Sunday, November 19, 2017
Health

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

RECOMMENDED READING


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
New shingles vaccine touted as a breakthrough for older adults

New shingles vaccine touted as a breakthrough for older adults

Medical researchers and government health policymakers, a cautious lot, normally take pains to keep expectations modest when they’re discussing some new finding or treatment.They warn about studies’ limitations. They point out what isn’t known. They ...
Published: 11/17/17
In Tampa Bay and elsewhere, early numbers show record sign-ups for Obamacare

In Tampa Bay and elsewhere, early numbers show record sign-ups for Obamacare

Despite the budget cuts, the attempts to repeal and replace, and reports of sharp rises in premiums, Floridians and other Americans are signing up for health insurance under the Affordable Care Act at record rates this year.Enrollment has surged 47 p...
Published: 11/16/17
Updated: 11/17/17
Study: Mental quickness exercises can lower risk of dementia

Study: Mental quickness exercises can lower risk of dementia

Where did I leave my keys?As we age, it can take longer to answer a question like that.Humans begin to lose cognitive ability at age 25. Dementia, or the decline of memory most commonly seen in aging adults, takes hold early on and is gradual, but ac...
Published: 11/16/17
Blood pressure of 130 is the new ‘high,’ according to update of guidelines

Blood pressure of 130 is the new ‘high,’ according to update of guidelines

The nation’s heart experts tightened the guidelines for high blood pressure Monday, a change that will sharply increase the number of U.S. adults considered hypertensive in the hope that they, and their doctors, will address the deadly condition earl...
Published: 11/13/17
Are Honey Nut Cheerios healthy? A look inside the box

Are Honey Nut Cheerios healthy? A look inside the box

I had a bowl of Honey Nut Cheerios recently. It had been awhile. Regular Cheerios are more my thing. But sometimes I finish my box faster than my kids do and find myself straying to their side of the cupboard.Honey Nut is America’s best-selling break...
Published: 11/11/17
Owner of Bayfront Health St. Petersburg faces federal inquiry over funds for low-income patients

Owner of Bayfront Health St. Petersburg faces federal inquiry over funds for low-income patients

The corporate owner of Bayfront Health St. Petersburg could be facing a serious federal investigation related to its commitment to take care of St. Petersburg’s poorest residents.In its most recent filing with the U.S. Securities and Exchange Commiss...
Published: 11/09/17
Updated: 11/14/17
Learn to practice gratitude year-round, not just on Thanksgiving

Learn to practice gratitude year-round, not just on Thanksgiving

Is it part of your Thanksgiving tradition to go around the dinner table and have everyone share one thing they are thankful for? The exercise reminds us that the day is about more than just turkey and pie. And, for those who take it seriously, it for...
Published: 11/07/17
Updated: 11/10/17
When the goal is getting to the ER fast and cheap, some choose Uber over 911

When the goal is getting to the ER fast and cheap, some choose Uber over 911

Matt Lavin had just arrived in Charlottesville, Va., for a business trip when he started feeling sick. By the time he got to his hotel around 11 p.m., he felt excruciating pain. "I didn’t know what was happening, but I knew something wasnR...
Published: 11/06/17

Stunning study: Heart stents fail to ease chest pain

A procedure used to relieve chest pain in hundreds of thousands of heart patients each year is useless for many of them, researchers reported Wednesday.Their study focused on the insertion of stents, tiny wire cages, to open blocked arteries. The dev...
Updated one month ago
Vigil calls attention to overdose victims, and brings hope

Vigil calls attention to overdose victims, and brings hope

NEW PORT RICHEY — The room was filling up fast. For Monica Rousseau, the sight of so many people searching for a seat at the annual Narcotics Overdose Prevention and Education candlelight vigil was both heartbreaking and uplifting. "I can’t even gues...
Updated one month ago