What Trump’s Repeal of “Obamacare” Means for the Future of Healthcare

By Daniel Miller, 1/25/2017

Many low-income individuals are currently stockpiling their medications, fearing the repeal of the Affordable Care Act will take their ability to pay for them.

On his first day in office, President Donald Trump signed an executive order aimed at fulfilling one of his most toted campaign promises: dismantling and replacing the Affordable Care Act, more commonly known as “Obamacare.”

Throughout his campaign, Trump repeatedly criticized the Affordable Care Act, stating in the second presidential debate: “Everything’s broken about it. Everything.”

On top of his criticism of the Affordable Care Act, which ensures healthcare for roughly 20 million Americans, Trump has described the Act on his campaign website as an “incredible economic burden,” stating he wishes to enact free market reforms on the healthcare industry and fully repeal “Obamacare.”

With the Senate voting in favor of budget reforms aimed at affecting government spending, with particular focus being given to the federal subsidies, expansion of Medicaid, and tax credits allotted for in the Affordable Care Act, Trump may in fact get his wish.

Finding a replacement for “Obamacare”

“The repeal of the Affordable Care Act will be devastating, especially for the 20 million who received adequate coverage under it,” said Clarence Spigner, a professor of health services at the University of Washington.

“The U.S. is the only industrialized country which does not have an effective form of health insurance to cover all of its citizens, yet we spend more than any other country which does,” Spigner said. “For example, England spends only around nine percent of its gross domestic product on healthcare, and we spend twice as much.”

This outlook is partially echoed by a report from the Congressional Budget Office published on The Huffington Post, which states at least 18 million people will lose insurance, and premiums will increase up to 25 percent for those buying coverage on their own.

As of now neither Trump nor Congress have a proposal in line for replacing the Affordable Care Act. The most likely course of action currently appears to be a “repeal and delay” strategy, in which Republicans will phase out the Act over several years.

The idea behind this strategy is to create “a transition [period] and a bridge so that no one is left out in the cold, so that no one is worse off,” according to House Speaker Paul Ryan quoted in an article published by ABC News.

The economic impact of repealing “Obamacare”

Trump has often cited premium increases and increased government spending as his reasoning behind seeking to repeal the Affordable Care Act. However Trump has made virtually no comment on the billions that will be lost in tax revenues as a result of fully repealing the Act.

Philip Haas, associate professor of health services at the University of Washington, said he had mixed feelings on whether a full repeal of the Act is justified:

“Yes, in the sense that the Affordable Care Act did not go far enough because it was a compromise between the Republicans and Democrats and it did not influence the many drivers that make U.S. healthcare the world’s most costly. No, in the sense that it would be easier to build from the Affordable Care Act than to build from scratch,” Haas said. “In my teaching and consulting, I have had some exposures to best practices in the industrialized world’s other health care systems and believe that we should be borrowing their best practices rather than haggling over the Affordable Care Act.”

How Americans will be affected by the repeal of “Obamacare”

One of the most notable impacts of repealing the Affordable Care Act is the changes that Medicaid will be forced to undergo. As part of the Act, Medicaid was expanded to provide coverage to low-income individuals with incomes of up to 138 per cent of the poverty line, which includes just under 16 million Americans.

The budget reforms recently passed by the Senate leaves the coverage of these nearly 16 million Americans uncertain.

“From the perspective of a social worker, insurance for low-income people is a very vital part of their lives because it’s intertwined with every part of their life,” said Shari Miller, who worked for nonprofit agencies in the Spokane area for 11 years and holds a bachelor’s degree in social work.

Individuals with pre-existing conditions, such as this individual holding her daily dose of pills for stage IV metastatic breast cancer, may experience difficulties finding medical coverage if the Affordable Care Act is fully repealed with no replacement.

“There’s a few nonprofit healthcare centers, and organizations like Planned Parenthood, but other than that as far as medical bills and prescription fees go, they would have to pay for it out of their own pockets,” Miller said.

As Trump moves forward with his decision to take on the Affordable Care Act, many of these low-income individuals will have the future of their healthcare hanging in the balance.

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