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The uncertainty of the future of the Affordable Care Act (aka Obamacare) has been making headlines since the new administration announced its plans of repealing the ACA and dismantling all or part of the legislation which brought down the country’s uninsured rate to a historic low of 8.9%. While this is hardly a bipartisan issue, negative sentiments mostly stem from middle class families and folks that had more affordable insurance options prior to the insurance mandate taking effect. So what now? What happens if we go back to the days when medical insurance wasn’t as easily accessible?

Millions of people will become uninsured if all or part of the ACA is repealed. According to a study by the Congressional Budget Office, around 18 million people will lose their health insurance, the majority of whom are currently covered on individual healthcare plans. Furthermore, millions of individuals currently covered by employer-provided plans or Medicaid are also in danger of losing their insurance. The number of people who are not insured will continue to snowball every year, until approximately 32 million Americans will eventually lose their healthcare coverage.

Here are some other consequences the ACA repeal:

Some Healthy People Will Choose to Drop Their Insurance

The ACA requires that everybody have health insurance or pay a penalty. One of the main goals of repealing the ACA is doing away with that penalty. Without a penalty, however, some young, healthy people will decide to drop their insurance coverage and take their chances on not getting injured or sick. Obviously, even the most careful and healthiest of us do get sick or injured, so not having health insurance is not only extremely risky, but it ends up being extremely costly across the board.

Some People Won’t Be Able to Afford Insurance Without the Subsidies

Under the ACA, many people receive subsidies for their insurance premiums. Without the subsidies, some of them will no longer be able to afford health insurance.

Premiums Will Go Up for Everyone

If you want to continue to be insured, expect to pay more. If the penalty and subsidies are dropped, fewer people will be buying insurance. With fewer people paying in, and with more of those people being older and in poorer health, insurance companies will be forced to raise their premium rates.

Premiums for individual health insurance plans are projected to go up as much as 25 percent shortly after the ACA is repealed, and will continue to increase over the next 10 years. By 2026, premiums could potentially be more than double what they are now.

Plans May Not Be Available in Many Areas

Another effect of repealing the ACA is that many insurance companies could stop offering plans to individual buyers. If you are someone who now buys your own insurance — if you are not covered by an employer or another group — individual plans may not be available after repeal. In short, the ACA “worked” because everyone was mandated to buy-in. Without the mandate, individuals can choose to go without coverage and when they do, this will, according to the CBO’s findings, exert “upward pressure on premiums and downward pressure on enrollment in the nongroup market.” With premiums going up and enrollment going down, insurance providers will simply elect not to provide coverage in certain areas. The CBO report alarmingly points out that “about half of the nation’s population lives in areas that would have no insurer participating in the nongroup market” and then goes on to estimate that one year after the repeal of the marketplace subsidies is to take effect, the number of those in the nongroup market “would continue to increase, extending to about three-quarters of the population by 2026.”  

Will There Be a Replacement Plan?

As it stands, we don’t know if the President and Congress will be creating a replacement for the ACA. If they do, then some of the problems people are worried about may not happen. Right now, though, there is a lot of uncertainty. President Trump’s first Executive Order suggests replacement plans may be in the works to give “greater flexibility to States and cooperate with them in implementing healthcare programs.” Hence, healthcare legislation and mandatory coverage will, most likely, no longer be mandated by the Federal Government and will be managed at the state level. This will open the healthcare market up to competition which many say will drive the cost of healthcare insurance up while others contend it may ultimately make health insurance more affordable.

How will it end? We don’t know but it’s certainly a hot topic of debate and one that could impact millions of Americans.



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