The ACA: It’s not broken, don’t repeal it
The Affordable Care Act has stirred partisan emotions from the start. But more than seven years later, it works. It works for Democrats, Republicans, Independents and any American needing health care. Being sick isn't partisan. But sadly, Washington is.
In the immediate hours after Donald Trump was sworn in as president of the United States, he retired to the Oval Office to sign a hastily drafted executive order that caused chaos and confusion around the Affordable Care Act (ACA). The order called on federal agencies to begin dismantling the ACA “to the maximum extent permitted by law.”
With the stroke of his pen, the new president kicked off the first step in his plan to intentionally sabotage America’s health insurance markets by instilling doubt and confusion for consumers, states and insurance providers.
A few days after signing the executive order, the Trump administration quietly canceled millions of taxpayer dollars in prepaid advertisements for outreach during the crucial final week of open enrollment for Healthcare.gov. Research has shown that the last week of open enrollment tends to draw younger enrollees, whose participation is critical to keeping health insurance affordable and the marketplace stable.
The administration’s plan worked.
The Centers for Medicare and Medicaid (CMS) reported that far fewer Americans enrolled for health coverage during the final week of enrollment this year than they did during the same time period last year. And that’s in spite of projections of a surge during the final week of open enrollment this year due to more sophisticated targeting and outreach.
Although the administration’s efforts to undermine the American health-care system are deeply troubling, it is important to point out that the president is not acting alone. His Republican allies in Congress are disrupting the market by promising to repeal the ACA without a replacement in sight.
The effect of this coordinated effort is that insurers are hesitant to continue to participate in the ACA marketplace for the upcoming year. Just this month, the CEO of Molina Healthcare noted the “considerable uncertainty” around the exchanges at an annual health-care conference as his company makes plans for next year.
So why are Republicans purposefully sabotaging the insurance markets created by the ACA?
Trump and congressional Republicans are betting that if they can successfully destabilize the market, insurers will either be forced to flee or dramatically increase premiums to offset market uncertainty. The president is hoping the ensuing chaos experienced by American consumers will allow him to claim that the ACA is in a “death spiral” and needs to be repealed. This deeply cynical political game endangers people’s lives, but it is by no means inevitable.
The truth is that the ACA is working both nationally and right here in New Jersey. Thanks to the ACA, New Jerseyans have better health coverage and health care today than before it became law seven years ago. More than 660,000 people have gained health coverage in our state through either the ACA marketplace or the expansion of Medicaid to more hardworking families.
But the ACA does not just benefit people who gained insurance as a result of the law; it also ensures that employer-provided insurance covers essential health benefits such as preventive care, treats women the same as men so they are no longer paying more for their care, eliminates annual and lifetime insurance coverage limits and allows children to stay on their parent’s plans until they are 26 years old.
Another significant consumer protection included in the ACA prevents insurance companies from discriminating against anyone with pre-existing conditions by charging them more or simply refusing to sell them a plan. In New Jersey alone, about 1.2 million people are living with pre-existing conditions who are protected against insurance discrimination, thanks to the ACA.
For example, one of my constituents, Michelle, wrote to me earlier this year about losing her job in 2014 due to a health condition, but because of the ACA, she was able to get the care she needed despite her status as a cancer survivor. Before passage of the ACA, insurance companies could refuse to sell Michelle a plan or could charge her whatever they wanted in premiums to simply make insurance unaffordable. Today she is back on her feet, working and contributing to the American economy.
Protecting people like Michelle by ensuring access to quality health care when they need it most is what the ACA has always been about. Repealing the law would undo the progress we’ve fought so hard to make and put Americans' health back in the hands of insurance companies.
As one of the authors of the ACA, I have always been committed to building on the progress we’ve made to expand access to affordable health care. No law is perfect, and for seven years, I’ve been wanting to work with congressional Republicans to find ways to strengthen the law. But Republicans have refused to come to the table and instead have been dead set on one thing: repealing the law. Now they are not determined just to repeal the ACA; they want to purposefully sabotage the law and put Americans at risk, which is both shameful and unacceptable.
It is time to put an end to this ideological fixation on repealing the ACA without any idea of what to replace it with. I remain committed to defending the progress we’ve made under the ACA and continuing to build on our efforts to ensure that all Americans have access to quality, affordable health care.
Frank Pallone, Jr. represents New Jersey’s 6th Congressional District. He is the ranking member on the House Energy and Commerce Committee and served as chairman of the Subcommittee on Health when the Affordable Care Act was passed into law in 2010.