What is at Stake if the ACA is Repealed?

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For over 50 years, public health care programs have been a bedrock for our nation’s health care coverage to low income and elderly residents. In Tennessee, half of our children and half of our states’ births are covered by TennCare, our state’s Medicaid program, or the Children’s Health Insurance Program (CHIP). More than half of our nursing home residents are covered by TennCare.

Our nation is about to engage in a discussion to reassess and fundamentally change bipartisan national health policies that have been integral to our country’s social fabric for 50 years, as well as create an alternative to the Affordable Care Act. While the details are unknown, these changes are presumed to drastically cut funding for our low income, older, and vulnerable neighbors, and reduce their rights as consumers.

What does this mean for Tennessee?

  • 230,000 Tennesseans have gained health insurance through the ACA’s Marketplace –and 80% of them qualified for premium subsidies, which made their coverage affordable. Leadership in DC wants to get rid of the Marketplace, but haven’t said how they will replace coverage for these 230,000 Tennesseans.
  • 250,000 Tennesseans were newly enrolled in TennCare under new eligibility requirements put in place by the ACA. If the ACA is repealed, these Tennesseans will likely lose this coverage.
  • 5 million Tennesseans benefit from TennCare, Tennessee’s Medicaid program. This is over 20% of the state’s population, and includes half of the state’s babies. TennCare also pays for more than half of nursing home care in the state. The new administration wants to block grant this money, which would mean drastic cuts in funding, a removal of most or all of the legal protections for TennCare enrollees, and would force the reduction of TennCare coverage on an annual basis.
  • 2 million Tennesseans are on Medicare. Leadership in DC has pledged to reassess this long-standing, bi-partisan bedrock to access to health care for our seniors.
  • 49 hospitals are at risk of closing, partially because of uncompensated care. If our federal funding gets cut, we will see even more uninsured residents, which will be devastating for hospitals.
  • Every American with a health insurance plan gained rights through the ACA that included:
    • preventing women from being charged more than men
    • preventing people with pre-existing conditions from being denied coverage or charged more
    • limiting annual out-of-pocket for care
    • fair appeal process
    • free preventive care, such as contraception and physicals

The new administration has not yet come up with a plan on how they will ensure that these rights still exist if the ACA is repealed. We must be clear-eyed about the real, life-and-death impact of any proposal that seeks to make changes to Medicaid, Medicare, and the Affordable Care Act that may leave millions more Tennesseans uninsured, living sicker, dying younger, and being one emergency away from financial ruin.