The Nov. 21 issue of Part B News gathered reactions to the Trump Administration’s plan to repeal the Affordable Care Act from experts and medical practice personnel. Here are additional insights that didn't fit in the print edition:
In the heartland, no relief from Obamacare
Ashley L. Corbett, Administrator, Radiology Associates of Valdosta, Valdosta, Ga: "[I hope for] better healthcare options for the uninsured … in our southern region of Georgia, people still can't get insurance because there are no affordable plans being offered and no Medicaid expansion for the state. So if anything, hopefully people could at least purchase affordable private insurance again because they can't now.
The plans got much more expensive [after the ACA passed]. People in our region were easily seeing $500-$1000 premium hikes per month. That’s huge. And it is because of the requirements that insurers are supposed to cover now -- pre-existing conditions, free wellness and screening visits, etc. It has forced premium increases.
We thought it would be cheaper for our office to send our 15 employees to the market to purchase individual coverage, but it’s not. BCBS is the only one offering a plan on the marketplace/exchange in our region. The cost is high and there are no providers in network in Valdosta. There is only one plan off the exchange they can purchase and family coverage is averaging $1,400 a month, and that is with a high deductible. It’s not financially feasible for anyone to afford this."
Looking for a 'soft landing'?
Timothy Stoltzfus Jost, the Robert L. Willett Family Professor of Law at Washington and Lee University School of Law in Lexington, Va.: "Obviously the GOP would like a soft landing. You saw what happened in 2013 when 'If you like your plan, you can keep your plan' blew up – a couple of million people lost plans; they had access to other plans, but it was a major political fiasco and may have resulted in GOP gains in Congress. This would affect 10 times as many people. One would think that would be political dynamite."
Less power for some medical organizations
John F. Williams, former press secretary for the House Committee on Government Reform and Oversight and member of the Republican Senior Communications Staff Committee, now with law firm Hall, Render, Killian, Heath & Lyman in Washington, D.C.: "You’ve got insurance companies, the hospital associations and physician groups interested in renegotiating with House Republicans. It’s fascinating politically because they got on board with Obamacare. And talking to a few House Republicans, I don’t hear a lot of sympathy for them. They’re not going to cut their lines of communication, but those groups don’t have a lot of leverage with the Republicans right now."
More patients paying themselves
Timothy Stoltzfus Jost: "We could see movement toward fixed-indemnity policies, critical-illness policies, health care sharing ministries – some policies that pay cents on the dollar, with tight limits on coverage. Plans like those often don’t pay directly to the doctor – they pay to the patient. However much doctors hate insurers, they do usually pay the bills! But collecting from patients, particularly lower-income patients, can be a different story."
Watch out for Medicare
Terry Fulmer, President of the John A Hartford Foundation in New York City: "We noticed surprisingly little conversation about the elderly in the campaign. About 10,000 Americans turn 65 every day, and they rely on Medicare and Medicaid, two of our most important public programs that were largely ignored. The Affordable Care Act was the main focus, but as this administration unfolds, it’s not clear what the rhetoric will mean for boots on the ground. We feel it’s important to stay vigilant and call for more attention to improving care of older adults."