So Why Should We Care about the Affordable Care Act, Anyway?

It’s on. Yesterday, on day one of the 115th Congress, Republicans introduced measures that would enable them to repeal the Affordable Care Act with only a simple-majority vote (51 out of 100 senators). How can they do that? By keeping their repeals in accordance with budgetary rules, which would mean that not only would they dramatically cut essential parts of the ACA, they would keep cuts to Medicare so as to lower the deficit. More on this later. Committees have until January 27th, according to the Washington Post, to prepare replacement bills. Technically speaking, they can’t repeal the law in its entirety via reconciliation, but they can dismantle it to such an extent that it exists in name only. Democrats led by Senate Minority Leader Chuck Schumer announced today that they won’t support Republican efforts to repeal the ACA and demanded that the Republicans come up with a viable replacement bill that improves quality and accessibility of care for all Americans while lowering costs.

Know what the ACA means as President Obama and the Democrats rush to protect it from Republican efforts to repeal it starting yesterday. As stated before, some of these provisions may remain, at least nominally. President-elect Trump has indicated his support, for instance, of keeping provisions that forbid insurance companies from discriminating against people with preexisting conditions, and favors keeping children on their parents plans through the age of 26. But key to remember is that the individual and employer mandates provide the basis for those provisions. Without the funding, they’re just pretty words. The mandates provide the money to support the improved and expanded care for all Americans that the ACA rendered possible. Get rid of the mandates and you destroy the law, causing chaos in the market and failing to provide the financial means for the ACA’s life-saving improvements for millions of Americans. In no particular order:

  1. It provided millions of Americans with healthcare who did not previously have it.
  2. It forbids insurance companies from denying coverage entirely or charging exorbitant premiums of the chronically ill, the disabled, women, and the elderly because they’re too “high risk.” And don’t wait for Speaker Ryan’s so-called “Better Way” plan to fix this; as he said last year, less than ten percent of people under age 65 have chronic diseases (speaking as someone who was first diagnosed with a chronic autoimmune disease at age 7, I’d like to know where exactly he got that statistic, seeing as how the correct percentage is closer to 27), and they’re uninsurable anyway. So much for being pro-life.
  3. It encourages preventive care, meaning a move away from fee-for-service care and towards doctors working collaboratively to prevent their patients and communities from becoming ill in the first place.
  4. It encourages doctors to collaborate more (which, speaking as a person who sees numerous specialists for different chronic diseases, results in decidedly improved care and quality of life).
  5. It encourages a more holistic approach to healthcare, meaning that patients aren’t just diseased body parts existing in a vacuum, but entire people. So, for instance, you have a chronic pain condition? Well, in addition to your specialist, maybe you also should see a social worker who can help you strategize ways to cope with the physical pain itself and the mental and emotional stressors attendant on constant pain, as well as daily-life types of things you can do to mitigate pain. Managing your medical care doesn’t have to consume your whole life if you know how to handle it and have the necessary support to do so.
  6. Said holistic approach includes attention to additional facets of patients’ lives. Do they have a safe place to live? Access to food they can eat? Necessary accommodations at work and school? And so on.
  7. Doctors are rewarded based on their success in treating patients, not the number of tests/procedures/medications/etc. they attempt, making care more focused and efficient. And they’re more likely to be penalized if they make a mistake or something goes awry.
  8. High-risk patients, rather than facing discrimination in coverage as had previously been the case, are now more likely to receive pointed attention and the care they need because doctors’ salaries depend in part on maintaining their patients’ health.
  9. Which also means fewer hospitalizations and lower ER costs, which saves the public money and prevents hospitals from hemorrhaging money.
  10. It enabled children to remain on their parents’ plans through the age of 26, particularly important in a time when millennials struggle to find jobs with benefits and graduate school programs don’t always provide coverage that meets the needs of students, particularly those who require specialist care.
  11. It expanded Medicaid, meaning that healthcare was not just the province of the wealthy.
  12. It removed yearly and lifetime limits on coverage. Imagine a child with cancer, as Democrats referenced today, unable to receive literally life-saving treatment because they had already maxed out on coverage for that year. Or imagine a young adult unable to pursue their dreams and aspirations because they have a chronic condition and have to spend all their time and energy dealing with said condition or with figuring out how on earth they’ll pay for continual necessary medical treatment because of the lifetime cap. Or imagine a senior citizen who reached the limit for healthcare spending, and who now has to figure out how to pay for a nursing home or home-help aide.

Here are just some of the numerous reasons why the ACA is quite literally a lifeline for millions of Americans who may not even be aware of how much it benefits them.

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