The effects of a repeal of ACA

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Hmm..

A repeal of the Affordable Care Act, or Obamacare as it is popularly known, could reduce job growth by almost 1.2 million in 2019, according to a new report from the Economic Policy Institute. Although Republicans, who voted in favor of a repeal, say that cutting taxes associated with Obamacare would stimulate the economy, the report found that cuts for the ultra-wealthy are simply not enough, and would actually slow economic growth. 

The job losses would be the result of a reduction in low-income and middle-income Americans’ disposable income. When Americans don’t have to pay higher subsidies and out-of-pocket health care expenses, they tend to spend more. More than three-fourths of the jobs gained by the expansion of Medicaid were not in the health care sector.

Report: Obamacare repeal could cost the United States 1.2 million jobs

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The fundamental problem for the Republicans..

As Luntz said, what Americans fundamentally want is for their health insurance to be both generous in terms of what it covers and affordable in terms of the premiums they have to pay for it.

The Affordable Care Act tries to deliver that by subsidizing people’s insurance premiums. Those subsidies cost money, and that money was found largely through taxing rich people.

Republicans think that rich people are overtaxed in the United States. Indeed, a commitment to lower taxes on rich people is a core tenet of the modern-day Republican Party. Some think that reducing their tax burden will supercharge economic growth. Others think it is simply immoral that high-income households pay as much as they do. And others still think that both are true.

That means that whether they call it replacing Obamacare or repairing it or whatever else, all of their plans involve rolling back the tax increases on the rich. That leaves less money available to subsidize insurance for the nonrich. And that means the nonrich will either need to pay higher premiums or accept stingier coverage.

Why Republican efforts to "repair" Obamacare are doomed to fail - Vox

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Cotton isn’t the only member of Congress who appears to be ducking his constituents in recent days. Also on Wednesday, Rep. Peter Roskam’s (R-IL) office canceled a meeting with constituents about Obamacare after a staffer learned a reporter was present. “I am flabbergasted that Peter Roskam and his staff would turn us away,” Sandra Alexander, who organized the meeting, said. “They didn’t have the courtesy to listen to us. We are a peaceful group.”

Confronted with talking to constituents about health care, these GOP lawmakers chose to hide

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"it's in my understanding that the ACA mandate requires everyone to have insurance because the healthy people pull up the sick people, right?" she said. "As a Christian, my whole philosophy in life is to pull up the unfortunate. So the individual mandate, that's what it does, the healthy people pull up the sick." 

Bohon also criticized a proposal favored by Republicans that would put sicker people in high-risk pools for those with preexisting conditions, saying "we are effectively punishing our sickest people" by using the pools. Bohon pointed to previous state high-risk pools, which have exhibited high costs and poor coverage. Bohon asked why the government doesn't just "fix" the ACA or provide Medicaid for all instead of repealing the law.

GOP lawmakers get blasted at Obamacare town hall in Tennessee - Business Insider

But you see, that's exactly what the Republicans don't want to do, they favor the strong, healthy, rich and don't want to pull up anybody, despite calling themselves Christians. What they want comes from the dystopian world of Ayn Rand. 

They hate redistribution, the welfare state, universal healthcare, regulations that protect the vulnerable, what they want is hard capitalism with a minimal safety net and tax cuts for the rich.

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Here we have yet another effect, tearing up communities.

In the early 1990s, one of Florida's most populous counties had a problem. So many uninsured residents were using the public hospital that it was costing the county more and more money. But unlike other communities suffering the same fate, Hillsborough County had a unique solution. Local leaders were able to pass a half-cent sales tax increase to give health care services to about 30,000 uninsured residents. And 25 years later, the program is still going strong.

So health care advocates tried to bring this policy to other communities. But they kept running into similar problems: People with insurance didn't see it as priority to use public funds to create a safety net for their less privileged neighbors.

So when Republicans talk about repealing Obamacare, they promise to replace it with something better — and much of the talk is about individual health, even though every plan they've pitched so far would insure fewer people and shift the burden disproportionately to the poor, sick, and nonwhite. In fact, studies show a straight repeal would cause between 24,000 and 44,000 deaths a year.

Research shows that high rates of uninsurance tears at the fabric of a neighborhood. It makes the uninsured feel dehumanized; it makes residents feel like their neighbors are less trustworthy and benevolent. Instead of blurring the differences between people we see on a daily basis, it brightens them. And some research even suggests that as we're exposed to these signs of impoverished people in our communities, we become less willing to help them. We become less generous.

How repealing Obamacare could splinter neighborhoods - Vox

The article is full of disturbing research findings corroborating this view..

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Health insurance and career opportunity are impossible to separate for Erin Hoover. Hoover is a 37-year-old Florida State University student who will graduate with a doctorate in English literature this spring. She is also eight months pregnant. Until recently, Hoover had a clear plan. She would have her baby in March, graduate in May, and begin adjunct work to build up her resume. She felt like she was on a good path; one of her poems was recently selected for the Best American Poetry anthology of 2016. Adjunct positions typically don’t offer health insurance, but that seemed fine. Hoover expected she and her baby would continue to get coverage through the Affordable Care Act, which she has relied on since 2014. 

I spend a lot of time talking to Obamacare enrollees like Hoover: people who struck out on their own — left a job, started a business, went back to school — after Obamacare. They felt empowered to do this because in the reformed individual market, insurers had to offer everyone coverage — and couldn’t charge sick people more. And now, many of them are already beginning to rearrange their lives around the law’s uncertain future. There were 1.4 million self-employed people who relied on the marketplaces for coverage in 2014, recent research from the Treasury Department shows. That works out to one-fifth of all marketplace enrollees being people who work for themselves.

For so many Americans, Obamacare offered career freedom. A repeal could take that away.

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If you changed the goal to “all Americans should have affordable health insurance,” you would lose even more conservative Republicans—the ones who see health insurance as an undesirable way to pay for most health expenditures. They believe generous health insurance keeps people from being cost-conscious consumers looking for the most cost-effective provider of knee replacement surgery or cardiac care. If these procedures are covered by insurance, providers don’t have to compete to offer attractive prices (or even make clear to the patient what their prices are). 

If most of their health care costs are paid by insurance, people tend to use more care, and health care spending goes up. Hence, many Republican health care proposals feature tax subsidies that help people fund health savings accounts (HSAs), so they can shop for health care with their own money. They typically encourage health insurance coverage only for relatively rare “catastrophic” events, although they allow people to use their HSAs to buy more generous health insurance if they want it. Limiting the generosity of health insurance is a hard political sell. Most Americans like the security of having health insurance, even for routine doctor visits. Many people define a “good job” as one that comes with generous health benefits.

Why Is It so Hard for Republicans to Replace Obamacare? | RealClearHealth

Researchers have documented how ACA repeal would strip health coverage from tens of millions of Americans, making it harder for them to access needed care.  At the same time, it would lavish the nation’s very highest-income households with multi-million dollar tax cuts. This approach reveals the skewed priorities that are guiding the Republican-led assault on health reform.

Repealing the Affordable Care Act: Bad for the Poor, Good for the Rich | RealClearHealth

In this brief, we compare future health care coverage and government health care spending under the ACA and under passage of a reconciliation bill similar to one vetoed in January 2016. The key effects of passage of the anticipated reconciliation bill are as follows: The number of uninsured people would rise from 28.9 million to 58.7 million in 2019, an increase of 29.8 million people (103 percent). The share of nonelderly people without insurance would increase from 11 percent to 21 percent, a higher rate of uninsurance than before the ACA because of the disruption to the nongroup insurance market.

Implications of Partial Repeal of the ACA through Reconciliation | Urban Institute

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To hear President Donald Trump, House Speaker Paul Ryan and other Republicans tell it, Obamacare has been a disaster, even for those who obtained coverage through the law. Hammers has a very different perspective. She’s a freelance writer and editor, which means she has no employer-provided insurance. In the old days, if she’d gone shopping for a policy with her cancer diagnosis, she would have struggled to find a carrier willing to sell her one.

And it’s not just the pre-existing condition guarantee, which even critics like Trump say they support, that Hammers has found so valuable. The Affordable Care Act requires insurers to cover a wide range of services and treatments — which, in her case, has included multiple shots of Neulasta, a medication that boosts white blood cell counts and typically costs several thousand dollars per injection. The law also prohibits annual or lifetime limits on benefits, which, as a long-term cancer patient, she would be a prime candidate to exceed.  Policies with such robust coverage inevitably cost thousands of dollars a year, more than Hammers could afford on her own — particularly since battling the disease has cut into her work hours.

But the law’s generous tax credits discount the premiums and help with the out-of-pocket costs, too. “Without the Affordable Care Act, I honestly do not know what I would have done,” she said. The coverage Hammers has today still isn’t as good as what she had years ago, when she worked for a company that provided benefits. But it’s better than what she had in the years right before the cancer diagnosis, when she was buying insurance on her own. The latter plan covered fewer services and came with out-of-pocket costs high enough to discourage her from getting checkups. Obamacare’s introduction of free preventive screenings led her to schedule a long-overdue colonoscopy. During routine preparation for that procedure, a physician first felt a lump in her abdomen.  

Sometimes Hammers wonders whether, with less sporadic doctor visits, the cancer might have been caught a little sooner. “But I couldn’t afford a fat doctor’s bill. And I thought I was super healthy.” These days, something else looms even larger in her mind — the possibility that Trump and the Republican Congress will repeal the health care law without an adequate replacement, or maybe with no replacement at all.   “I’m terrified — isn’t that crazy?” Hammers said. “My biggest source of stress right now isn’t the fact that I have incurable cancer. It’s the prospect of losing my insurance.”

This Is What Obamacare's Critics Won't Admit Or Simply Don't Understand | The Huffington Post

Read the whole article, it's full of stories from people with a lot to loose if the ACA disappears.

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The Freedom Caucus are ideologues, Damn the people, whatever the consequences, a small state and deregulated markets come before people dying in the thousands..

The House Freedom Caucus, a conservative wing of congressional Republicans, voted Monday night to support a swift and aggressive repeal of the Affordable Care Act, complicating GOP efforts to unite around a plan to repeal and replace the healthcare law better known as Obamacare. According to reports, the Freedom Caucus said it would not back a repeal if it did not include all of the elements of a repeal bill that debuted in 2015. It also said it wanted to quickly repeal the law, even if no replacement bill was ready.

House Freedom Caucus wants swift Obamacare repeal - Business Insider

But just as Obama eventually embraced the once-derisive term “Obamacare,” liberals are trying to take back the radioactive “death panels” phrase in the second round of health reform debate. At a town hall meeting Tuesday in Iowa, Grassley faced accusations that Obamacare repeal would be akin to a death panel, as it could end health coverage for millions of Americans. “Over 20 million will lose coverage, and with all due respect, sir, you’re the man that talked about the death panels,” an Iowa farmer who relies on the health law argued at the event. “We're going to create one great big death panel in this country that people can’t afford to get insurance.” Grassley helped the death panel myth take off. He was a legislator who told his constituents they were right to worry about the government “pulling the plug on Grandma.” But eight years later, he’s facing a quite different argument from his constituents: that ending the Affordable Care would pull the plug on them if they lose coverage.

Today in Obamacare: liberals are taking back the term "death panels" - Vox

Pennsylvania Gov. Tom Wolf did not mince words in a recent letter to House Speaker Paul Ryan. "This is not hyperbole – access to treatment through Medicaid is keeping Pennsylvanians alive who might otherwise face overdoses or worse,” wrote Wolf, a Democrat, to Congress' top Republican leader. Government officials and politicians on both sides of the aisle in Pennsylvania are warning that a repeal of the Affordable Care Act, better known as Obamacare, would have disastrous consequences in the state — one that has been especially stricken by the nation's opioid crisis amid a messy state budget outlook.

Obamacare repeal in Pennsylvania could have 'devastating impacts' - Business Insider

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During their lengthy exchange, Cotton never gave McFarland an answer to her question: In the process of repealing Obamacare, what, specifically, would he do to prevent coverage gaps that could kill people like her?

“My family has been in the Ozarks since the 1800s. We are historically a Republican family, we are a farming family, we’re an NRA family, we’re an army family,” McFarland began. “Now, aside from inheriting their patriotism and their work ethic, I unfortunately inherited an incurable connective tissue disorder called Ehlers-Danlos Syndrome.”

McFarland gave a quick rundown of the havoc the disease wreaks on her body before telling Cotton the stakes. “Without the coverage for pre-existing conditions, I will die. That is not hyperbole. I will die. Without the protections against lifetime coverage caps, I will die. Without the Obamacare (or ACA) exchange health care plan that I have elected to continue after my Cobra that is going to kick in after I turn 26 this coming Sunday, I will die,” she said.

“Will you have a replacement plan in place to prevent coverage gaps the second the repeal goes through?” When Cotton tried to move onto other questions before answering her, the crowd shouted him down with chants of “do your job.” When he tried to obfuscate, the crowd interrupted him with chants of “yes or no.”

Woman who says Obamacare saved her life confronts GOP senator on repeal