Why repealing ObamaCare will be devastating for America's veterans
© Getty Images

Veterans and their families have made tremendous sacrifices for our country. Yet despite President Trump’s vow to “take care of the [v]eterans who have served this country so bravely,” new analysis by the Center for American Progress reveals that Trump and House Republicans are on the verge of taking healthcare away from an estimated 441,300 of America’s veterans who rely on Medicaid. And the proposed Senate bill — which makes larger cuts to Medicaid in the long term — would ultimately lead to even larger losses.

Every year, nearly 200,000 people leave active duty military service to begin their transition back to civilian life as veterans. Despite common misperceptions, the Department of Veterans Affairs (VA) does not cover the healthcare needs of all of the nation’s 20 million veterans — and it certainly does not sufficiently provide care for the health needs of veterans’ families.

ADVERTISEMENT

Instead, most veterans and their families depend on other types of insurance for coverage. This includes Medicaid, which currently covers close to 1.8 million U.S. veterans.

 

The Affordable Care Act (ACA), also known as ObamaCare, has been instrumental in providing health coverage for veterans and their families — many of whom have lived through several deployments and moves. According to the Urban Institute and the Robert Wood Johnson Foundation, the share of uninsured nonelderly veterans declined by nearly 40 percent between 2013 and 2015, thanks in large part to the ACA’s expansion of Medicaid coverage.

But these vital health coverage gains could be largely wiped out — and the burden on the already overstretched VA increased — if efforts to repeal the ACA currently underway in Congress succeed.

In addition to repealing the Medicaid expansion — a move some Republican governors strongly opposeboth the House and Senate plans make changes to essential health benefits that could prove particularly harmful for veterans.

Essential health benefits comprise 10 critical categories of services, such as emergency services and prescription drugs, that insurers must cover in the individual and small group market in all non-grandfathered health plans. The ACA also banned lifetime and annual limits on all health plans, including those offered by employers. That requirement is linked to the essential health benefit requirement — health plans could no longer impose lifetime or annual limits on any services that are considered essential health benefits.

If Congress allows states to make changes to the essential health benefit requirements, the services that are no longer considered essential could be subject to a lifetime or annual limit. For example, if states no longer considered mental health benefits to be an essential health benefit, it would bring back lifetime and annual caps for this critical care.

This would be disastrous for people with preexisting conditions — including veterans — diminishing the protections they have under the current law and astronomically increasing medical costs for some.

Preexisting conditions include all service-connected disabilities, such as post-traumatic stress disorder and hearing loss. Veterans are more likely than non-veterans to have a disability at all ages. Veterans who have served recently are particularly likely to have a disability, because recent improvements in military medicine have led to increased survival rates after injuries, which, in turn, has produced dramatic growth in the share of veterans with service-connected disabilities since 2001. Service-connected disabilities are a critical factor driving the difference in disability rates between veterans and their same-age peers. Put simply, it is veterans’ service to this country that has increased their likelihood of having a disability.

Some veterans also experience certain preexisting conditions, such as paralysis and amputation, that are very costly to manage. The cost of a prosthetic limb, for example, can rival the cost of a car and typically needs to be replaced every five years or sooner. For amputees and other Americans with costly medical conditions, the re-emergence of annual or lifetime limits for coverage could result in financial ruin.

Veterans and their families who have sacrificed for our nation deserve far better than being deprived of basic living standards such as healthcare. As a common saying in the U.S. armed forces goes, “Individuals join, but families deploy.” Military families bear the burden of bravely serving their country right alongside their enlisted loved ones and share in the numerous, lifelong challenges of transitioning back to civilian life.

We owe it to these brave women, men, and families to not make that transition any harder by threatening to take away some of the only coverage and supports they can rely on when VA care is not enough. Instead, the Senate “BetterCare” plan proposes to scale back key protections and benefits.

If President Trump and congressional Republicans are not swayed by a moral argument, perhaps they will be swayed by the political one: betraying veterans means betraying many of their own voters. New analysis from the Center for American Progress reveals that in the counties Trump won in the 2016 presidential election, 10 percent of adults are veterans — 45 percent higher than in counties Trump lost.

If Trump is sincere in his promise to care for our nation’s veterans, he and his colleagues should protect healthcare for the families who have protected our country.

Lawrence J. Korb, Ph.D., is a senior fellow at the Center for American Progress. He served four years on active duty as a naval flight officer and was the assistant secretary of defense in the Reagan administration from 1981 through 1985.


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