Not only would the
Against fast-moving developments, a look at some major issues for consumers.
WHY MEDICAID MATTERS
As health care costs have kept climbing, employers cut back on coverage, and Medicaid passed Medicare as the nation's largest public insurance program. It now covers about 70 million people, including children and able-bodied adults mostly served by private managed care plans.
In addition, the
Governors of both parties have warned
Medicaid limits got very little attention in the 2016 presidential campaign. The idea was a relatively late addition to Trump's talking points. Indeed, candidate Trump had started out promising no cuts to
But the human consequences could be politically volatile. "No one wins on health care policy," observed Holtz-Eakin.
WHAT DOCTORS ARE SAYING
Groups representing doctors and hospitals are overwhelmingly opposed to the Republican approach, because it's likely to result in millions more uninsured people. Consumer organizations like
Under Obama, the nation's uninsured rate dropped below 9 percent, a historic low. Progress has stalled, partly because "Obamacare" is politically divisive. Now, the uninsured rate may start climbing again, because both the
It "would have a profoundly negative impact on Americans," said
But doctors see a health insurance card as a ticket into the system, so patients can be screened for chronic conditions that can ultimately lead to serious illnesses. Obama's law made many preventive services free of charge to the patient.
"Now we are able to bring them in and get their blood sugars down, their blood pressure down," Blair said in a recent interview. "They're not going to have a disastrous complication like a stroke or a heart attack, at least not for the foreseeable future."
PRIVATE INSURANCE CHANGES
They focus instead on the market for individual policies, which Obama's ACA sought to reform by providing subsidies, setting requirements for comprehensive coverage, and creating online markets where consumers could compare plans. An estimated 17 million to 20 million people have individual policies. About 10 million are in the ACA's markets.
"Obamacare's" results have been mixed, with lower enrollment than expected, big losses for many insurers, and sharp premium increases. The situation varies from state to state, with healthy markets in some and others struggling to hang on to insurers. Consumers who are not entitled to subsidies can face shockingly high premiums.
Over the long run, premiums for younger people are expected to come down. But older adults and people who require comprehensive coverage are likely to pay more.
"Low-income people will end up paying higher premiums for plans that have bigger deductibles, compared to today," said