The Affordable Care Act, also known as Obamacare, has been under fire since the beginning of President Donald Trump’s election campaign, never mind his term as president. The healthcare act has faced renewed challenges in recent months as President Trump continues to fight the act in court, arguing that it is unconstitutional.
If this attempt succeeds, or any other effort to repeal Obamacare succeeds, it would cause millions of Americans to lose their health insurance. The only chance those people would have is if the Trump administration replaced the act with one of their own. Trump did plan to introduce a healthcare act of his own before the upcoming election, but the GOP refused to bring the proposal forward until they controlled the House of Representatives.
The Department of Justice requested that the U.S Court of Appeals to overturn the Affordable Care Act after it was ruled unconstitutional by a federal judge in Texas, who claims the ACA is unconstitutional because it removes a tax penalty for people without insurance. Trump reduced the tax penalty as part of the Tax Cuts and Jobs Act in 2017.
While the Affordable Care Act remains in law while the courts deliberate it – and until Trump manages to repeal it successfully – the repealing of Obamacare represents a considerable risk. Some 25 million Americans will be without insurance if the act is repealed.
Here’s a closer look at what would happen if the Affordable Care Act is repealed and who stands to lose their insurance.
Roughly 11.4 million Americans joined or continued their participation in an Obamacare exchange plan in 2019.
The ACA established public marketplaces where people could shop for affordable insurance that complied with ACA regulations. These exchanges also let people see if they qualified for healthcare subsidies funded by the government to make insurance more affordable.
Twenty-eight states have federally-run marketplaces, with 12 states using state-based marketplaces. Eleven states use either federally supported marketplaces or marketplaces with a partnership between state and federal services.
These exchanges are likely to disappear if the Affordable Care Act is repealed. If the law goes away, then exchanges cease to exist.
Experts are unsure what would happen to state markets, but people who got insurance through a federal marketplace would almost definitely lose their coverage. On the state level, it’s possible that states could protect and fund the exchanges themselves, but even this isn’t a simple process, and there’s no guarantee it would happen.
Sixteen million people have enrolled with Medicaid since the Affordable Care Act was introduced. Around 13.6 million of those people live in Medicaid expansion states.
The Affordable Care Act expanded Medicaid to cover people at or below 138% of the federal poverty level. Children and people with mental illnesses are now also covered by Medicaid. In total, 36 states, and Washington D.C, have adopted the Medicaid expansion. The remaining 14 states haven’t.
The federal government currently pays 90% of the costs for states with expanded Medicaid. Those states would no longer receive federal funding if the ACA were repealed. Some states simply don’t have the resources to continue to offer Medicaid expansion without federal assistance, meaning that people who enjoyed Medicaid due to the expansion could lose their coverage.
This would mean that millions of low-income Americans would be left without insurance.
Experts believe healthcare will likely go back to how it was before the ACA was enacted. They believe the most popular provisions of the act, such as protecting people with pre-existing conditions and allowing young adults to remain on parents’ insurance until age 26, would be removed.
If Trump completely repealed the Affordable Care Act, there would be an influx of uninsured Americans as insurance companies refuse to provide coverage for people with pre-existing conditions or pice them out of the market with exorbitant premium fees.
Around nine million people receive federal subsidies through Obamacare. Those people would stop getting the money they need to afford their insurance premiums and would also likely lose their insurance. Anyone looking for New York health insurance could be left without a leg to stand on.
One significant problem with repealing Obamacare is that it affects every part of the healthcare system. Overturning the law without introducing a replacement would cause widespread upheaval in the system. There is no simple and easy way to replace Obamacare completely.