By The Numbers: What An ACA Repeal Would Do To Iowans

The health care advocacy group Protect Our Care released a report on June 11 that documented the benefits of expanding Medicaid, as well as the efforts of the Trump-led Republican Party to derail the Affordable Care Act and roll back the clock on coverage qualifications.

“In the last two years alone, we have evidence that clearly shows better health outcomes for people who live in states that expanded Medicaid compared to those who live in states that did not,” the report read.

In March, the Trump Administration’s Justice Department filed a legal briefing making the case to a Texas judge that the ACA should be ruled unconstitutional. The case that started the legal proceedings, Texas v. Azar, saw a ruling handed down by federal district court Judge Reed O’Connor in December of 2018. The judge argued that the 2017 Tax Cuts and Jobs Act, which established the individual mandate – requiring individuals to have health insurance – was unconstitutional, making the entirety of the ACA unconstitutional as well.

For now, the ruling will have little impact because no injunction was issued, meaning that immediate compliance is not necessary. However, the Trump administration is eager to get the case to the Supreme Court and challenge the healthcare legislation in an effort to repeal it – which could happen in early 2020.

The American Medical Association released a report that said the following provisions would be impacted:

  • Access to their parents’ plan coverage for young adults up to age 26

  • Elimination of annual and lifetime caps on benefits

  • No pre-existing condition coverage exclusions or medical underwriting

  • Coverage of prevention and screening benefits with no deductibles or copayments

  • Required coverage for mental health and addiction treatment services

  • Federal support for expanded Medicaid eligibility

  • Premium subsidies for low- and moderate-income individuals and families to purchase coverage and cost sharing subsidies to lower out-of-pocket costs

“Republicans who continue to wage a war against Medicaid do so at their own political peril,” said Brad Woodhouse, Executive Director of Protect Our Care. “And as the program continues to improve the lives of millions, the GOP’s relentless sabotage efforts place even more Americans at risk of losing coverage.”

What would the impact of the ACA’s overturn be on Iowa? The report included state-specific data on the potential fallout of the legislation’s disappearance:

  • There are 476,399 Iowans enrolled in Medicare Part B and 104,662 enrolled in Medicare Advantage

  • 187,000 Iowans would lose coverage; this would be a 126% increase in the state’s uninsured population

  • 24,000 young adults would forfeit the coverage they receive from their parent’s insurance

  • 1,530,502 people in Iowa could have to again start paying for preventative care like flu shots, mammograms, cancer screenings and contraception

  • 39,039 Iowans would lose access to tax credits created to help pay for marketplace premiums

  • 51,596 Iowa seniors could see their prescription costs rise by more than $1,000 per year

  • Access to treatment would be in jeopardy for 800,000 people with opioid use disorder; many of who became eligible through Medicaid expansion

  • Key Support for rural hospitals would disappear, leaving Iowa hospitals with $684 million more in uncompensated care


by Josh Cook
Photo by Josh Cook
Posted 6/12/19

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