What all too many people do not understand is that the Affordable Care Act (ACA), or Obamacare, provides coverage to about ~35 million Americans. There are of course the individuals that buy their insurance on the exchanges (~20 million), but there are another ~15 million individuals that receive coverage from Medicaid Expansion as well as CHIP / Children’s Health Insurance Program.
So in order to determine the exact impact of a repeal/replace of Obamacare, you need to add those two numbers together. This means that anywhere from ~30-40 million individuals could lose their access to affordable health insurance coverage. While the exact numbers impacted are hard to determine (as they change as a person’s financial status changes), this is a good estimate using Centers for Medicare and Medicare Services as well as US Health and Human Service Department.
When it comes to the roughly 15 million at risk of losing Medicaid, this fact is not as widely reported on by the press or others. Much of the focus is on the families that are enrolled in the exchanges. But there are about 15 million people who are receiving insurance (many for the first time) as the result of Medicaid expansion. Thirty two states expanded their offerings as the result of the ACA.
Why are 15 million people at risk in 2017?
Obamacare/ACA changed the rules for Medicaid eligibility. The income limit was increased to 138% of the federal government poverty level, or around $17,000 for an individual. There were also some rule changes around ages and/or disability. The end result is Medicaid being expanded to those 15 million bodies, many of whom have jobs (granted low paying ones) but that just live week to week.
If Affordable Care Act is repealed and/or replaced during 2017 (or even a future year) what will happen to those people? They tend to be very low income, elderly, sick, etc. Will they have other options, or will they no longer have any access to health insurance? This is a large number of people who are at a major risk.
What do do?
The options available will be very limited. First and foremost, it depends on whether Congress will decide to somehow continue to fully fund the expanded Medicaid. They could do it at the state or federal level. But if there are any changes made to the overall funding level, then Medicaid Expansion may either end, or the number of beneficiaries will be reduced as 2017 progresses. Or maybe the impact will not be until 2018 or later.
Since most of the 15 million who are at risk live in poverty, they will generally qualify for any type of medical free available. But the problem is in finding it. One option is to use a free local community clinic, and there are hundreds of thousands of these across the United States.
If the medical care needed in emergent, and if Expanded Medicaid goes away, then those 15 million patients can turn to financial aid from a hospital. Most providers offer either free or very low cost, income based health care when the patient has no ways to pay a bill. So that is something else to consider. We have other health care assistance programs listed on the website as well.
But maybe the best option is to put your mouth, email, effort into making changes. Make your voice heard with Congress. Vote, attend town hall seminars throughout 2017, and do what needs to be done to ensure your medical care does not go away. As if ~40 million people lose their insurance (~15 million on Medicaid) then that could be devastating to those families, children, and seniors. It will impact many hard working people that just live paycheck to paycheck and that want to get some basic medical care.