Affordable Care Act

Map of Ohio noting rural health care centers
This entry is part 3 of 5 in the series Why Federal Programs Matter to Rural Counties

Republicans have no plan for healthcare.

We saw this during the Republican Congressional efforts to repeal the Affordable Care Act (ACA, aka Obamacare). They attempted to repeal the ACA although millions of Americans would have lost their health coverage. Thousands of people protested these efforts. Although the Republican Congress did their best to fast track this and keep the public from providing input, the protests effectively stopped the repeal effort. However, efforts to undermine and destroy the ACA, as well as efforts to drastically cut Medicare and Medicaid are still underway. The recent tax cut bill that primarily benefit the wealthy is their self-imposed excuse for making these cuts. If these same folks stay in power in the Congress, you can be sure there will be dire consequences for people who rely on the ACA, Medicare, or Medicaid for their healthcare.

Healthcare is not a luxury or a choice.

If you are sick, you need it, plain and simple. It doesn’t matter if you are rich or poor or in the middle. Folks die without it, people get sicker if they delay receiving it, and children lose all hope for a reasonable chance in life when they suffer from illnesses or disabilities that are not treated. That is surely the reason that virtually every other advanced country in the world has found a way to provide healthcare to ALL of its citizens, while spending less, and receiving more effective services.

The ACA brought us a long way toward insuring the majority of Americans and making it possible for them to receive healthcare services and preventive care. The elimination of the ACA, along with the cuts to other healthcare programs, will force millions from healthcare and drive up medical costs and private insurance premiums for all. And if you suffer from a preexisting condition, you may well find that you cannot get healthcare coverage at all.

Rural communities will be impacted even more than those who live in metropolitan areas by the Republican efforts to undermine the ACA and to cut Medicare and Medicaid. The reason is simple—rural healthcare facilities, like those in District 15, substantially depend on people being insured or covered by Medicaid and Medicare.

Many of these rural healthcare facilities, the services they provide and the jobs they create, could be gone if the Republican efforts to destroy the ACA and to cutback Medicare and Medicaid succeed. Here are some of the providers that are likely to be affected in District 15.

County Federally Qualified Health Center Hospitals
Athens Hopewell Ohio Health Doctors Hospital (Nelsonville); Ohio Health O’Bleniss Hospital (Athens)
Clinton HealthSource of Ohio Clinton Memorial
Fairfield Fairfield Community Health Center Fairfield Medical Center
Fayette HealthSource of Ohio Fayette County Memorial
Hocking Hopewell none
Madison Rocking Horse Center Madison Health
Morgan Muskingum Valley Health Center none
Perry Hopewell none
Pickaway Primary One Health Berger
Ross Hopewell Adena Regional Medical Center
Vinton Hopewell none

The Trump Administration and the Republican Congress have found new ways to implement the cuts they failed to pass in their “repeal with no replace” effort. They have two potent weapons to do this – the executive power to simply refuse to discharge their responsibilities for implementing the requirements of the ACA and the Congressional power to cut funding from the healthcare programs. These mechanisms are less easily seen by the public, but are just as deadly. Below is a brief summary of the current attacks on your critical healthcare programs.

Affordable Care Act (ACA) – The ACA was designed to insure millions of Americans, to make sure that people with preexisting conditions could get insurance, and to rein in health insurance costs by expanding the market of insurable people and capping insurance company profits.  And it worked! Medical cost inflation had started to recede, millions of Americans got insurance for the first time, people with preexisting conditions finally got insurance, and annual premium increases for everyone had started to decline.

Thanks to the outcry and demonstrations from ordinary citizens, the Republican efforts to repeal without any replacement failed.

However, the ACA depends on a balance of maintaining a large insurance pool, controlling insurance profits, assuring that the insurance people have cover basic health needs, protecting preexisting conditions, and providing some subsidies for lower income people. Because of this critical balance, Republicans have found more subtle ways to destroy the ACA. They have already…

  • Eliminated the mandate that people have insurance (starting in 2019). Without assuring a large and diverse pool of insured persons, insurance companies will have to increase premiums and deductibles for the rest of us.
  • Decided NOT to defend the ACA in Federal court. The ACA has passed every legal challenge to date, but if the Justice Department does not defend it, it may fall to even the most frivolous lawsuits.
  • Undermined the entire system for assisting people in finding insurance such as reasonable advertising and assistance to have people sign up for insurance during the enrollment periods. Last year the Trump administration closed the Federal Exchange during the enrollment period. More recently the administration reduced funding for organizations that help people navigate the exchanges.
  • Created chaos about whether they’ll keep subsidies. Insurance companies need to know what their costs will be in order to set premium rates for the next year. The Trump administration is intentionally keeping all this up in the air (whether they will provide any subsidy to insurance companies and whether or not they will continue to help low income people purchase insurance. The uncertainty alone will cause insurance companies to raise rates for everyone.

Protests were effective in stopping the outright repeal of the ACA which would have removed millions from healthcare coverage and affected all of us at least indirectly. However, there is a continuing assault on our healthcare programs. Protests against individual actions will not be enough. We must elect representatives who hold Americans’ healthcare as the priority it is.


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