Walk into a room full of people and mention the Affordable Care Act and before you can say “Obamacare” you might hear more opinions and anecdotes than the hundreds of provisions in the act itself.
President Donald Trump based a large part of his election campaign on the promise to repeal and replace the healthcare program. Even before he took office, the U.S. House of Representatives and Senate set the stage for rolling back Obamacare by voting in a budget strategy allowing them to make major changes. Though President Trump promised to unveil a plan that would provide “insurance for everybody” with lower premiums and deductibles, according to a Jan.11, 2017, news conference with the Washington Post, that never really came to fruition. Trump did repeal the individual mandate, which required people to buy health insurance or pay a penalty, in 2017, saving some families money but the number of uninsured Americans has risen under his tenure.
Currently, perhaps as a response to the COVID-19 pandemic, which has put millions out of work and left many without health insurance, insurers selling ACA plans have been lowering rates in some parts of the country and don’t appear to be tacking on steep rate increases for 2021, either. The only downside of this is that some folks who qualify for subsidies to help them buy health insurance could experience a reduction in that aid.
Whether or not Trump will go on to repeal the ACA should he win the Nov. 3 election, it’s important that you still know the top immediate financial impacts on your wallet should the Affordable Care Act get repealed.
Pro: More Choices, More Savings
Repealing Obamacare lets each patient shop for plans with benefits that most closely fit their needs. Although states like California, Massachusetts and New York have five or more exchange carriers to choose from, healthcare exchange providers continue to pull out of the Obamacare market. Five states have only one carrier that offers coverage across all counties, leaving 18% of U.S. citizens with no choice.
President Trump’s vision for healthcare would let individuals shop for insurance across state lines, creating a strong national exchange with plenty of individual choices. One version of a Trumpcare plan promoted by Sen. Rand Paul of Kentucky allows individuals and businesses with few workers to create associations for maximum bargaining power.
Additionally, since Trump repealed the individual mandate in 2017, some states have created new state-based marketplaces for 2021. People who live in New Jersey and Pennsylvania can buy into coverage there that might be cheaper than the federal plans. Running their own marketplaces may allow the state greater control and save people money in the long term.
Con: Cost of Lost Coverage for the Sick
Without healthy people paying into the healthcare system, insurance companies must raise rates for sick individuals to keep healthcare profitable. In many instances, patients undergoing treatment for serious health conditions would no longer be able to afford continued treatment.
Repealing the Affordable Care Act could leave sick patients and their families having to choose between imminent death or financial ruin.
Con: Cost of Lost Coverage for Young Adults
Under Obamacare, young adults can stay on their parents’ coverage until age 26. This age group could end up losing coverage should insurance companies revert to removing young adults from their parents’ policies when they reach age 18 or 21.
College-age kids typically enter the workforce as part-time employees, retail clerks or workers in the hospitality and restaurant industries making minimum wage with no insurance provided. A college student working a 25-hour workweek at $10 per hour would have a gross income of only $13,000. Although Medicaid or college-based insurance can be a possibility for some, many would need to resort to medically underwritten health insurance if the ACA gets repealed, leaving their moms and dads to pick up the cost.
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