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Thursday , November 15 2018
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Millions of Texans Could Lose Coverage if ACA Repealed

AUSTIN, Texas — Congress has set in motion what it says is a plan to repeal and replace the Affordable Care Act. But what could happen in Texas if the plan is only repealed?

One study projects that ending Obamacare without immediately enacting an equivalent plan would result in 2.6 million Texans losing health coverage by 2019. Anne Dunkelberg, associate director at the Center for Public Policy Priorities, which produced the study, said a repeal of the plan would hit the state’s working families hardest.

“Close to 85 percent of them are getting subsidies. The average subsidy is 75 percent of the premium,” Dunkelberg said. “So, if those subsidies go away, the vast majority would not be able to afford to just pick up the other 75 percent of the premium.”

The study also found that Texas stands to lose about $62 billion in federal healthcare funding over the next decade if the ACA is repealed, and it would pay out billions more to doctors and hospitals to cover the cost of uncompensated care.

Congress has vowed to replace Obamacare but has yet to reveal the details of any plan it is considering.

Dunkelberg said that if Congress only repeals the plan, the significant gains made in the state’s uninsured rate by Obamacare would likely be reversed.

“Even though Texas still has the worst uninsured rate, and the highest uninsured number in the country, and didn’t do the Medicaid expansion along with 18 other states, we still had a big, major reduction in our uninsured rate as a result of it,” Dunkelberg said.

She said she’s also concerned that any new plan could reverse basic requirements, allowing insurers to sell policies that don’t cover key expenses such as prescription drugs, mental health or maternity care.

“Being able to have a talking point that says that the price of the premium went down when in fact the reason it went down is that it’s no longer covering anything that you actually need, and it leaves you open to medical bankruptcy,” Dunkelberg said.

The report warned that a repeal of the ACA without an adequate replacement would mean that almost 30 million Americans could lose access to affordable health care.

Author – Mark Richardson, Public News Service

Analysis: Repeal of Healthcare Law Likely to Cause Chaos

CHARLESTON, W.Va. — Repeal of the Affordable Care Act without immediate replacement would throw the U.S. healthcare system into turmoil for the next three years, according to economists.

The Urban Institute projected that the most likely plan for repeal would leave nearly 30 million Americans uninsured by 2019, send insurance markets into chaos and threaten the economic viability of hospitals around the country.

Edwin Park, vice president for health policy at the Center on Budget and Policy Priorities, predicts insurers will start canceling coverage in the face of billions of dollars in losses if there is no longer a mandate for consumers to buy insurance. But, Park said, the largest impacts may come in two years, when the repeal of the Medicaid expansion and the insurance subsidies that help people pay for coverage will likely kick in.

“More than doubling the number of uninsured that otherwise would occur,” Park said. “And that would be a higher number than was in place pre-Affordable Care Act, because of the virtual collapse of the individual market that would result.”

President-elect Trump and Republicans in Congress have criticized Obamacare for its rising premiums and reduced choice of doctors and insurance options. They campaigned on the promise of immediate repeal, even though the program has just finished its largest signup period ever.

First up for repeal are the taxes, mostly on high-income households, that pay for much of the program. Park said they found that more than half of these tax cuts would go to the rich – millionaires or richer – according to Congressional Budget Office figures.

Without that revenue, he said replacing the ACA would be difficult, or could require taking funds from Medicare or Medicaid. Park said that could explain the delay.

“The most critical aspect is that there is no replacement plan,” Park said, “that replacement would happen at some subsequent point, assuming there even is a replacement plan.”

The Urban Institute projects that, by 2019, healthcare providers will have to give four times the amount of uncompensated care they do now. Park said in that year, they will also lose $146 billion in revenue because they have fewer patients with insurance – which will be a threat to many hospitals.

“Rural hospitals in states that have seen improvements because of adoption of the Medicaid expansion in their states – that would all be reversed, and more, under ACA repeal,” Park said.

More information is available at

Dan Heyman, Public News Service