People Like the ACA, so it’s hard to Repeal. Here’s why.

It’s not surprising that so many people like the ACA (Affordable Care Act), and that it’s been difficult for Republicans to repeal.

ACA (Obamacare) versus AHCA

Here are 12 reasons people like the ACA (also known as Obamacare), along with detail in supporting charts that compare it with the Republican’s American Health Care Act (AHCA). Most of this work is attributed to The Century Foundation.

1.  The uninsured rate across all ages and income levels has fallen to the lowest level on record, thanks to the ACA’s health insurance exchanges, Medicaid expansion, and other provisions.

The uninsured rate across all ages and income levels has fallen to the lowest level on record, showing that people like the ACA.

People Like the ACA because both young and old benefit

The uninsured rate has fallen for all income levels, showing that people like the ACA.

2.  States that expanded Medicaid have seen much larger gains in health insurance coverage. Texas, which had the lowest uninsured rate, is one of those that chose not to expand Medicaid. Shameful.

People like the ACA, especially those living in states that expanded Medicaid.

3.  Millions more workers are now protected against financial ruin because of the ACA banned caps on insurance benefits.

People like the ACA, because millions are now protected from financial ruin.

4.  National health expenditures are still high, but the ACA has flattened the growth curve below pre-ACA projections. In fact, costs have risen at the slowest rate in over fifty years since the ACA was enacted, and projections of future costs have fallen sharply.

Even though costs are still too high, people like the ACA, because it has flattened the growth of costs.

Even though costs are still too high, people like the ACA, because the growth of costs has slowed to the lowest in 50 years.

Growth in real healthcare costs have slowed, even for those with employer-provided insurance.

5.  By shifting from fee-for-service business models to incentives based on outcomes and value, the ACA has caused a decline in unnecessary testing and a related savings in costs. As a result, 83% of consumers buying health insurance through are paying no more for premiums in 2017 than 2016, so clearly the ACA is still working.

People like the ACA, which is responsible for reducing the number of unnecessary tests by changing the incentives away from fee-for-service.

6.  The quality of care received by hospitals patients has improved since the ACA. There have been much fewer hospital-acquired conditions and a sharp drop in readmission rates.

People like the ACA, because they've seen care quality improve.

People like the ACA, because care quality has improved, and hospital readmission rates have fallen.

7.  The ACA has also been good for the economy in general. It has substantially improved the long-term budget outlook, according to the CBO, and it even extended the life of the Medicare Trust Fund by 11 years.

People like the ACA but may not know that it has improved the long-term debt outlook.

People like the ACA but may not know that it has extended the Medicare Trust fund by 11 years.

8.  GOP-fueled rumors of an impending ACA “death spiral” were debunked by analysis of the latest state-level data by The Brookings Institute, showing that premium increases are not having a significant effect on insurance sign-ups.

People like the ACA and are skeptical of Republican claims that it's in a death spiral. They would rather ACA problems be fixed than the law repealed.

9.  The GOP’s American Health Care Act (AHCA) would have caused 24 million people now insured under the ACA to lose insurance, according to the Congressional Budget Office. The latest rumored changes to that would worsen those projections.

People like the ACA but don't like the AHCA, because tens of millions would lose health care, and tens of thousands would die as a result.

10. Consumers know that the American Health Care Act (TrumpCare) is more about tax reform than health reform, shifting federal funds away from helping low- and middle-income Americans get health care, and instead giving large tax breaks to special interests and high-income Americans. Seniors under the age of Medicare eligibility would be harmed the most, especially those with low-income. The after-tax premium increase for a 64-year-old making $26,500 would be $12,900. Someone that age making $1,000,000 would get a $12,900 tax cut.

People like the ACA but not the Republicans AHCA, because they see it as tax reform rather than health reform.

11. Repealing major ACA revenue provisions would mostly benefit Millionaires. 800,000 people in 20 states and D.C. would lose billions of dollars in tax credits to give tax cuts to just the top 400 households.

People like the ACA but don't like the AHCA, which mostly benefits millionaires.

12.  People who self-report having better health have higher employment rates and earnings, and that helps drive the economy and GDP.

People like the ACA and know that their health effects their earning capacity.

Comments on “People Like the ACA, so it’s hard to Repeal. Here’s why.


    The Battles Ahead: Meet the Biggest Opponents of Single-Payer – WOW! This excellent piece is part of Fighting for Our Lives: The Movement for Medicare for All.

    Excellent side-by-side comparison of Obamacare and the GOP’s replacement plan (LA Times)

    American Health Care Act, a Summary & UPDATE – The nonpartisan Congressional Budget Office says the AHCA (Trumpcare) would cause 24M people to lose health insurance by 2026, and as a result tens of thousands would likely die needlessly. Trump care 2.0 is said to be even worse.

    Let the Health Care Reform Debates Begin, Again – This was my editorial reaction to GOP’s draft repeal of the ACA.

    Ask the Right Questions about Healthcare – There’s still time for Congress to replace Obamacare with real health reform that saves over $1 trillion/year and satisfies President Trump’s campaign promise to make sure every American has access to health care that’s better and more affordable than what is available today, but they’ll need to ask the right questions.

    Escape Fire: The Fight to Rescue America’s Healthcare – Features an EXCELLENT documentary film

    US Healthcare System has Cancer. Can Trump Fix it? – It’s my hope that Trump will recognize the need to treat our healthcare system’s “cancer” aggressively, naturally and holistically. But will he? Can he? Here are the challenges he faces.

    Universal Healthcare Opposition – What’s REALLY behind universal healthcare opposition? It seems to be an ideological fear of helping “LOSERS”.

    Why Republicans Want to Repeal Obamacare – Former Labor Secretary Robert Reich dives into what is driving repeal efforts, but he fails to mention the demographic shifts that threaten GOP political control, and how allowing tens of thousands of people to die without health care would benefit them.

    Influencing Healthcare Policy – Lobbying, Incentives & Insurance – Healthcare reform, whether it’s Obamacare or Trumpcare, seems to be influenced largely by these three factors to maximize profits.

    Chipping Away at Healthcare Special Interests Yet? – Revenue growth in the healthcare industry, driven largely by the corrupting influence of political lobbying, is unsustainable. Real health reform needs to resolve the conflicting motives of the public sector and private sector.

    HEALTH or SICK Care? – Unfortunately, fee-for-service healthcare incentives caused medical schools to focus almost entirely on diagnosing and treating illness and injury, not preventing it. Prevention goes against the business model of profiting from each patient’s visit, test, prescription and procedure – a model with the perverse incentive to do more and more, and charge more.

    Why High Medical Bills Are Killing Us – In his 38-page TIME magazine special report, “Bitter Pill: Why Medical Bills are Killing Us,” Steven Brill dives into our health care system to understand why things cost so much. Unfortunately, this important article is now behind a subscriber paywall, so I posted a summary and video introduction by the author.

    The Unbreak Campaign – This MD-driven Declaration Of Independence seeks answers to the same questions I ask in the above editorial. One of the leaders of this movement is ZDoggMD, probably the ONLY healthcare speaker/rapper ever, who uses his gift of sarcasm to educate the public on important issues.

    Disrupting Healthcare with Functional Medicine 2.0 – Healthcare is shifting from a Blockbuster’s bricks & mortar model to a Netflix on-demand, anytime/anywhere model. What we desperately need is a new “operating system” for healthcare that is predictive, preventive, personalized and participatory.

    Why Medicare-for-All is Not Enough – Beyond just improving the efficiency of how healthcare is paid for and adopting the exceptionally efficient Medicare system for everyone, we need to address the NEED for medical care in the first place, with incentives that focus more attention on overall health and wellness.

    Wealth Inequality, Healthcare and the Economy – People, including Congressional Republicans and Democrats, have little real understanding of how wide the wealth gap has become and it’s impact on healthcare and the economy, so this article features an excellent video infographic on the topic and other statistics.

    Corporate Behavior and Rising Health Care Costs – The aging population adds to healthcare costs but is a global problem, so what makes our healthcare system the most expensive in the world by far and without the positive outcomes to justify it? I see problems with our politics, special interest lobbying, and societal beliefs. And I find it telling that public health officials can accurately gauge one’s average weight and BMI by zip code, and that longevity in poor neighborhoods can be over 20 YEARS LESS than in affluent neighborhoods on the other side of the same town.

    Public Opinion about the Future of the Affordable Care Act — (New England Journal of Medicine) This politically neutral article shows how public opinion differs between Democrats and Republicans based on differences in their core values. (interesting)

    Postmortem Lessons from the Latest ACA Battle — (New England Journal of Medicine) The ACA was carefully designed and implemented to produce results and withstand threats, and it largely works. More than 90% of Americans are now insured, and people with preexisting conditions have unprecedented access to care. That’s why there was so much opposition to Republicans repealing it without something as good to replace it with.

    What Doctors Say About Strengthening the ACA for the Long Term — (New England Journal of Medicine)

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