Repealing the Affordable Care Act Without a Replacement Would Leave Even More Without Insurance

This week, two additional Republican senators came out against the Senate healthcare bill, leaving it with too few votes to move forward. Though the Better Care Reconciliation Act (BCRA) has been defeated in its current form, the fight to preserve the Affordable Care Act (ACA) and healthcare for millions of Americans is far from over. This defeat has revived efforts to repeal the ACA without a concurrent replacement. 

Repeal of the ACA without a replacement would immediately repeal the Medicaid expansion, which provides about 290,000 Marylanders with health coverage, and eliminate health insurance subsidies that help middle-income families afford insurance. At the same time,  it would cut taxes for the wealthy. As a result, 32 million Americans would lose coverage by 2026, health insurance premiums would double, and the individual insurance market would collapse in most of the country.

Nearly half a million Marylanders would lose their health insurance by 2019, according to an Urban Institute analysis earlier this year. Between 2019 and 2028, Maryland would lose $28 billion in federal funds for Medicaid, CHIP, and programs to reduce the cost of insurance premiums.

Repealing the ACA also does very little to reduce spending. Although repeal would reduce federal spending by $1.3 trillion for 2019 to 2028, uncompensated care would increase by $1.1 trillion over the same time period. This means we wouldn’t be saving, just using taxpayer dollars in a far less cost effective and productive way. Maryland will be forced to spend more state funds to make up for the loss of billions of dollars of federal investment in health care.

Given the failed efforts in the Republican-controlled House and Senate to approve a concurrent repeal and replacement bill so far, it also seems unlikely that Congress would be able to reach an agreement on a replacement bill in the future, which would have further repercussions for our state’s insurance market and Maryland families.

These problems with repeal are why a bipartisan group of 11 governors, including Maryland Gov. Larry Hogan, issued a joint statement Tuesday opposing repeal without replacement and asking Congress to focus on stabilizing insurance markets. Congress should build on the successes of the Affordable Care Act and continue to make health care more accessible and affordable for all Americans.