Officials with the U.S. Department of Health and Human Services and White House Council of Economic Advisers were making a last ditch attempt Tuesday to defend the Affordable Care Act against a potential repeal effort by a Republican majority in Congress and President-elect Donald Trump.
But they said even worse than repealing the law would be a plan to replace it two or three years later.
“Repeal and delay would actually mean repeal and collapse,” Aviva Aron-Dine, Senior Counselor to the Secretary at the U.S. Department of Health and Human Services, said Tuesday in a conference call with reporters.
But don’t take her word for it.
She said the American Academy of Actuaries recently noted “repealing major provisions of the ACA would raise immediate concerns that individual market enrollment would decline causing the risk pool to deteriorate and premiums to become less affordable. Insurance would likely reconsider their participation in the market and some may choose to exit in the near term. This could lead to severe market disruption and loss of coverage among individual market enrollees.”
Beyond that, the idea of repeal and delay would also hurt people who don’t participate in the individual market because it would impact state budgets and local hospitals, Aron-Dine said. A large portion of state and hospital budgets would be in limbo.
She said the idea of repeal and delay “amounts to a gamble with Americans’ healthcare.”
U.S. Health and Human Services Secretary Sylvia M. Burwell said it’s important to take stock of where “we are today compared to where we were before the Affordable Care Act.”
To that end, the federal agency in charge of implementing the Affordable Care Act provided state-level data outlining the benefits of the law.
“Whether Connecticuters get coverage through an employer, Medicaid, the individual market, or Medicare, they have better health coverage and care today as a result of the ACA,” Burwell said.
In Connecticut, 2.15 million people are covered through employer-sponsored plans, but that doesn’t mean they haven’t benefited from parts of the ACA. According to a fact sheet released by Health and Human Services, an estimated 25,000 young adults in Connecticut have benefited from a provision that allows kids to stay on their parents’ health insurance. Also under the ACA, health plans must cover preventative services such as flu shots, cancer screenings, contraception, and mammograms at no extra cost.
It has also slowed premium growth. Since the ACA was enacted in 2010, coverage grew 4.2 percent a year through 2015, compared to 7.4 percent per year over the previous decade. An estimated $8.7 million in refunds have been given to this population since 2012.
In Connecticut, which was the first state to expand Medicaid coverage, 761,137 people have benefited, including 306,614 children, according to federal officials. More than 205,000 Connecticut residents have health insurance because Medicaid was expanded, according to the Connecticut Department of Social Services. The state also receives about $710 million in federal support to help provide coverage.
More than 102,900 Connecticut residents have received coverage through the health insurance exchange. An estimated 80,759 Connecticut residents have received tax credits on average of about $357 per month to help them get coverage.
It’s estimated that up to 1.55 million people in Connecticut have pre-existing health conditions that would have prohibited them from receiving coverage before the ACA.
Another forgotten benefit of the ACA was that women and men are now treated equally.
“Before the ACA, women were often charged more than men just because of their gender,” federal officials said. “That is now illegal thanks to the ACA, protecting roughly half the people of Connecticut.”
Even the harshest critics of Obamacare are skeptical of the repeal and delay strategy.
Philip Klein, the managing editor of the Washington Examiner who wrote the book “Overcoming Obamacare,” recently wrote that Republicans could open the 2017 session and easily pass a repeal of Obamacare. That would allow them to say they met their commitment, but delaying implementation for several years because there’s no agreement on an alternative “is a horrible idea.”
He said insurance companies likely will continue to exit the exchange and disrupt the current insurance agreements.
He was critical of Republicans for not developing a replacement over the past six years in anticipation of this moment.
In Connecticut, Jim Wadleigh, CEO of Access Health CT, was reminding consumers Tuesday that there’s two days left to sign up for plans that will start on Jan. 1.
Customers must purchase a health insurance plan by midnight on Dec. 15th to have coverage Jan. 1. Enrollment ends this year on Jan. 31.
“With recent ACA headlines being what they are, we know there’s a lot of uncertainty,” Wadleigh said. “But I want to make clear – very clear – that the Affordable Care Act is still the law, and Access Health CT is still here for you.”