Thursday, January 18, 2018
Health

Study: Obamacare repeal without replacement only would make 30 million uninsured

WASHINGTON — Repealing President Barack Obama's health care law without a replacement risks making nearly 30 million people uninsured, according to a study released Wednesday.

Separately, a professional group representing benefit advisers warned congressional leaders of the risk of "significant market disruption" that could cause millions of Americans to lose their health insurance.

Republicans dismiss such dire scenarios, saying that they are working on replacement legislation for a President Donald Trump to sign. Nonetheless, the complex two-stage strategy the GOP Congress is contemplating has raised concerns not only among supporters of the law, but also industries like hospitals and insurers.

The plan is for Congress to first use a special budget-related procedure to repeal major portions of the Affordable Care Act, or ACA, next year. The effective date of that repeal would be delayed by months or even years to give lawmakers time to write replacement legislation.

The replacement law would presumably do many of the same things that Obamacare does, such as subsidizing coverage and protecting people with health problems. But it would not involve as much federal regulation, and it would eliminate a highly unpopular requirement that most Americans get health insurance or face fines.

The new study from the nonpartisan Urban Institute looks at a scenario where "repeal" goes through, but "replace" stalls. It predicts heavy collateral damage for people buying individual health insurance policies independent of government markets like HealthCare.gov. Though nonpartisan, the Urban Institute generally supports the goal of extending coverage to all Americans. Previously it has criticized some of the subsidies provided under Obama's law as insufficient.

The new analysis warns that repealing major parts of the health law without a clear replacement could upend the health insurance market for people buying their coverage directly, outside of the workplace. That group has grown substantially under the health care law, but also includes millions of other customers.

The study found that 22.5 million people would lose coverage directly due to repeal of the law's subsidies, Medicaid expansion, and its individual requirement to carry health insurance.

Another 7.3 million would become uninsured because of the ripple effects of market upheavals. That could happen if insurers lose confidence in the Republican promise of a replacement and abandon the individual market. A key industry worry is that a repeal law would get rid of subsidies and mandates but still leave insurers on the hook for covering people with health problems.

The number of uninsured people would rise to nearly 59 million in 2019, since the ACA did not completely eliminate the problem of people without coverage. As a result, the nation would have a higher uninsured rate than when the ACA passed in 2010, the study found.

Federal and state governments would save billions, but the potential price would be social dislocation and a political backlash.

"This scenario does not just move the country back to the situation before the ACA," the study concluded. "It moves the country to a situation with higher uninsurance rates than was the case before the ACA's reforms.

The concerns raised by the Urban Institute study were underscored Wednesday in a letter to congressional leaders from the American Academy of Actuaries. The group represents professionals who advise corporations and government on how to design and maintain benefit programs like pension and health care plans.

The actuaries said even if Congress delays the date of repeal, the uncertainty could prompt insurers to stop offering individual plans for people not covered by employers.

"Delaying the effective date of repeal while a replacement is worked out likely won't be enough to assure the stability and sustainability of the individual market," wrote Shari Westerfield, the group's vice president for health care practice.

Earlier, hospitals warned that they would suffer heavy financial losses if Congress repeals coverage for millions of new paying customers. Those would be magnified if lawmakers leave in place cuts that hospitals accepted as part of the deal to pass the Obama health law. Insurers are also uneasy, even if the ACA hasn't turned out to be as profitable as expected.

Republicans say they won't allow chaos to happen.

"We are not going to rip health care out of the hands of Americans," House Ways and Means Chairman Kevin Brady, R-Texas, said in a recent interview with Associated Press reporters and editors. "Republicans are going to give Americans choices and an appropriate transition."

Comments
5 things we learned about Trump from his medical checkup

5 things we learned about Trump from his medical checkup

Five things we learned about President Donald Trump from Navy Rear Adm. Ronny Jackson, the doctor who oversaw Trump’s first medical checkup in office. SLEEP Trump doesn’t get much shut-eye. Jackson guessed that Trump snoozes four to five hours a nig...
Published: 01/17/18
A century after the 1918 pandemic, science takes its best shot at flu

A century after the 1918 pandemic, science takes its best shot at flu

WASHINGTON — The descriptions are haunting. Some victims felt fine in the morning and were dead by night. Faces turned blue as patients coughed up blood. Stacked bodies outnumbered coffins. A century after one of history’s most catastrophic disease o...
Published: 01/17/18
A popular school fundraiser is just ‘junk-food marketing to kids,’ experts say

A popular school fundraiser is just ‘junk-food marketing to kids,’ experts say

For 43 years, schoolkids and their parents have clipped the labels from cookie bags and cracker boxes as part of a popular rewards program called Labels for Education.Through this and similar programs — think Tyson’s Project A+ or General Mills’ Box ...
Published: 01/17/18
Pinellas is at the center of a rise in Florida flu outbreaks

Pinellas is at the center of a rise in Florida flu outbreaks

Feeling a little sniffly or scratchy or stuffed up? It may be the flu, and you don’t want to wait around to see a doctor this year. This is not the time to write off flu-like symptoms, Tampa Bay area health officials and doctors warn. The influenza v...
Published: 01/16/18

CDC says ‘There’s lots of flu in lots of places.’ And it’s not going away anytime soon.

A nasty flu season is in full swing across the United States, with a sharp increase in the number of older people and young children being hospitalized, federal health officials said Friday.The latest weekly data from the Centers for Disease Control ...
Published: 01/12/18
Mease Countryside Hospital begins $156M expansion project

Mease Countryside Hospital begins $156M expansion project

SAFETY HARBOR — Mease Countryside Hospital is launching a $156 million expansion to build a four-story patient tower with all private rooms and a four-story parking garage.The tower will include 70 private patient rooms, a 30-bed observation unit, cr...
Published: 01/11/18
Flu shot? This is why you should still get one this year

Flu shot? This is why you should still get one this year

This year’s flu season is shaping up to be a bad one. Much of the country endured a bitterly cold stretch, causing more people to be crowded together inside. The strain that has been most pervasive, H3N2, is nastier than most. And, we’re being told, ...
Published: 01/11/18
He was 21 and fit. He tried to push through the flu — and it killed him.

He was 21 and fit. He tried to push through the flu — and it killed him.

Kyler Baughman seemed to be the face of fitness. The 21-year-old aspiring personal trainer filled his Facebook page with photos of himself riding motorbikes and lifting weights. He once posted an image of a kettlebell with a skeleton, reading: "Cros...
Published: 01/11/18
Serena Williams tells scary story of childbirth complications

Serena Williams tells scary story of childbirth complications

The image on the cover of the February issue of Vogue features Serena Williams proudly showing off her adorable daughter.The story she tells of the changes wrought on her life by the arrival of Alexis Olympia, whom she calls by her middle name and ...
Published: 01/11/18
‘Pregnancy centers’ draw scrutiny as lawmakers seek to elevate their status

‘Pregnancy centers’ draw scrutiny as lawmakers seek to elevate their status

Annie Filkowski used to see the signs during her drive to school each morning. "Free pregnancy tests," they said.So when she feared she might be pregnant at 16, shortly after starting to have sex with her boyfriend, she remembered them. And walked in...
Published: 01/10/18
Updated: 01/12/18