With an early morning vote in the Senate on Thursday, Republicans are moving ahead with a repeal of the Affordable Care Act. This puts Congress on the dangerous and inhumane path of ending health insurance coverage for millions of Americans.
There is a better way. Five Republican senators, including U.S. Sen. Susan Collins, had signed on to an amendment to delay a repeal to give lawmakers more time to develop a replacement so millions of Americans won’t be left without health insurance. While their time frame for crafting a new plan — less than two months — was much too short, their action briefly sent the important message that a quick repeal of the ACA should be off the table. The amendment was withdrawn amid a flurry of activity in the Senate late Wednesday into the early hours of Thursday that culimnated in a vote to approve a blueprint to repeal the federal health insurance reform law.
Every Republican other than Kentucky’s Rand Paul voted for the repeal. If Collins and the four sponsors of the delay amendment were serious about not repealing the law without a replacement in place, the responsible thing would have been to vote against the Senate repeal framework. We hope the group will reintroduce the amendment or something similar as the repeal legislation proceeds through Congress.
Sen. Angus King has long opposed a repeal of Obamacare and cosponsored an amendment last week to stop a fast-track appeal. He voted against the repeal legislation.
Because Republican leadership has arranged to consider an ACA repeal through the budget reconciliation process, only 50 votes, rather than the typical 60, are needed in the Senate to repeal it.
“Repeal and replacement is a complicated task, and my number one concern is that we not create a gap in coverage for individuals who are currently insured and who rely on that coverage,” Collins said in a statement earlier this week, before Thursday’s Senate vote. “By providing more time to come up with legislative solutions, we have a better opportunity to produce a thoughtful, workable replacement that ensures Americans have access to affordable, diverse insurance plans that meet their needs.”
This remains the right standard because repealing the ACA without a suitable replacement would leave millions uninsured, reduce funding for addiction treatment and shrink hospital revenue, among other adverse consequences.
At a press conference on Wednesday, President-elect Donald Trump again said Obamacare was a “disaster.” That is not true.
With passage of the ACA, the percentage of Americans without health insurance has been cut nearly in half, from 16 percent in 2010 to 8.6 percent last year. The decrease in the number of uninsured has been most dramatic among low-income Americans. Twenty million Americans who did not have health insurance before the ACA are now covered.
A recent analysis by the Harvard Medical School and New York University found that repealing the ACA would have devastating consequences for nearly 2 million Americans with substance use disorders and mental illness. Through the ACA and the Medicaid expansion it enabled, more than 1.8 million Americans are getting needed addiction and mental health treatment. In Maine, more than 19,000 people are getting treatment because of the ACA, even though the state did not expand Medicaid. An ACA repeal would drain $5.5 billion from this treatment, the analysis found.
People with pre-existing conditions, such as asthma, high blood pressure and cancer, cannot be denied health insurance under the ACA. In Maine, 229,000 adults have conditions that would allow insurance companies to deny them coverage without ACA protections, according to analysis by the Kaiser Family Foundation.
Hospitals are also financially healthier because of the Affordable Care Act. The cost of uncompensated care — treatment a patient is unable or unwilling to pay for — has dropped significantly as a percentage of hospitals’ overall budgets.
There are some problems with the health insurance reform law. Premiums are increasing rapidly, partly because of a lack of competition in many states.
But policymakers could address these issues as part of a reasonable package of fixes to an imperfect law, rather than repealing it entirely.
