Why Protecting the ACA Should be Important to All of Us

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As yet another replacement for the ACA has been created, the threats posed to the health of our nation, especially to our most vulnerable populations, continue to rise. Senator McConnell’s new bill was written to please the most conservative Republicans in the Senate and therefore, it will take coverage away from those who need it most and worsen the coverage that is available. The Massachusetts Alliance on Teen Pregnancy are concerned about this bill and the impact it will have on the health of young women. We are especially concerned about the impact it will have on the issues discussed below.

Medicaid cutbacks. The Congressional Budget Office (CBO) estimates that the new bill will cause Medicaid funding to decrease by around one-third after 20 years. Even in the states that chose to expand Medicaid, the number of people that would lose crucial coverage would be significant. Additionally, obtaining other affordable insurance plans will become much more challenging due to some other aspects of the bill. The bill eliminates subsidies given to lower-income people to help pay for out-of-pocket costs altogether by 2019. The bill would transform Medicaid into a rigid system with per capita caps and minimal funding and this will have devastating consequences on those low-income people who rely on Medicaid for insurance coverage.

Many young women depend on Medicaid to get access to maternity care and contraception. If they lose this coverage, it is possible to see increases in the rates of complications from pregnancy and labor and in the number of unwanted pregnancies.

Essential benefits and pre-existing conditions. Obamacare required all plans to cover a certain list of essential benefits. These benefits have been crucial in improving women’s health because it required insurers to cover maternity care and preventive care, like contraception. The new bill would allow insurers to offer plans that don’t cover all essential benefits as long as they have at least one plan that covers them all. This would make certain plans less expensive for healthy individuals but it would mean these plans don’t cover very much. Comprehensive plans would still be available for those who need them but for a significantly higher cost. This bill would also take away the ACA’s stipulation of requiring insurers to cover those with pre-existing conditions. If this bill passes, insurers could charge more to those with a history of disease, refuse to cover certain health conditions, or just completely deny these individuals coverage.

If insurers are no longer required to cover essential benefits on all plans, getting maternity care, especially at an affordable cost, will become much more difficult.

Opioid crisis. One piece of Senator McConnell’s new bill that was added in to appease the more moderate Republicans is $45 billion over the next ten years devoted to combating the opioid abuse crisis in this country. Money devoted specifically to this issue is extremely important because less people affected by opioid abuse will be able to get help if Medicaid coverage decreases and plans no longer have to cover essential benefits. However, many Democrats have criticized this gesture for being superficial because they feel this sum of money is not sufficient to actually combat the opioid crisis. Massachusetts Senator Markey said in a speech he made recently that if the ACA was not repealed, it would provide over $91 billion over the next ten years to be used to fight the opioid crisis.

The number of infants born in Massachusetts with opiates in their system is currently triple the national rate. It is critical for the health of mothers and children in this state that this crisis gets the funding it deserves in order improve the situation.

Defunding Planned Parenthood. Most Republican legislators do not want to provide funding for an organization that also provides abortion and therefore, this version of the bill would still defund Planned Parenthood. However, Planned Parenthood mostly provides affordable access to primary care and things like cancer screenings to women who need it. If this bill causes Planned Parenthood clinics shut down, women will not only lose places to go to seek care but they will also have trouble getting it elsewhere due to Medicaid cuts and more expensive plans that aren’t required to cover essential benefits.

Abortion is only a small piece of the multitude of services Planned Parenthood actually provides. Without it, young women all over the country will lose a provider of basic and affordable healthcare.
The changes that the ACA made to our health care system were made to protect individuals and improve the health of our country overall. And it was successful in doing so because many organizations estimate that around 20 million people gained coverage as a result of the ACA. This new health care bill will increase the number of people stuck in a deleterious cycle of losing many ways to access care. From decreasing Medicaid funding, to removing the requirement to cover essential benefits and all people regardless of pre-existing conditions, to lowering and eventually eliminating subsidies for out-of-pocket costs, we all stand to lose something if this bill passes.

About the author:

Madi Bernstein is the Social Media Intern for the Alliance this summer. She is a rising junior at Tufts University who is majoring in Community Health and minoring in Sociology.