What if they Repealed the Health Care Law?

I confess that I do not fully understand the reason why Republicans are so fiercely opposed to the health care reform law, more properly known as the Patient Protection and Affordable Care Act of 2010 (PPACA). It cannot be denied that it enacted many reforms favorable to the American people. It might be said that the opposition has been fueled by the health insurance industry, or that well-heeled Republicans object to the higher taxes the law imposes on wealthy taxpayers. But that would not explain the widespread fervor of grass root Republicans against the law. There must be something more. Now the House of Representatives has voted along party lines to repeal the law. That vote could not succeed because of Democratic control of the Senate, but who knows? Perhaps at some later date Republicans will gain the strength to carry out their plan to totally repeal all of the provisions of the law. What will happen then?

1. Repealing PPACA would add to $230 billion to the deficit. According to the Congressional Budget Office (CBO) estimate, the health care reform law reduces the deficit by $230 billion over the next decade. This is because the law not only provides for government financial support of many reforms but also provides for higher taxes on wealthy taxpayers in order to pay for the reforms. The taxes exceed the amount needed to finance the law by $230 billion.

2. If health care reform is repealed, 32 million fewer people will have insurance than if the bill is left to stand. This is according to the CBO estimate. These millions of people would constitute a burden on the health care system. Many of them would die of their illnesses and many others would go back to using the ER as their first line of medical treatment.

3. Repealing reform would mean higher health insurance premiums. The amount people actually pay for premiums would be much higher under repeal because right now most people will be able to get a subsidy from the government to help pay for the cost of health insurance.

4. If the law is repealed, senior citizens will not get relief from the “doughnut hole.” Senior citizens who are beneficiaries of the Medicare Part D drug program should be aware that the health care reform act has already begun to close the “donut hole.” That is the period during which seniors have to pay the full cost of their prescriptions after they amass $2,700 in drug costs. After $2,700, Medicare does not resume paying for drug expenses until seniors reach $4,350 in out-of-pocket payments, a figure most seniors never reach in one year. The health care reform bill has already cut the donut hole by $500 and has instituted a 50 percent discount in brand-name drugs. It will eventually abolish the donut hole. For many seniors who simply cannot afford to buy their essential medications during the donut hole, that will be life saving. If the law is repealed, the doughnut hole will remain.

5. If the law is repealed, uninsured people or people who have been denied insurance because of preexisting conditions will lose the temporary program enacted to help them buy health insurance. The health care reform bill creates an Insurance Exchange that begins in 2013 and will enable purchasers to search for the best and lowest-cost insurance. Until the Exchange is put in place, however, the bill creates a temporary insurance program to help uninsured people or people who have been denied policies because of preexisting conditions.

6. If the health care law is repealed, the insurance companies will be able to go back to denying health insurance because of preexisting conditions, placing lifetime caps or annual caps on health insurance coverage, or rescinding a patient’s policy when the patient files a claim for benefits.

7. The PPACA allows displaced workers to keep their COBRA coverage until the Exchange is in place and they can access affordable coverage. Repeal would take away that right.

8. The law creates a long-term-care insurance program, financed by voluntary payroll deductions, to provide benefits to adults who become functionally disable. Repeal would remove that program.

9. The law requires that health plans allow young people up to age 26 to remain on their parents’ insurance policies if their parents so choose. Repeal would mean no such coverage for young people.

10. The law eliminates co-payments for preventative services and exempts preventative services from deductibles under the Medicare program. Repeal would mean return of such co-payments and deductibles.

11. The law prohibits Medicare Advantage (the private Medicare insurance program subsidized by the federal government) from charging enrollees higher cost-sharing for services in their private plan than is charged in traditional Medicare. Repeal would take away this protection.

There are a number of other beneficial provisions of the law that are now in effect. Others will take effect in 2013 and 2014. If the Republicans are able at some point to repeal the health care law, it will mean the loss by millions of Americans of reforms that make it easier and less expensive to obtain health care. It will also mean that greedy health insurance companies will be able to go back to gouging the public.