Research: ACA repeal could leave 31 percent uninsured
Amid the coronavirus outbreak, the White House recently released a statement announcing its latest challenge to the Affordable Healthcare Act via the U.S. Supreme Court.
Meanwhile, a new MoneyGeek study — compiling data from other health care studies, the Census Bureau and U.S. Department of Health and Human Services — found more than 12 million Americans with pre-existing conditions could lose insurance coverage. That number is likely to be higher as unemployment and underemployment increase during quarantine.
As things currently stand, that would include losing coverage for vaccines and treatment related to coronavirus. Idaho would be one of the most impacted states if these laws change. Takeaways from the study include:
• 8.4 percent of the national population — and the same percentage in Idaho, or roughly 83,000 Idahoans — have “declinable conditions” and are either uninsured or using the ACA now.
• 15 percent of Americans are insured under the ACA, with even more underinsured or with out-of-pocket costs so high they skip care.
• An additional 16 percent of the U.S. population are currently uninsured. According to other studies and surveys, many of the working poor still find the ACA-related insurance costs still too high to afford.
• Combining those figures, at least a third of Americans potentially benefit from a statutory health care cost-reduction scheme.
• 26 percent — more than a quarter — of the population has a potentially declinable condition (regardless of their insurance coverage today).
These figures only cover ages 18 to 64; elderly people aren’t included as most are Medicare-eligible. However, Medicare is not comprehensive and does not cover services such as checkups, some medication costs, and nursing home fees.
In Idaho, elderly people who need nursing home “level of care” services in assisted living homes don’t receive Medicare benefits to pay for it. If they’re not Medicaid-eligible so the state picks up much of the tab, they’re forced to drain their own assets and their families’.
According to the nonprofit health research group Kaiser Family Foundation, an estimated 54 million Americans aged 19 to 64 have a pre-existing condition making them “potentially declinable” for coverage. Of those, the MoneyGeek study found, 12.5 million Americans are either uninsured or have coverage through the ACA.
What exactly does “declinable conditions” mean? It means that even if you have private coverage (or are applying for it), insurance companies won’t pay for any care related to those diagnoses. Before the Affordable Care Act took effect, private insurers cited a variety of common diseases and conditions to deny coverage. The KFF study found that, before the ACA required otherwise, more than half of insurers denied coverage to people with common health conditions.
Examples of declinable conditions include Alzheimer’s/dementia, arthritis, fibromyalgia, cancer, congestive heart failure, heart disease and stroke, diabetes, kidney disease, mental disorders, Parkinson’s disease, pregnancy, and pending surgery or hospitalization.
Among other things, the Affordable Care Act made it illegal for insurers to deny coverage to consumers based on pre-existing health conditions. However, since it was enacted about half of U.S. states have challenged the ACA mandate. Earlier this month the U.S. Supreme Court announced it would likely hear the matter in late 2020. If the justices effectively repeal the ACA or key parts, pre-existing conditions could once again disqualify people from coverage.
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Sholeh Patrick, J.D. is a columnist for the Hagadone News Network. Contact her at Sholeh@cdapress.com.