Renewed attacks to repeal and undermine the Affordable Care Act

About one year ago, policy makers and advocates worked tirelessly to protect the Affordable Care Act (ACA) when Congress nearly voted to repeal it. At MBPC, we covered both the House and Senate bills intended to repeal and replace the ACA.

Here’s a recap from summer 2017 of what ACA repeal would mean for Montana.

Unfortunately, the work to protect affordable access to health care is not over; there are now a handful of ways that the Trump administration and Congress are attempting to repeal the ACA and undermine key parts of this legislation. To be clear, the repeal efforts are unlikely to be successful. Republicans in Congress couldn’t repeal the ACA with 52 Senate seats; they’re unlikely to get it done now with 51. Yet the other efforts to attack important components of the policy are underway and we should pay attention.

There are several proposals and lawsuits that could shape the future of the ACA and affordable health care for Montanans. On June 19, 2018, a group of conservative policy advocates released a proposal to repeal and replace the Affordable Care Act. It is similar to the Graham-Cassidy repeal bill, which we saw last year. Here is MBPC’s take on the Graham-Cassidy bill from September 2017.

The new ACA repeal proposal would do the following:

  • Eliminate most of the ACA’s consumer protections and benefit mandates that are important for people with pre-existing health conditions, including the requirement that plans cover essential health benefits, such as mental health and substance use treatment, prescription drugs, and maternity care;
  • Eliminate Health Insurance Marketplace subsidies that help about 10 million people across all states get help paying for individual market coverage;
  • Severely disrupt the individual market for health insurance, potentially causing markets in some states to collapse;
  • Eliminate Medicaid expansion for low-income adults which has helped 94,000 Montanans access affordable; and
  • Replace Medicaid expansion and subsidies with a state block grant. We have discussed the problems with block grants in previous blogs.

It is unlikely that Congress will take up repeal legislation in the near term. However, this move is a clear sign from conservative groups that ACA repeal is still at the top of their agenda. Look for our follow up blog later this week that will outline the additional attacks on the ACA that seek to undermine pre-existing condition protections and allow for strict work requirements.

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