The Affordable Care Act (ACA), commonly known as Obamacare, has been a controversial topic in American politics since its implementation in 2010. With the election of President Donald Trump in 2016, many have wondered about the future of this legislation, particularly given the Republican Party’s long-standing opposition to it. As Congress and the incoming Trump administration prepare to take steps to repeal the ACA, it is worth considering the potential consequences of such a move, particularly for the most vulnerable Americans.
One state that would be particularly affected by the repeal of the ACA is Iowa. According to a recent report, if the law is repealed without a suitable replacement, around 230,000 fewer Iowans will have health coverage in 2019, including 25,000 children. This would be a devastating blow to low-income families in the state who rely on the ACA for affordable health insurance.
In addition to the loss of coverage for thousands of Iowans, the repeal of the ACA would have a significant impact on the state’s economy. Iowa would lose $446 million in federal funds, which would lead to reduced employment and spending in local businesses. Hospitals and other healthcare providers would also be affected, as more people would turn to them for uncompensated care, which would likely be provided in emergency rooms. This, in turn, would leave those who are insured to pay the bill through their own premiums, or for healthcare providers to swallow the cost.
It is worth noting that the ACA has had a significant positive impact on healthcare coverage in Iowa. Between 2013 and 2015, the number of Iowans without health insurance declined by almost 93,000, representing a 37% decline in the number of uninsured individuals. The most significant decrease occurred for non-Hispanic white Iowans, among whom the number dropped by 85,000, accounting for 92% of the decrease statewide.
Increased coverage came in two ways: more individuals purchased private insurance directly, with subsidies available to most of those through the ACA, and more Iowans obtained health insurance from Medicaid. At the same time that options expanded for people to access publicly funded or subsidized coverage, the number of Iowans obtaining health insurance through their employer actually increased by 28,000 over the two-year period. The ACA does not appear to have caused employers to eliminate health insurance and push employees onto public plans.
In short, the ACA has made high-quality health insurance available to thousands of low-income individuals and families in Iowa who otherwise could not afford coverage. About 55,000 Iowans purchased insurance on the exchange during the 2016 enrollment period, and 85% of them qualified for the premium tax credit. The average monthly premium for those purchasing insurance on the exchange was $425.
While the ACA is not perfect, its repeal without a viable replacement would have dire consequences for Iowa and other states. It is essential that Congress and the incoming Trump administration carefully consider the potential effects of their actions and work to ensure that all Americans have access to affordable, high-quality healthcare. Failure to do so would be a disservice to the most vulnerable members of our society and a significant setback for public health in the United States.
The repeal of the ACA would not only impact Iowa but also have far-reaching consequences for the entire country. The ACA has had a positive impact on healthcare coverage, particularly for low-income Americans, but it has also generated some criticism. Opponents of the ACA argue that it places too much emphasis on government involvement in healthcare and imposes too many mandates on individuals and businesses. They also argue that it has led to higher premiums and deductibles for some individuals.
While the ACA is not perfect, it is clear that repealing it without a viable replacement would have dire consequences for millions of Americans.
