If the Affordable Care Act is repealed as promised by Donald Trump and Republicans in Congress, the delicate balance of the act will undone and the result will be chaos. The ACA is not a perfect program but repeal could lead to insurance companies pulling out of the program as they see it is being ended or substantially changed. And, if Medicaid expansion is rolled back and the program turned into a block grant, more chaos will ensue. On top of all that, the Affordable Care Act included many changes in Medicare as well including higher premiums for those with higher incomes. Repealing those increases will blow a bigger hole in the Medicare budget. Also, coverage in the “donut hole” for Medicare drug coverage is gradually being increased. That would have to be saved or costs would go up for beneficiaries.
There is no magic cure for health care. Republican Congressional leaders want to cut costs but Donald Trump campaigned saying that Obamacare would be repealed and that coverage would be much better. He offered few specifics but his thoughts might run into deficit hawks in the Republican Congress. In fact, Trump has talked of the need for universal coverage. However, the man he is putting in charge of the Department of Health and Human Services is Congressman Tom Price of Georgia who wants to destroy the Affordable Care Act and dismantle Medicaid and Medicare.
It is going to be incumbent on health care advocates to constantly remind lawmakers and the media what the issue is all about, the ability of everyone in this country to have health care at every age. It will be important to document the health problems people face and how changes in legislation effect them in very personal terms. This is always how progress has been made, by having the facts and shining a light on the plight of those in need. We have to make every member of Congress understand the impact of proposals offered and make sure they respond to needs. Health care is a pubic service and must be a right and not just another commodity in the marketplace.