If the Affordable Care Act is repealed this year by Congress, over 30 million people will lose health insurance. People right here in Valley County who get coverage from the Idaho Health Exchange could within a year have no health insurance.
Those who promote repeal of the ACA have had seven years to come up with a replacement plan, but they have no plan, just slogans.
Prior to the ACA, the private health care market was in a death spiral. Rates were going through the roof and fewer and fewer people were able to get private individual plans. If you had a pre-existing condition, you were denied insurance or were charged rates that were unaffordable.
Passage of the Affordable Care Act did the following:
▪ Reduced by 32 percent the uninsured rate in Idaho from 2008 to 2015.
▪ Guaranteed benefits — like maternity care, prescription drugs and mental health care. Removed higher premiums for women based solely on gender.
▪ Protected 129 million people with pre-existing conditions like cancer, asthma and diabetes from being denied coverage or charged higher premiums.
▪ Saved millions of dollars by providing no-cost preventive services like cancer screening and vaccines.
▪ Removed lifetime caps on benefits for 105 million people.
▪ Brought the uninsured back into the doctor’s office and away from costly hospital emergency departments. Enabled doctors to provide outpatient care before illness became an emergency.
▪ Enrolled 100,000 Idahoans in the Idaho Health Exchange in 2015. Over 70 percent got subsidies to reduce their monthly premium payments. (However, those with income below 100 percent of poverty are not eligible for subsidies because the Idaho Legislature refused to implement Medicaid expansion, creating a gap in coverage for low-income people.)
▪ Made family planning services available for free, reducing unattended pregnancies and pregnancy complications.
The ACA is based on three basic principles, like a three-legged stool.
1. Individual mandate: Everyone must have insurance. You can not wait until you are sick to get insurance. Over 20 states prior to the ACA tried to set up a health exchange without an individual mandate, and the premiums in this “high-risk pool” rose dramatically, because only sick people enrolled.
2. Premium subsidies based on income. If you take away the subsidies, many will be unable to afford health insurance.
3. People with pre-existing conditions are not charged more for their health insurance.
If you remove any one of these three legs, the stool will fall. If you set a grace period of a few years for repeal, the exchanges will crash long before the actual deadline. Insurance companies will start pulling out of the market. Millions will lose coverage.
Why should I support Obamacare, if I have employer-based or other private insurance? An increase in the numbers of uninsured will increase the costs to hospitals, and unpaid bills will be passed on to the insured customers. We are all in this together.
In spite of the rhetoric about the ACA being repealed, we still recommend that individuals who do not have health insurance sign up during the current enrollment period that lasts until Jan. 31, 2017. Go to yourhealthidaho.com to sign up. Do your own research. A family of four — two parents in their late 30s or early 40s with two children —making $50,000 per year can get a good plan for around $315 per month.
With the ACA, countless people have benefited by getting needed surgery they had put off and getting outpatient care for their diabetes, heart disease or mental health issues, instead of getting so ill they require hospitalization.
If you have seen the benefits of the ACA in your own life, call Sen. Mike Crapo at 208-224-6142 and Sen. Jim Risch at 208-224-2752, and let them know your experience, and ask them not to let Congress repeal the Affordable Care Act without first having a comparable replacement.
Bill Thomas, LCSW, Clinical Social Worker; Edith Welty, MD; and Thomas Welty, MD; live in McCall.