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Affordable Care Act By Utah Senator Gene Davis

The Affordable Care Act (ACA) has been great for the American people. More citizens than ever now have access to affordable, quality health care. Regardless, Republicans in Congress have spent the last seven years promising to “repeal and replace” the ACA, also known as Obamacare. Despite these promises, the first weeks of 2017 have shown that not only did Republicans not have any alternative to the ACA, but they were unable to come up with one that could meet the diverging demands of their own caucus. After missing the selfimposed symbolic deadline of March 23 (the seventh anniversary of the signing of the ACA into law), a vote was scheduled for the following day. However, when it became clear that there were far too many “no” votes within the GOP caucus, House Speaker Paul Ryan cancelled the vote. Given this embarrassing and unnecessary defeat, you might expect the Republicans would move on or, better yet, work in good faith with their Democratic colleagues to improve the ACA, rather than dismantle it. Still, many GOP legislators are vowing to try again to modify many of ACA’s key provisions, including the insurance mandates and fully subsidized Medicaid expansion. A Kaiser Foundation poll shows support for the ACA is at its highest level since the law’s introduction in 2010. Though the ACA is much more popular with Democrats (73% approve while 74% of GOP members view the law unfavorably), voices on both sides agree that health care in the United States can stand improvement. Enacted in 2010, the omnibus healthcare reform package was designed to provide affordable healthcare access for Americans above 133% of the poverty line. The ACA also envisioned closing a glaring coverage gap by fully expanding Medicaid coverage for those falling below 133% of the poverty line. To assist states, the federal government developed a plan to subsidize the vast majority of that Medicaid expansion. The original intent included a mandate that states provide full Medicaid expansion with the federal government matching 100% of state dollars. That full funding would gradually scale back to 90% as more people enrolled in the program. However, the 2012 Supreme Court case National Federation of Independent Business vs. Sebelius repealed this original provision of the law. Despite this, many states have implemented full Medicaid expansion. Unfortunately, Utah declined to join. Kentucky, however, did. Legislators in the Bluegrass State enacted full Medicaid expansion under the ACA in 2014. Just two years after enacting expansion, Kentucky’s uninsured rate of non-elderly adults fell from 19% in 2013  to 7% in 2015. In the process, Medicaid expansion saved Kentucky $1.15 billion in uncompensated care. Medicaid expansion makes it a state with some of the nation’s top performers for lowincome coverage access. Additionally, Kentucky has created its own insurance marketplace exchange. Thanks to a well-designed exchange, Kentucky has been

able to offer low insurance rates to those seeking health care on the marketplace. Combined with full Medicaid expansion, Kentucky was able to dramatically improve its healthcare system. Kentucky has been a state with historically poor health care but has now experienced a total transformation under the ACA. Despite all the positives demonstrated by the ACA, many Republicans are seeking to change some of its core provisions in their healthcare revision plan, also known as the American Health Care Act (AHCA). The new Republican plan, presented in early March of this year, seeks to cease full Medicaid expansion funding by 2020. Additionally, states are obligated to keep the Medicaid funding plans they had in 2016 under the proposed Republican law. This means that states that haven’t fully expanded Medicaid yet will not get an opportunity to under the new administration. Moreover, Republicans seek to remove the mandate that required Americans to enroll in an insurance program from the ACA. The Republican plan still seeks to preserve the requirement that allows children to stay on their parent’s insurance until age 26, and they want to continue providing care to persons with pre-existing conditions. The new AHCA proposed repeal of full federal matches for the program by 2020. This flies in the face of the reality that since its implementation in 2014, Medicaid expansion under the ACA granted 11 million Americans access to quality health care for the first time. Reduced federal funding will likely restrict healthcare access to millions of Americans who wouldn’t be able to receive health benefits with the ACA and Medicaid expansion. Furthermore, enacting Medicaid expansion is more fiscally responsible than letting states go without coverage. Utah has been losing money by settling for traditional Medicaid coverage at a 70% federal match rate and neglecting the 90% federal match rate that is available through the ACA. Despite this, Republicans claim that Medicaid in its expanded form is “financially unstable” and seek to preserve traditional federal matching levels. However, expanding Medicaid could save Utah money. By expanding to a 90-10 match, the state would contribute significantly less to operate its second largest healthcare program. Additionally, without access to quality health care, many Americans are forced to use the emergency rooms to obtain primary care services and other healthcare needs. This places an extraordinary fiscal burden on hospitals and states as they provide a financial safety net for unrecovered billions of dollars in medical expenses. Prior to ACA, those without healthcare benefits were triaged in the hospital emergency room. If they had a chronic condition, they were sent home only to return with the same problem days later. And beyond the fiscal aspects of covering the uninsured, neglecting Medicaid expansion hurts those Utahns most in need of coverage. Nationwide, under the ACA, 20 million people gained

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Hinckley Journal 2017  

The Hinckley Journal of Politics is the only undergraduate-run journal of politics in the nation and strives to publish scholarly papers of...

Hinckley Journal 2017  

The Hinckley Journal of Politics is the only undergraduate-run journal of politics in the nation and strives to publish scholarly papers of...

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