WASHINGTON (AP) -
Repealing President Barack Obama’s health care law without a clear
replacement risks making nearly 30 million people uninsured, according to a
study released Wednesday.
that won’t happen because they are working on replacement legislation for a
President Donald Trump to sign. Nonetheless, the complex two-stage strategy
the GOP Congress is contemplating has raised concerns.
The plan is for
Congress to first use a special budget-related procedure to repeal major
portions of the Affordable Care Act, or ACA, next year. The effective date
of that repeal would be delayed by months or years to give lawmakers time to
write replacement legislation.
The replacement law
would presumably do many of the same things that “Obamacare” does, such as
subsidizing coverage and protecting people with health problems. But it
would not involve as much federal regulation, and it would eliminate a
highly unpopular requirement that most Americans get health insurance or
analysis from the nonpartisan Urban Institute looks at a scenario where
“repeal” goes through, but “replace” stalls. It predicts heavy collateral
damage for people buying individual health insurance policies independent of
government markets like HealthCare.gov. Though nonpartisan, the Urban
Institute generally supports the goal of extending coverage to all
Americans. Previously it has criticized some of the subsidies provided under
Obama’s law as insufficient.
The new analysis
warns that repealing major parts of the health law without a clear
replacement could upend the health insurance market for people buying their
coverage directly, outside of the workplace. That group has grown
substantially under the health care law, but also includes millions of other
The study found
that 22.5 million people would lose coverage directly due to repeal of the
law’s subsidies, Medicaid expansion, and its individual requirement to carry
Another 7.3 million
would become uninsured because of the ripple effects of market upheavals.
That could happen if insurers lose confidence in the Republican promise of a
replacement and abandon the individual market. A key industry worry is that
a repeal law would get rid of subsidies and mandates but still leave
insurers on the hook for covering people with health problems.
The number of
uninsured people would rise to nearly 59 million in 2019, and the nation
would have a higher uninsured rate than when the ACA passed in 2010, the
Federal and state
governments would save tens of billions of dollars, but the potential price
would be social dislocation and a political backlash.
“This scenario does
not just move the country back to the situation before the ACA,” the study
concluded. “It moves the country to a situation with higher uninsurance
rates than was the case before the ACA’s reforms.
“To replace the ACA...with
new policies designed to increase insurance coverage, the federal government
would have to raise new taxes, substantially cut spending, or increase the
deficit,” the authors added. That’s because the taxes used to finance
Obama’s coverage expansion would also be repealed.
they won’t allow chaos to happen.
“We are not going
to rip health care out of the hands of Americans,” House Ways and Means
Chairman Kevin Brady, R-Texas, said in a recent interview with Associated
Press reporters and editors. “Republicans are going to give Americans
choices and an appropriate transition.”