This is What’s Actually Happening with the Affordable Care Act (and What it Means For You)

The Affordable Care Act has made A LOT of headlines over the last few weeks. Republicans have begun the process to repeal and (probably) replace the ACA, leaving a whole bunch of people like you and me confused – and more than a little scared – about what might come next.

Unfortunately, that’s because the facts are being shrouded by misinformation and fearmongering from both Republicans and Democrats, making it difficult for the average American citizen to clearly understand what will (and won’t) happen with their health care.

I am not an economist, an insurance expert, or a scholar of health policy, but I couldn’t help but feel that we needed a simple, quick-and-dirty guide to what congress is currently doing with the ACA, and what that will mean for us.

What did congress vote on, exactly?

Around 1:30 a.m. on Jan. 12, senate Republicans voted to kill the budget from taxpayer-funded portions of the ACA. The following day, the same vote passed in the House of Representatives. This passed because voting on budget-related issues can be done with 50 votes (easy, when there are 52 Republicans). Replacing ACA (aka Obamacare), or voting on any non-budget related issues, will require a 60-person supermajority, which Republicans can’t achieve unless eight Democrats get on board. This means, essentially, that Republicans can now start working to defund portions of Obamacare, rendering those parts useless, but ONLY if they keep their wording related to budget issues. Changing any part of the ACA unrelated to budgeting will require that 60-person vote.

Did I just lose my insurance?

No. Many people woke up Thursday to sensational articles and messages from their political leaders that Republicans voted away their coverage in the middle of the night. While anyone who supports the ACA should definitely be concerned, I wish our representatives and the media could have been clearer about this, because frankly, reading those headlines was really f*cking scary.

Because fashioning a replacement will take so long, experts say your current coverage should continue through at least 2018. 

As of right now, Obamacare is still in effect. Some policymakers supported a “repeal and delay” approach, which is the thing that seemed to scare people the most, because it would repeal the ACA without an immediate replacement. A Congressional Budget Office Report says this would cause 18 million people to lose coverage and seriously destabilize the market, sending premiums soaring.

Understanding that might not be the most politically-sound choice, many Republicans, including House Speaker Paul Ryan and Pres. Donald Trump, want to ditch “repeal and delay” and replace Obamacare immediately upon repealing it.

That means Republicans will need a replacement plan that at least eight Democrats will sign off on, which many people think won’t ever happen. If it does happen, coming up with a replacement plan that will sway eight Dems is going to take a while. Republicans are obviously actively working to repeal Obamacare, but it could be here to stay – for months or possibly years – until a replacement plan is introduced. 

Health policy expert Robert Laszewski told the Washington Post that, because fashioning a replacement will take so long, your current coverage should continue through at least 2018. 

What’s the deal with Trump’s executive order? 

On his first day in office, Trump signed an executive order demanding that federal agencies dismantle “any provision… that would impose a fiscal burden on any State, or a cost, fee, tax, penalty, or regulatory burden on an individual.” Translation: Federal agencies were ordered to quit it with those tax penalties for people who didn’t sign up for coverage. Experts say this could be problematic, because if younger and healthier people who feel they don’t need insurance aren’t forced to pay into the pool, insurance companies will make less money – and hike up premiums for everybody. 

The executive order can’t make any replacements or change any provisions written into the Obamacare law, but it offers another way for Republicans to relax and weaken Obamacare before a repeal is possible.

What about the ACA’s protections for young people and folks with pre-existing conditions?

The most popular aspects of Obamacare are the provisions that guarantee coverage to those with pre-existing conditions, allow young people to stay on their parents’ plans until they’re 26, and cover birth control for women. Understandably, anyone who fits into any of those categories (I’m raising my hand) might feel scared that their coverage will be dropped if and when the ACA goes away.

The votes on Jan. 12 and Jan. 13 were budget decisions that DO NOT have anything to do with those provisions, and as of right now no coverage is being immediately dropped because of them. What’s more, most Republican policymakers agree that those protections should be preserved, even if the rest of Obamacare is gutted.

These protections will only go away if the replacement plan excludes them, and as of right now no replacement plan exists.

What can I do about it?

Anyone who agrees or disagrees with the repeal of the ACA should contact their local representative immediately. According to a congressional staffer, the most effective way for your opinion to be heard is to CALL YOUR REP, rather than use social media or write a letter. Look up your local representative here, then pick up the phone. It doesn’t have to be a long phone call. You won’t have to explain the nuances of your understanding of health policy. Explain to the staffer you speak to that if your rep votes repeal the ACA, or votes for a replacement plan that doesn’t have consumer protections, or WHATEVER matters most to you, your rep will not have your support for re-election. 

Your representative is just that: a representative. But their votes will never reflect the opinions of their constituents (you) unless you make those opinions known.

What other questions do you have about the Affordable Care Act? Start a discussion in the comments!

 

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