“WHAT HAVE YOU GOT TO LOSE?” A Look at the Impacts from Repealing the ACA (Affordable Care Act).


A Look at the Impacts from Repealing the ACA (Affordable Care Act).


 Those old Crosby Stills and Nash lyrics have been running though my mind as the newly empowered Republicans in Congress and the Trump Administration prepare to run amok on health care coverage for all Americans. No, not jobs, not the economy, not Russian hacking, nor ISIS. It’s taking away health coverage that occupies their attention. 

Round One:

Let’s start with seniors and the disabled. The ACA reforms extended the life of the Medicare trust fund by about a decade. The ACA provided coverage for preventive services and a closing of the donut hole in prescription drug coverage for seniors. Over 5.6 million California seniors and disabled will be impacted.

Next working families with employment-based coverage. The ACA required preventive care, 10 essential health benefits, required medium and large employers to offer coverage and pay for at least 60% of the costs of a bronze plan. The ACA also eliminated annual and lifetime caps and exclusions of those with pre-existing conditions. About 16 million Californians will be affected.

Individuals with individual coverage will lose the subsidies that help pay their premiums and reduce their copays and deductibles – about 1.5 million citizens and legal residents enrolled in Covered California. They will lose their guaranteed coverage regardless of pre-existing conditions. Their ability to negotiate collectively for their coverage in Covered California will be eliminated, as well as the important provisions that assure apples to apples comparisons of coverage and prices.

The poor will lose their guarantee of Medicaid coverage for all citizens and legal residents with incomes less than 138% of the federal poverty level; selected groups such as pregnant women, children, seniors and the disabled will be protected. States will lose the federal match (95%) for those newly eligible under the ACA for Medicaid – over 3.5 million in California.

California stands to lose $20 billion in federal funds for health coverage for low, moderate and middle income Californians if the ACA is repealed.

California’s numbers uninsured citizens and resident will double after being reduced by over 50% under the ACA.

Round Two:

The age to qualify for Medicare eligibility will be increased from 65 to 67. In the future, newly eligible seniors will no longer qualify for traditional Medicare but rather for a voucher to purchase private individual insurance – a market that does not now exist.

Medicaid will become a health care block grant to the states. Over 12 million poor Californians will lose their federal entitlement to coverage. The level of funding and any strings attached are not decided.

My advice: don’t go to sleep on this and don’t give up, communicate with your elected representatives early and often. These decisions are being made NOW; you snooze you lose.

There is no agreed upon Republican plan to replace the ACA, not even a semblance of one; their mantra is repeal now, figure out a replacement later.


Prepared by: Lucien Wulsin

Dated: 1/6/17

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