EDITORIAL: Develop ACA alternative first

Jan. 26--Some members of Pennsylvania's congressional delegation support repealing the Affordable Care Act without first developing a replacement for it.

They should reconsider because a repeal would be devastating to a state government budget that already is deeply in deficit. And that damage would be compounded by adverse impacts on the economy.

President Donald Trump, who narrowly won election with the help of rural, low-income blue collar Pennsylvanians, should recognize that the impact of a repeal in Pennsylvania would fall primarily on the very demographic that put him in the White House.

Eliminating the Medicaid expansion that is a key part of the ACA would strip health insurance from 670,000 working Pennsylvanians, according to state Treasurer Joe Torsella and Auditor General Eugene DePasquale. Another 400,000 state residents who do not have access to health insurance through their employment would lose coverage if health insurance exchanges are eliminated.

The Medicaid piece alone would eliminate about $3 billion of federal spending in Pennsylvania, money that flows through the state government mostly to health care providers, resulting total lost economic activity of about $4.5 billion a year, the financial officers said. The spending fuels about 30,000 private-sector health care jobs, many of which likely would be eliminate because the state government, already facing a $600 million deficit this year alone, could not pick up the difference. Pennsylvania already has an unemployment rate of 5.6 percent, a full percentage point higher than the national average and higher than that of 44 other states.

Resulting lost economic activity also would further damage the state government budget, which is dependent upon income and sales taxes for most of its revenue.

As the state struggles to contain an opioid epidemic that claims nearly 10 lives a day, DePasquale also notes that coverage under the ACA Medicaid expansion has helped 63,000 Pennsylvanians to enter addiction treatment.

Pennsylvania's congressional delegation should recognize that the ACA has become integral not only to the delivery of health care but to the overall health of the state economy itself. Members should not vote to eliminate key provisions of the law until viable alternatives are in place to maintain health care access and the state's economic vitality.

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