The Affordable Care Act in the age of Trump

Since the creation of the Patient Protection and Affordable Care Act was enacted in 2010, around half a million Coloradans have gained health care coverage. But this has come at a cost to others throughout the state. The US Department of Health and Human Services, which administers the federal health exchange, reported in December 2016 that roughly 419,000 Coloradans had gained a health insurance plan through the Affordable Care Act between 2010 and 2015. Most of these new enrollees gained coverage through an expansion of Medicaid that was required for states to set up their own health exchanges, as Colorado has done. Others who do not qualify for Medicaid but purchased health care through the state’s insurance exchange were also some of those who gained coverage.

However, since the inception of the law there have been a number of complaints and problems facing the Affordable Care Act. One problem that many in Colorado have faced is the cancellation of health insurance plans they held that were cancelled. This caused anger after a claim President Obama made that ended up as the “Lie of the Year” on the fact-checking website, Politifact. He had said that “if you like your plan, you can keep your plan,” referring to an individual’s health insurance plan. This came to be untrue as many began to receive cancellation letters in the mail. Many of these plans were cancelled because they did not meet regulatory standards created by the Affordable Care Act. The health insurance companies never offered which parts of the law they were not able to meet.

Additionally, rural Coloradans have faced much higher premiums than their urban-living counterparts. This problem has always been present since the Affordable Care Act rolled out. In 2013, The Denver Post reported on problems with health insurance plans facing rural Coloradans. They reported that some parts of rural Colorado would see 40% increases in premiums the following year. In September of 2016, The Denver Post reported on a steep rise of premiums expected to increase on average by 50% in 2017.

With rising premiums and plan cancellations, many are beginning to question whether the Affordable Care Act is able to accomplish creating a nationwide health care system that reduces costs, increases insured rates, and provides better health care. The President-elect of the United States, Donald Trump, called for a repeal of the law, a position held by almost every Republican colleague on Capitol Hill. But Republicans on Capitol Hill, have expressed different ideas on how to proceed with a repeal. Some have argued to repeal the law immediately and then work on a new replacement. Others have argued for a repeal of the law coinciding with a replacement law being enacted at the same time. At a recent CNN Town Hall event, Speaker of the House Paul Ryan spoke about how he would like to proceed saying, “We want to do this at the same time, and in some cases in the same bill,” referring to a replacement to the Affordable Care Act.

If the plan is immediately repealed without a replacement, roughly half a million Coloradans who gained insurance through the expansion of Medicaid will likely receive a cancellation letter in the mail and not have health insurance until a replacement plan is in place. Additionally, jobs in the healthcare sector will be significantly reduced as demand for health care services will decrease with less people insured. Where the US Congress places their efforts on the repeal of the Affordable Care Act will have significant impacts on many Coloradans. It could take months or even years for a new plan to be enacted, and many will not be able to hold their breath.