McConnell's ObamaCare repeal would hurt millions, and you could be among those hurt
© Keren Carrion

Though Sen. Mitch McConnellAddison (Mitch) Mitchell McConnellSenate passes 0B defense bill Overnight Health Care: New GOP ObamaCare repeal bill gains momentum Overnight Finance: CBO to release limited analysis of ObamaCare repeal bill | DOJ investigates Equifax stock sales | House weighs tougher rules for banks dealing with North Korea MORE (R-Ky.) has thus far been unable to pull the votes together to repeal or replace the Affordable Care Act, the fight over healthcare is far from over.

The Senate is still planning to vote next week on a repeal bill. The House budget resolution proposes cutting Medicaid and “other programs” by $1.5 trillion over the next decade (and cutting Medicare by $487 billion). President Trump’s proposed budget would also take a large ax to the program.

Earlier this summer I spoke with a number of people outside the health policy world about the efforts by Republicans in Congress to repeal and replace the ACA who told me they were not following the debate closely. They said it didn’t affect them because they are on Medicare or have coverage through their employer.

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One of the reasons the repeal effort has stalled is that people are beginning to understand that repeal and cuts to Medicaid would touch all of us. It is important to keep this front and center in the coming weeks and months as the debate continues.

 

If you are a senior and have coverage through Medicare, proposed cuts to Medicaid would slash vital services you may rely on now, or may need at some point in the future. Medicaid is more than a healthcare program for low-income families; it covers two-thirds of nursing home residents in the United States.

Even if you enter retirement comfortably in the middle class, years of nursing home care, if needed, can run your savings dry. When this happens, the costs are picked up by Medicaid. The cost of home care is also covered by Medicaid, allowing millions of seniors to continue living at home rather than in nursing homes.

Those funds would also be on the chopping block. Whether you are currently a senior, a relative of a senior or a future senior, you will likely be affected by the availability — or absence — of these benefits at some point in your life.

Persons with disabilities, or who have loved ones with disabilities, would also be affected by Medicaid cuts. More than one-third of Americans with disabilities are covered by Medicaid; the program pays for the services that allow these individuals to live and work in their communities.

If you are one of the 14 million who gained health coverage as a result of the ACA’s expansion of Medicaid to childless adults and to greater numbers of parents, that coverage is at risk.

If your child relies on Medicaid, your child’s coverage is also at risk because massive cuts to Medicaid could affect all eligibility groups, not only those who gained coverage through the ACA. Medicaid covers four in 10 children and half of all births. Recent research suggests that the effects of Medicaid for children extends to the next generation, too; it reduces preterm births and increases birth weights of children born to those who themselves had Medicaid when they were young.

People with job-based coverage should bear in mind that they may not always have job-based coverage. One pre-ACA study found that in a three-year period, 40 percent of those with coverage through their employer had a change in coverage, with one-quarter of them becoming uninsured. Medicaid and the health exchanges provide affordable coverage options for people who lose job-based coverage — options that would no longer be affordable or available for many under the repeal and replace bills.

An organization of major U.S. businesses came out against ACA repeal and cuts to Medicaid, arguing that it would raise premium costs for employers and employees. Millions more uninsured Americans would result in more uncompensated care in our hospitals — hospitals will shift those costs onto those who do have coverage.

The Republican plans would have also drastically weakened, if not entirely eliminated, the ACA protections from catastrophic costs for those with job-based coverage. All insurance plans are now prohibited by law from including annual and lifetime limits on essential health benefits. Prior to the ACA, six out of 10 Americans with job-based coverage had a lifetime limit in their plan. Those who exceeded the limits — because of chronic illness, catastrophic accident or any other health crisis — faced the choice of forgoing necessary care or taking on debt and risking medical bankruptcy. These protections would have been at risk under the Senate bill.

If you work in the healthcare industry, your job could be at risk if the ACA is repealed or Medicaid is slashed. Even employment in other industries would be affected as the health funding losses ripple out through the rest of the economy.

Finally, the attempts to repeal the ACA and slash Medicaid affects all of us because, in the end, they are about what kind of society we want to live in. These changes would take us back to a place where an accident or illness — affecting you, a relative, or a neighbor — can quickly send a family into a financial tailspin, where health services are only available until the family’s funds run out, and where millions of low- and middle-income families are priced out of health coverage entirely.

If this is not the kind of society you wish to live in, even if you have the best coverage in the world, the Republican’s health proposals should matter to you. This is about all of us.

Ken Jacobs is the chairman of the University of California Berkeley Center for Labor Research and Education.


The views expressed by contributors are their own and not the views of The Hill.