Many news articles about the President-Elect and his cabinet appointments highlight the plans they, and Republicans in Congress, have made to repeal the Affordable Care Act. Although repealing the Act seems to have been a high priority for Republicans for a number of years, there is no viable plan to replace it. Instead, they want to “repeal and delay,” suggesting that they will come up with a better plan at some point.
As an Elder Law attorney, I read these articles with great concern. Short of replacing the Affordable Care Act with a single payer system such as Medicare – which they obviously are not going to do – it is extremely difficult to see how they could avoid 30 million American citizens losing their health care coverage, and chaos in the insurance markets.
Their main objections to the Affordable Care Act seem to be the individual mandate (that healthy people have to purchase insurance) and the provision of premium subsidies to people who cannot afford to pay for insurance. At the same time, they say they will require insurance companies to continue to insure people who have pre-existing medical conditions.
It is simply impossible to reconcile these objectives.
Without a large insurance pool of healthy people (who will one day become old and sick themselves) paying premiums, it would be impossible cover the health care needs of those who are currently old or sick. Hence, the individual mandate.
Similarly, those who cannot afford insurance need some form of subsidy, otherwise how are they going to pay for coverage?
If we are going to maintain a system of private insurance that includes millions of people with pre-existing medical conditions, the only possible results of removing the individual mandate and subsidies for low-income individuals would be: the denial of coverage to millions of citizens, or premium increases to levels that millions of citizens could not afford.
It is hard to believe that those who voted for change really had in mind this kind of change.
If you need advice regarding your health care or long-term care, contact the elder care attorneys at Lamson & Cutner here, and we will be happy to help you.