The real cost, in people, of repealing the ACA

According to an article in JAMA “more than 4 million children would lose health insurance if the ACA is repealed via budget reconciliation, almost 1 million of these are younger than 5 years”. 

Poor and working-class Americans are most likely to suffer. Largely due to the ACA, the proportion of uninsured nonelderly veterans decreased from 11.9% in 2013 to 6.8% in 2015. Rolling back the ACA’s expansion of Medicaid leaves in the lurch 15 million people who have been newly covered since 2014. If Medicaid were funded below pre-ACA levels, as in some Medicaid block-grant proposals, even more people would become uninsured. Support for long-term care for people with disabilities, a key function of Medicaid, would be eroded.

Even as the number of uninsured people increases, support for uncompensated care in an ACA replacement plan is unlikely to keep pace. A report, commissioned by the Federation of American Hospitals and the American Hospital Association, estimates a financial loss of $165.8 billion between 2018­ and 2026 if Congress were to pass an ACA repeal bill similar to one vetoed by President Obama in January 2016.

Another ACA provision likely to be included in repeal without replacement would eliminate an important stream of funding for the Centers for Disease Control and Prevention (CDC).

Only 20% of Americans want Congress to repeal the law immediately and work out the details of a replacement plan later . It is clear that a number of Republican senators prefer a path forward that pairs repeal with concomitant replacement, a more politically challenging prospect.

What is not being mentioned in these statistics is the real cost in people who will suffer because of the possible repeal of the ACA.  Rather than talk about that most healthcare companies have been focusing on the financial impact (why am I not surprised).   The fact remains that the United States lags well behind other countries in ensuring healthcare for all our citizens while we continue to increase military spending while giving tax breaks big oil who is reporting record profits.

Pharma companies need to tap into the frustration of patients and healthcare consumers.  They have an opportunity to actually help patients cut through the clutter that has become our healthcare system, but it has to be mandated from the top of the organizations.  Looking for the next blockbuster to appease Wall Steet is not going to help people get the care they need nor is the complex world of online health information.  It’s time to put patients at the center of everything we do.

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