NOTE: Yes, I’m reposting this for two reasons: First, it’s an extremely important to get the word out about the actual numbers at risk; and second, because I’ve expanded the table to include and revised the infographics additional data from today’s Urban Institute analysis, which looks at how many would lose coverage under different circumstances.
By request, I also added the percentage of the total population in each state who would lose coverage.
Oh, and I’ve made the embedded infographics smaller so you don’t have to scroll so much to get to the comments. Don’t worry, though—if you copy or download them to share elsewhere...and please do so, that’s what they’re for!...they should be full-sized.
For the hell of it, I have them listed in reverse alphabetical order this time.
It takes an awful lot of time and effort to maintain the ACA Signups website. Ironically, with the ACA potentially having the plug pulled in the near future, I’ve been busier than ever attempting to document not only the progress of the ongoing Open Enrollment Period but also trying to keep up with the frenzy over what in God’s name Trump and the GOP have in mind for the ACA, Medicare and Medicaid next year. I don’t know what the future will hold, but I’m going to try and keep the site going at least through the end of 2017.
With that in mind, if anyone’s in a position to help support the ACA Signups project, it would be tremendously appreciated.
Last week, in my latest exclusive entry at healthinsurance.org, I crunched the numbers to see just how many people would likely lose their healthcare coverage if congressional Republicans, along with Republican President-elect Donald Trump, were to follow through with their explicit promise to repeal the Affordable Care Act (otherwise known as "Obamacare") early next year.
As I noted, the GOP is still incredibly vague about what exactly they'd replace the ACA with. No matter what they claim, it's only the "repeal" part which they've been clear about so far. All indications are that they plan on pushing the "repeal" part through almost immediately upon Trump taking office. Therefore, I focused specifically on what would happen if the ACA were repealed, in full, in early 2017 with immediate effect (as opposed to this weaselly 2-3 year delay business they've been bandying about which could potentially be even worse for the healthcare market as a whole in some ways).
Remember, there are four categories of people who would lose coverage:
- ~12.3 million (was 11.3M; see update): People enrolled in Medicaid/CHIP specifically thanks to the ACA's expansion provision in 32 states + DC
- ~9.0 million: People enrolled in ACA exchange (Individual Market) policies who are receiving heavy federal subsidies via the ACA exchanges*
- ~1.4 million: Young adults 19-25 years old enrolled in their parents' plans (via group or non-group markets) specifically thanks to the ACA provision
- ~470,000: People enrolled in ACA-funded Basic Health Plans in Minnesota & New York
*The Kaiser Family Foundation just released a report receiving a lot of attention which estimates how much ACA subsidy money is going to each state which would be wiped out by the law being repealed. They tally the number of exchange enrollees at 9.4 million. My estimates are a bit lower because those at the very top of the subsidy income range only receive nominal subsidies (perhaps $10-$20/month) which would likely just be irritating as opposed to forcing them to drop coverage entirely.
My methodology and many of the data source links can be found here. The rest can be found here. I've simplified the full spreadsheet below, and have also whipped up handy InfoGraphics for all 50 states (+DC) for folks to share on social media:
SEE IMPORTANT UPDATES RE. MEDICAID EXPANSION DATA
The Urban Institute has completed their own analysis of just how many people would lose coverage in the event the Republicans partially repeal the Affordable Care Act without a replacement...and the projections are even worse than a full repeal starting in 2018, if you can believe it.
Why? Because a partial repeal would eliminate all the coverage that a full repeal would...but would also leave in place all of the "good stuff" :
" it would leave the insurance market reforms (including the non-group market’s guaranteed issue, prohibition on preexisting condition exclusions, modified community rating, essential health benefit requirements, and actuarial value standards) in place."
While this sounds great in theory, the reality is that keeping all of the "carrots" while removing all of the "sticks" would have the effect of sending premiums through the roof (far, far beyond the 25% unsubsidized average we saw this year)...which, in turn, would lead to the entire individual market collapsing, not just the subsidized market.
In other words, the effect of a full repeal would be to kick up to 23.1 million people off their coverage...but the effect of a partial repeal would be to cause up to 29.8 million to lose theirs.
Note that the state infographics below assume a full repeal. For a partial repeal, tack on about another 30% to each total.
Per request, I've updated the table to include a) the Urban Institute estimates in the event of a partial repeal and b) the percent of population which would lose coverage in each state under either a full or partial repeal scenario.
