What ACA Repeal Would Mean for PASNAP Members and Our Patients

By Patty Eakin, RN, PASNAP President

Across the country, tens of thousands of people have participated in actions to show their opposition to right-wing plans to rip away healthcare coverage from millions of Americans.

In Philadelphia, PASNAP led the charge, helping to organize a rally and press conference that saw 600 people saying together, “Hands off our healthcare!” We gathered at Temple University Hospital, which sits in one of the poorest sections of Philadelphia, which is the poorest big city in America, and also America’s biggest city without a public hospital. That means that, by default, hospitals like Temple and Einstein and Hahnemann and St. Christopher’s — the hospitals where PASNAP members work — serve as critical safety nets for the city’s poor.

By its own calculations, Temple will lose $45 million per year if the Affordable Care Act is repealed without a comparable replacement. We know that none of our hospitals can afford that kind of loss without sacrificing staffing and patient care.

At the rally, we heard from healthcare workers who testified with eloquence and passion about the damage and suffering that would be caused by repealing the ACA, stopping Medicaid expansion and gutting Medicare. One woman spoke about how the Medicaid expansion literally saved her life by covering her for the surgery she needed on her lung.

While the event received good coverage on TV news, it’s clear that we still need to educate ourselves and the public on the very real, very massive problems that will arise if these attacks on healthcare are carried through.

Everyone — whether you are covered by private insurance or through the ACA, Medicare, or Medicaid — will be negatively affected. Even CHIP, the very successful program that covers children, is on the chopping block.

President Trump has stated he wants to keep the popular parts of the ACA, such as allowing children to stay on a parent’s plan until age 26, and barring insurance companies from denying coverage due to pre-existing conditions. But insurance companies could only afford to do this and still make a profit because of the ACA mandate that pushed everyone — even the young and healthy — to get health insurance.

When that mandate is removed, the system breaks down: Insurance companies will lose money, and we know better than to think they will simply absorb those losses. Instead, they’ll pass the costs on to other consumers, including those with employer-provided plans. No one will escape the pain of increased premiums, co-pays, and deductibles.

The repeal of the ACA and its expansion of Medicaid would also be a drag on local economies. Low and middle income individuals would suddenly lose the tax credits that had helped them buy insurance. States would suddenly lose federal payments for Medicaid expansion. In Pennsylvania, we would lose 137,000 jobs, which would be a staggering blow to local economies. To make that worse, we would also lose $2.4 billion in state and local tax revenue that funds schools and roads.

Critics love to call the ACA a “job killer,” but the real job killer would be its repeal without a replacement that provides comparable coverage.

Another myth worth debunking is that the ACA negatively impacted Medicare. In fact, the ACA strengthened Medicare in a number of ways. First, it pushed hospitals to become more efficient and reduce re-admissions at great savings to Medicare. It saved money for seniors by gradually reducing the “donut hole” for Medicare Part D, which forced recipients to pay out of pocket for prescription drugs after modest initial coverage. Through these and other measures, the ACA has helped to extend the solvency of the Medicare trust fund by an additional 13 years, according to the Medicare Board of Trustees.

Medicare will lose this ground if the ACA is repealed. Even worse, Paul Ryan, the Speaker of the House, has long favored plans that would replace Medicare as we know it with “vouchers,” ending guaranteed coverage and instead forcing seniors to shop in marketplaces. They claim that Medicare is broken despite clear evidence that it is actually doing quite well financially and as a service provider.

As a nurse, my primary concern is ensuring that everyone can access quality, affordable healthcare. Repealing the ACA will take us backward, and would result in as many as 3,425 additional deaths every year in Pennsylvania alone. That’s not just sad. It’s immoral, and even worse because it is totally avoidable. But we make a tragic mistake if we think that any of us — with health insurance through our employers — will be unaffected by repeal of the ACA. In reality, the damage will be far reaching: higher premiums and co-pays and deductibles, caps on our coverage, adult children thrown off of our plans, potential layoffs, and more. The list could go on, but isn’t that scary enough?

written by

The staff of the Pennsylvania Association of Staff Nurses and Allied Professionals

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