Repealing ACA without a replacement is wrong

During a June 30 interview with Fox Business Network, Pennsylvania’s Republican U.S. Sen. Pat Toomey expressed support for repealing the Affordable Care Act without having a replacement ready, which would jeopardize health care for 1.1 million Pennsylvanians now covered as a result of the ACA. It would also risk losing Medicaid expansion that Gov. Tom Wolf championed, and critical protections the ACA extended to millions of Pennsylvanians with employer-sponsored coverage, such as free preventive services, a ban on annual and lifetime limits and the ability to cover dependents up to age 26.

As was evident at the TV town hall Toomey held on Thursday, his constituents want answers. These affected Pennsylvanians know that repealing the ACA means more than 700,000 Pennsylvanians will lose their coverage due to the loss of the state’s expanded Medicaid program.

Among those losing coverage under this scenario is Anna, from York County. She recently told me her story of having two children with severe, chronic medical conditions. Her family had insurance, but even with this, the out-of-pocket costs to the family were forcing Anna to choose between paying her utility bills and buying her children’s medicine. Expanded Medicaid has put Anna’s family back on its feet, and she can now pay all her bills.

Another 426,000 Pennsylvanians now get individual coverage through the healthcare.gov exchange because of the ACA. Without the ACA, insurance companies would not be required to offer this coverage to individuals with pre-existing conditions, who might not have any other coverage options. About 80 percent of these people get subsidies to help pay premiums, and about 55 percent of the lower income people with this coverage also get cost-sharing reduction payments to help with deductibles, co-pays and co-insurance. All these subsidies go away if the ACA does, meaning most of these people would be priced out of the health insurance market if they are able to get coverage at all.

Another Pennsylvanian at risk of losing coverage is Carl in Cumberland County. A small-business owner, Carl’s health issues forced his premiums up from $400 to $3,400 per month in just two years prior to the ACA’s passage, leading him to drop his coverage because he couldn’t afford it. Under the ACA, Carl, 62, now has affordable coverage that includes his pre-existing condition.

Often lost in the debate over the ACA is the impact repealing this law would have on people with employer-sponsored coverage. These consumers can get preventive services, including colonoscopies, annual screening mammograms, and well-baby and well-child checkups at no cost. Many employer plans had annual and lifetime limits on coverage, which are now banned under the ACA. People with chronic conditions or expensive diseases, such as diabetes, heart disease and cancer, often hit these limits before the ACA, meaning these families faced huge, sometimes financially devastating, out-of-pocket costs.

The ACA also allows employer plans to cover dependents up to age 26 who may be completing their education or in entry-level jobs without benefits.

Toomey glibly states placing a deadline for Congress to replace the ACA will force action. But this ignores history he should be familiar with, having served on the “super-committee” in 2013, which was charged with writing a budget to avoid deep cuts to many services, known as “sequestration.” Toomey’s committee failed to get a budget plan even to a vote, despite a congressionally set deadline.

Pennsylvanians should remember this history and not allow Toomey to help repeal their vital coverage with the vague promise that something will be there by an arbitrary deadline to replace it.

This story was originally published July 11, 2017 at 1:37 AM with the headline "Repealing ACA without a replacement is wrong."