After years of Republicans promising and campaigning on an outright repeal of the Affordable Care Act, the new Congress that’s reconvening in Washington, D.C. this week looks poised to finally do just that. But so far there’s been little to no talk of an actual plan to replace what has become known as Obamacare, and that has many Americans worried that healthcare could end up getting worse and more expensive.
A group of Iowa patients, business owners, doctors and healthcare navigators gathered in Des Moines yesterday to call on Iowa’s members of Congress to not repeal the ACA with no alternative. Many shared their stories of how the ACA actually had worked and helped them through a health crisis.
“Under the ACA, something happened that I didn’t even know had happened: you get a free exam every year,” said Midge Slater, a retiree. “Unbeknownst to me, I did have cancer. And that’s how that was found.”
572,000 Iowans on Medicare could lose that access to free preventative screening services were the ACA repealed.
Overall, 230,000 Iowans would be at risk of losing their healthcare coverage in 2019 and Iowa would no longer receive $7 billion in federal funding for Medicaid over the next ten years. Advocates warned that the entire healthcare industry would see an upheaval, and even people not on plans through the ACA could see their coverage dropped as providers shift costs off to employer-based healthcare.
“Not only would this wreak havoc on our state budget, it would wreak havoc on the family budgets of people in this state,” noted Mary Nelle Trefz of the Child and Family Policy Center.
That could all lead to some very difficult choices for many Iowans. As Debbie Neustadt told a gathered group of reporters and activists, a recent colonoscopy she had found pre-cancerous cells, which she’ll have to monitor in the future, but she may not be able to afford it without the ACA. She worried that ending the ACA’s requirement that healthcare providers cover preexisting conditions would leave her in a tough situation.
“The office showed me how much it was going to cost to have a colonoscopy [without healthcare coverage], and that’s $5,000,” Neustadt said. “So in three years I have to decide if I can afford $5,000 to see if I have cancer. I need the Affordable Care Act so I can have health coverage so I can monitor this process. I hope preexisting decisions are covered after Congress gets done this year. I don’t want to make the choice between $5,000 for a colonoscopy and any other budget issue I have.”
For those who have helped Iowans navigate through the system, they’re worried about how many older Iowans will be able to afford coverage post-ACA. The program’s subsidies helped make many costly private plans much more affordable.
“I’ve assisted hundreds of people to apply for the personal health credits,” explained Mike Tramotina. “To me these 230,000 Iowans are not just faceless … In my experience the most common user of healthcare.gov in Iowa is a middle-aged to older woman, many married to a husband who is retiring, whose employer covered them both for years. Now the husband is retiring and going on to Medicare, which means the wife loses the family healthcare coverage … An individual plan could cost her $800 to $1,200 a month. As many retirees, they cannot afford that.”
Many of the panel members noted that plenty of the ACA’s provisions are actually quite popular, despite Republicans’ overall opposition to it. The problem, they pointed out, is that you can’t have some of it without the other – the more popular programs are only feasible because of the insurance mandate.
“The death panels obviously didn’t happen, but are indicative of how silly the entire healthcare debate became,” said Mike Draper, owner of Raygun. “I think the ACA was a good start. I would like to see it built upon, rather than just scrapped. The idea that you can eliminate insurance requirements, but everyone still gets to keep their coverage and it costs less is insane.”
Everyone expected a contentious debate in D.C. and around the country over a potential full repeal, especially if there’s no viable alternative put forward. With a new President Trump soon to be inaugurated, Republicans will largely have their way on what they want to do with the ACA. But it appears they’ll likely try to delay any actual effects of a repeal until after they’re up reelection.
“I think a repeal would only go in after the midterm elections, which I don’t think is a coincidence,” Draper mentioned. “They know that if they scuttle the entire thing that the shock would be so much that people wouldn’t want that either.”
Mostly, Iowans who depend on the ACA for their healthcare just wanted to end the partisanship and political games over America’s healthcare debate.
“It’s healthcare, it’s people’s lives. It shouldn’t be a political football,” said Neustadt.
by Pat Rynard