Repealing Obamacare: Your Top 6 Questions, Answered

With the incoming administration, we have a huge fight on our hands to protect health care coverage. Despite all of the Affordable Care Act (ACA)’s benefits and successes, Congressional Republican leaders — including Rep. Tom Price, President-elect Donald Trump's pick to lead the Health and Human Services Department — are threatening to repeal the law with no replacement. This would cause millions of people to lose health insurance coverage and critical health protections. In fact, repealing the ACA would roll back the historic gains the law has brought; gains like guaranteeing that women can get birth control without a copay, and closing some major gaps in health care equity in communities that have faced barriers to care for far too long.

Want to know more? Here are some common questions that we’ve been hearing from people who care about affordable health insurance, and what we know right now about the upcoming attack.

 

Q: What does “repealing Obamacare” mean?

A: In a nutshell, repealing the ACA without a replacement means as many as 30 million Americans — 82% of whom come from working families — lose health insurance.

Repealing the ACA means that over 55 million women would lose access to no-copay birth control, cancer screenings, STI testing, annual exams, and other preventive care. It means that all women lose protections against insurance companies charging them more than men for the same health care plans. It means that insurance companies could, once again, consider being a woman a "pre-existing condition" and flat-out deny health coverage to millions of women. It means the ability to stay on your parents’ health care plan until you turn 26 will be stripped away.

All these consequences would particularly hurt communities that already face unfair, systemic barriers to accessing health care — especially communities of color, immigrant communities, and people who identify as LGBTQ.

 

Q: When will a repeal happen?

A: President-Elect Trump said he will repeal the ACA on his first day in office: January 21.

However, it’s looking unlikely that a repeal will happen then because Congress would first have to pass a bill. So, the ACA won’t disappear on January 21. Your health care coverage will stay in effect until there is a change in the law, which takes time.

That said, Congressional Republicans are already rushing ahead to rip apart our health care system: On January 4, GOP senators voted to start debate on a resolution aimed at repealing the ACA. Then, in the middle of the night on January 12, Senate Republicans voted for key committees to draft ACA repeal bills by January 27. So far, they have not produced any plans to replace the coverage that would be lost or to make sure people have continued access to affordable care.

 

Q: How will repealing the ACA impact people who have Marketplace coverage and private insurance? Should I still get covered?

A: Although the election didn’t shatter health care access overnight, that access is in jeopardy — so get care while you have coverage, and take advantage of the open enrollment period. The ACA and all its benefits are still here for you (for now).

• If you have health insurance, then take care of yourself and make your medical appointments; get the care you deserve and are entitled to under the law.

• If you have a health plan through the Marketplace, go to HealthCare.gov to update your information by January 31 and make sure your plan still fits your needs.

• If you don’t have health insurance, enroll now — the deadline is January 31. Go to Planned Parenthood Health Insurance Facts to see the plans you’re eligible for.

 

Q: Do Americans want Obamacare repealed?

A: Repealing the ACA is not popular. The American public believes it is wrong to tear apart their health care access and take away the system that keeps their families healthy and financially secure.

The vast majority of Americans don’t want to see the ACA repealed without a replacement. Americans support the ACA and its birth control benefit, and they don’t want women to go back to paying more for health care.

What’s more, Americans across the political spectrum don’t want dangerous and backward policies associated with repealing the ACA, such as letting insurance companies impose annual or lifetime limits on benefits, like they did before the ACA.  

 

Q: How would an ACA repeal affect people on Medicaid?

A: Repealing the ACA would leave millions of the poorest Americans without insurance.  The Medicaid program was designed to provide coverage to people with low incomes; however, before the ACA it was still out of reach for many with low incomes.

The ACA allowed states to expand their Medicaid programs to even more low-income adults. So far, 32 states have expanded Medicaid. That added nearly 17 million more people to the rolls since late 2013, right before the health care law took effect. (This number includes both the people who qualified for Medicaid under the expansion, as well as the people who qualified for it under pre-ACA Medicaid criteria.)

So, repealing the ACA would put these expanded Medicaid enrollees’ insurance and care in jeopardy. Keep in mind that these types of threats to affordable health care coverage particularly affect groups which already face systemic barriers to care, like people of color, people with low incomes, immigrant communities, and people in rural communities.

 

Q: How would a repeal hurt communities of color?

A: Historically, communities of color have faced barriers to accessing health care and as a result, experience worse health outcomes. The ACA has been critical in improving health care equity for people of color — but a repeal would roll back the positive gains that communities of color have experienced under the ACA.

Those positive impacts include higher rates of insured people: Since the implementation of the ACA, Americans have seen the largest reduction in the number of uninsured people in four decades. These coverage expansions are important for the Latinx and Black communities, and particularly for women of color — who are more likely to be uninsured than white Americans. If the ACA is repealed, the uninsurance rate among many communities of color would increase: from 11% to 20% for the Black community; from 21% to 32% for the Hispanic community; from 9% to 22% for the Asian community; and from 14% to 26% for Native Americans/Alaska Natives.

An ACA repeal also would take away key preventive care provisions that screen for many diseases and risks that people of color disproportionately suffer from. Because of systemic barriers to accessing high-quality, affordable health care, Black women have disproportionately high instances of breast cancer, and Latinas are more likely to be diagnosed with cervical cancer than women of other racial/ethnic groups. The ACA has allowed for no-copay preventive care that provides regular screens for these conditions.
It’s also important to note the incredible gains made in people’s access to a regular source of health care. In particular, the percentage of Latinas with a regular source of health care (e.g. doctor’s office, clinic, or health center) increased 25% between 2010 and 2014. Again, repealing the ACA and taking away people’s health care coverage would jeopardize that regular care.