5 Impacts on Medicaid if the ACA is Repealed

Should the Affordable Care Act be repealed, many experts have determined that the resulting impacts could be highly disadvantageous for the insured and uninsured alike in more ways than one. Repealing the ACA would pose the greatest potential threat to individuals of low income by greatly reducing their ability to receive coverage under new federal and state terms.

The following are some of the most prominent ways that the prospective bill to repeal healthcare has been described as capable of damaging the welfare of those who depend on Medicaid.

Diminished Federal Spending and Lower Enrollment

Should ACA be repealed, federal spending on Medicaid would be projected to drop by hundreds of billions within the following decade. In the place of Medicaid expansion would be a state-based per-capita system. With a per-capita system in place enrollment would decline sharply. Experts with the Congressional budget office have calculated that the potential drop in enrollment could be as high as 14 million within the next ten years.

Unlimited Potential for Higher Premium Costs

Repealing the current ACA terms would remove the current limitation that states have to prevent exorbitant premium charges. With this limitation removed, even currently-insured citizens would be far less capable, if not completely unable to match the rising premiums of their policies.

Higher Incentive for Unethical State Fund Allocation

Not only would the amount of available capital to invest in federal and state Medicaid spending decrease substantially, but the allocation of what little available funds there are to invest in Medicaid for short-term savings instead could potentially increase.

With unrestricted flexibility to use federal funds for priorities such as tax cuts, states would be able to legally disregard the welfare of those in need of healthcare by cutting the public’s accessibility to benefits for higher federal fund carryover.

Inadequate Funding to Meet Rising Healthcare Costs

Even those who are able to remain insured by Medicaid under a block grant system of would be potentially subject to disadvantages in terms of the timeliness of their access to healthcare. Because the responsibility to leverage additional healthcare cost would be entirely left to states with no incentive to do so, those who become unemployed or uninsured in said states would have no hope for any increase in funding to help them. The cost of healthcare would increase, but the funding to actually provide it would become increasingly inadequate.

Inflated Work Requirements

A common misconception is that the majority of health insurance beneficiaries who struggle with premiums willfully choose not to work. On the contrary, many insured policyholders Medicaid are currently employed and yet still struggle to meet premium costs.

By giving states the ability to greatly increase work requirements for eligibility, working-class families already using the maximum amount of time available to subsist would either be uninsured or prohibited from applying altogether. Eligible adults who are between jobs would be especially less likely to receive coverage.

Conclusion

Various conditions under the current ACA model have already been well-documented as relatively disadvantageous for low income citizens in a variety of ways, but should it be repealed, these disadvantages could deepen dramatically. Children, seniors, disabled adults, working class families, and eligible adults unable to meet steep work requirements may face even more daunting blockades to receiving vital healthcare.

Adult beneficiaries who do not meet any pre-established criteria for disability or pregnancy would be subject to highly difficult work requirement impositions in order to be considered eligible for care. Without being able to meet the work requirements or satisfy the criteria for either disability, pregnancy or old age, many adult beneficiaries would be left with little to no choice but to give up on enrolling altogether.

Not only would adult beneficiaries without qualifying conditions but unsatisfactory work status be far less likely to have their eligibility approved, but states looking for short-term savings would be given the ability to entirely do away with any ACA Medicaid expansion enrollment. Under these conditions, millions of people who depend on Medicaid would be left uninsured and practically stranded without health coverage.
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