaos. Even the constitution of the U.S. had to be amended when certain elements didn't function as effectively. They should just try to improve it."
And this is more than a debate for the Sunday morning talk shows. By playing political gamesmanship, Republicans are playing with people's lives and wellbeing. I have a pre-existing condition. I was born with a congenital heart defect that requires me to have to take medication and annual tests like ECHO's and EKGs to monitor my heart valve to assure it is functioning properly.
So far, no Republican has proposed an alternative to Obamacare that would prevent an insurance company from covering my check-ups but not my tests.
If the ACA is repealed, 20 million people will lose their coverage. This seems like a very big price for the GOP to pay for a short-term political victory. Without an adequate replacement, they could be feeling sick in 2018.
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