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7 Ways ACA Repeal Will Affect You (Even If You Get Insurance Through Work)

On Friday, President Donald Trump signed an executive order directing federal agencies to opt out of requirements of the Affordable Care Act wherever possible. Whether this will create much immediate impact is up for debate. However, given that Congress is already on board with ACA repeal, it’s likely only a matter of time before Obamacare is dismantled, effectively or actually.
ACA repeal
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What does this mean for you? Well, if you purchase your insurance through the ACA, you might wind up without health insurance. The Congressional Budget Office estimates that ACA repeal would leave 18 million Americans without health insurance in the first year alone.

But even if you get your insurance through work, Obamacare repeal will likely affect you in multiple ways. The impacts might vary, depending on whether Republican legislators provide a replacement simultaneously with repeal. However, given that the Senate rejected Democrat-proposed amendments to protect provisions like guaranteed access for those with pre-existing conditions, it’s probably safe to assume that any replacement will not provide all of the protections of the ACA.

Here are just a few ways ACA repeal might affect you:

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  1. Your Employer Might Not Offer Health Insurance Anymore

Under the Affordable Care Act, companies with 50 or more employees were required to provide affordable insurance to those who worked at least 30 hours a week. This might not affect full-time workers, since many employers have traditionally offered coverage for employees who work 40 hours a week or more. However, ACA repeal would allow companies not to provide coverage for those who work, say, 35 hours a week.

  1. Preexisting Conditions Could Keep You From Getting Coverage

“Under the ACA, employers cannot impose a waiting period for coverage of a pre-existing condition,” writes JoAnn Volk at Health Affairs Blog. “Prior to the ACA, individuals who became eligible for an employer plan—for example, once hired for a new job—might have to wait up to 12 months for the plan to cover pre-existing health conditions.”

Volk adds that coverage under another plan might “buy down” the waiting period, with certain restrictions. But if we return to pre-ACA rules about pre-existing conditions, losing your job and not being able to afford COBRA might mean going a whole year without coverage once you find another job with health insurance benefits.

  1. The End of Coverage for Dependents Until Age 26

Obamacare extended health insurance coverage to dependents until age 26. Currently, this means that if you’re under age 26 and your parents’ health insurance covers children, you can stay on it until your 26th birthday. That provision is likely to go away under a replacement plan, meaning that if you’re covered under your parents’ insurance — or your adult kids are covered on yours — you’d have to make other arrangements.

  1. The Return of Lifetime Caps

“None but the very rich can afford to get seriously ill in America and hope to pay for it themselves,” wrote Roger Ebert at The Guardian in 2010 after President Obama signed the Patient Protection and Affordable Care Act into law.

Before Obamacare, even having health insurance was no guarantee. That’s because many insurers instated annual and lifetime caps on how much they would pay out. Get a serious illness requiring extended hospitalizations, repeated surgeries, or expensive medications, and you could wind up going bankrupt.

  1. More Out-of-Pocket Costs

Obamacare put a cap on how much insurance companies could require policy holders to pay out of pocket. The end of ACA likely means the end of this protection, meaning that you could have continuous coverage and still have trouble paying for your medical care.

  1. Access to Birth Control

ACA mandated that insurers provide birth control, e.g. the pill, IUD, implants, etc., free of charge (with a few exceptions). Partly as a result, abortion rates fell to their lowest since 1973, when the procedure became legal in every state. Replacement plans probably will not provide cost-free birth control.

  1. You Might Wind Up Stuck in Your Job

If Congress repeals the Affordable Care Act without a replacement that contains protections that apply to your situation, you might think twice about changing jobs and risking loss of coverage. Becoming a freelancer or reducing your hours would also be difficult, as you might not be able to buy affordable insurance on your own.

Bottom line, if you’ve benefited from Obamacare under any of these provisions, now’s a good time to let your representatives and senators know. Even if you hated the ACA, and are cheering for repeal, it’s worth it to advocate for laws that protect you and your family — no matter what your employment status.

Tell Us What You Think

How else would repeal affect you? We want to hear your thoughts. Talk to us in the comments or join the conversation on Twitter.

Jen Hubley Luckwaldt
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37 Comments on "7 Ways ACA Repeal Will Affect You (Even If You Get Insurance Through Work)"

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In 2012, I lost my job and had to buy private insurance for myself and my son at a cost of $150.00 per month with a $5,000 deductible. In 2015, that same policy had jumped to $650per month for just me with a $6,500 deductible. My son joined the military and had insurance coverage at that time, so I don’t know what it would have cost to have covered him. My policy more than quadrupled in 3 years on Obamacare with a higher deductible, 1 less person covered, and no change in my health. I believe the story of those… Read more »

This is the last pay scale article I will ever read – because it’s just democrat fear-mongering propaganda!


This is the last pay scale article I will ever read – because it’s just democrat fear-mongering propaganda!

mary kay A. LAIRD

Have you read the information about the replacement that is in the works? It appears you have not. This is full of assumptions and not accurate based on what is being reported across many different media outlets regarding the replacement. Terrible reporting. I am unsubscribing from Payscale.

I Can\'t Read

This article is trash. A lot of assumptions and no mention of potential benefits – sounds like a CNN wanna-be wrote this based on articles shared on their facebook feed. Back to Glassdoor….for decent information.


All your doing here is assuming that each of those WONT be included in the next health plan. This is a major assumption and one without merit. Second, you provide no data, no evidence and no sources to back up any of this stuff, this is pure speculation being passed as fact, it’s disengenuous and misleading.


I agree with ‘disgusted’: democrat fear-mongering propaganda. I will be unsubscribing from Payscale.

Tina Smith

Trump did not say he was repealing every thing in Obamacare. You are using scare tactics to cause people to fight to keep Obamacare. Everyone’s premiums since the ACA went into effect are much higher. My son has Obamacare. The premium he can afford had a $6200/yr deductible. People on Obamacare CANNOT afford to pay for care before they hit the deductible. Obamacare really benefited no one!


Really, Wow!! Written like a true crybaby liberal, need a tissue? Absolutely the last article I will ever read on payscale, keep your obvious liberal whimpering to yourself and avoid dabbling in the fake news trend……unbelievable!


For the most part, these are good points. The thing I don’t like about how this is written though, is that with or without intent, it comes across as fear mongering. Yes, these are all valid concerns. But people who have insurance through the ACA right now are scared enough as it is. Let’s not create panic when in fact there are still many discussions being held on what to do.

A. Johnson
hummm, I haven’t heard the same things you have heard. I heard with my own ears Trump say that his would cover pre-exsisting conditions, and that the he wants to get better and more coverage for American’s with less/lower cost! I work in a school and over the last 2 years, our insurance has went up both years, considerably alot higher and out of pocket for us! Due to Obamacare. People are having to pay higher premiums, for less coverage and more stipulations on what you can and cannot have done (when you need it) and high deductables! I mean… Read more »
Tired of the Liberal Whining
Tired of the Liberal Whining
Oh my God, the sky is falling! We might loose Obama Care! Everybody panic and join in as we condemn the source of all evil (Trump)! I hope you realize that most of the people who have been covered under the (Un)Affordable Care Act couldn’t afford it without federal help. Plus, the out-of-pocket cost to meet annual deductibles of $8000 to $12,000 before coverage even BEGINS means you are paying for insurance you can’t even use! How are you covered if you can’t even use it? The federal government has to GET OUT of our lives and let the states… Read more »
Philip Roberts

ALL of what you’ve touted, as benefits of the ACA, fail to carry ANY weight, whatsoever, when the SUPPOSED beneficiaries can not afford the excessive, ever escalating premiums. So, Ebert’s comments would be apt, as it pertains to the “who” can possibly afford to participate in the ACA. I do not support government involvement in health care! That is ALWAYS A GUARANTEED recipe for failure!

Philip D Roberts, Independent thinker

Lauren Evoy Davis

Great points, all, especially the ending of lifetime caps. I write about oncology and the costs of cancer care are criminally high. Thanks for this important piece.

Nettie B

Our ‘Government Decision Makers’ should get the same healthcare plan they want for the public and eliminate lifetime benefits for those who serve a short time. Remove pensions – healthcare and any other benefit that ‘We the People” don’t get but have to accept from them.

Bert W.
There are a number of negative, even angry comments here. If you disagree with the article, that’s not a bad thing! It is good to read something now and then that you don’t like or disagree with because these days it is so easy to collect a few information sources that support your views, and the trap there is that it is easy to end up getting isolated in our own virtual echo chambers. If nothing else, reading something that you disagree with allows you to get a handle on what other people are thinking, even if you think that… Read more »
As an HR professional I appreciate the hard ugly facts as this article points out. It is difficult to know what might be a replacement, if anything based off current affairs but we need to be prepared. When the ACA was first passed, we also had to ptepare ourselves for unknowns and that was done by paying close attention to lawmakers and relying on the industry professionals to weed though the noise and inform us of the important facts. People may feel its fear mongering, but this is just preparation and trying to make sense of a lot of the… Read more »
There are many people who have benefited positively from the ACA. Rather than throwing the baby out with the bath water, fix it! When it was passed it was a watered down version of what Obama wanted to pass. He wanted a universal plan not what actually was legislated. He knew it wasn’t ideal but he had no cooperation for 8 years to make any changes. The Republicons refused to support a universal plan because they get too much dark $$ from both the insurance industry and big Pharma. Both lobbied heavily against a universal plan. We are the only… Read more »
Veronica Baum

I wonder how people on disability with Medicaid will be affected

Jerry Fardella
Obamacare needs a full repeal. Once that repeal is enacted, there will be a transition period; during the transition period, your coverage remains EXACTLY the same..this gives lawmakers a year or so to decide on the ACA replacement…first of all, it is incredibly complicated to dismantle…also lawmakers have “Rules of the Senate and House,”which must be followed in order to enact any legislation; this further complicates the issue…in a nutshell, Conservative hopefuls such as the Heritage Action Foundation, have many pages dedicated to a better deal for country…some of the highlights are the following:1) allow competition across state lines. 2)… Read more »
corporations buy competitors to scale up and get better economies of scale. Costco does it. Car companies do it. In fact, there is no free market that actually exist. Name me one market that isn’t controlled by a few companies – whether as a monopoly or oligopoly. Without exception, 20% of the biggest companies in any given market control 80% of market share. That is economies of scale in action. Only do lemmings who believe in rightist dogma believe that labor unionizing to get similar scale and bargaining power is socialism and bad Because you and yours will be able… Read more »
News flash. Insurance is socialism. If you don’t want socialism, pay everything out of pocket. Use toll roads. Goto private school. Pay for the ER on credit card. That would be the free market in action. Don’t rely on others chipping in to help out to build common goods like roads and schools and police to ER visits. Do it yourself. Obamacare just made insurance Costco like. Formed bulk buying markets in states that understood power of bulk purchasing and subsidies. But it’s obvious so many just don’t get the concept of economies of scale or bulk purchase pricing, it’s… Read more »
PayScale client

I am sad to see PayScale is publishing politically charged articles. If you are going to report be accurate and report both sides. This article did nothing to educate but evoked tons of negative emotions.

Dubious in Tennessee

Did anyone think that taking all with pre-existing conditions and having no cap on expenditures was going to be cheap? You can do away with these things if you like, but if you are ever in a lurch from changed circumstances, you might wish this was different. Why not ask way healthcare is so very expensive in the first place? Do not see too much aimed at fixing that issue.

I agree with Gwen… I had affordable healthcare before ACA. I paid $300 a month for my entire family with private insurance. For almost the exact same coverage, ($5k deductible and $10 out of pocket max), my premium is now $1200. With my employer paying $400 of it, I’m still left to pay the other $800 a month. I looked on the exchange and they were even more expensive to me because my employer would not be paying part of it. At least before ObamaCare, I could afford my insurance and pay the deductible. Now I pay a premium that… Read more »
Shoal Creek
Hmm. I smell fear. The fear of a snowflake that needs to go back to her college campus safe space! I pay cache to my integrative health care D.O. because he refuses insurance of all kinds. Even with that, I pay less to my doctor than I do to my employer-sponsored health insurance. The only reason I even have my employer-sponsored health insurance is because the ACA tax penalty and combined with my employer’s contribution to my HSA, I come out about $50 ahead to sign up for the insurance vs. refusing the insurance (it helps that I can pay… Read more »

The ACA was flawed from the start, because the insurance companies were left in the loop to extract their pound of flesh. This is why premiums have gone up for so many people. The reason the insurance companies stayed in the picture was because their friends in Congress didn’t have the sense to remove them. We need a single-payer solution that cuts out the insurance companies and just leaves the consumers and the service providers.

Rachel Rich

We can’t have a prosperous country without medical insurance for all. Before Obamacare my cousin, best friend and neighbor all lost their homes and jobs due to illness.

Patrice S
This piece provided facts of how ACA has improved healthcare and the acts we should take if we want to keep these pieces of the law. A recent study shows, over half of Americans have no idea the effects of ACA laws. More than 33% of American adults did not know ACA and Obama Care are the same legislation. Facts are provided about the provisions under the law not opinions. While I disagree with people being penalize for not purchasing costly healthcare, the healthcare protection were gained. This is a watered down version of the original law. We should not… Read more »
I’m curious if the pre-and post ACA plans had comparable coverage. For those of you criticizing the premium increases did your pre-ACA plan include the provisions outlined in this article? From my prior reading on this topic elsewhere it seemed that most of these lower cost plans were not that comprehensive and left the policy holder with significant exposure. Also, many of the republican proposals are talking about state administered high risk pools for those with pre-existing conditions with fixed federal payments by the Fed to the State and most of the exposure handled by the individual state (if person… Read more »
Matthew Boghdady

Not true, PayScale. It seems by this article you’re a liberal company that is trying to dismantle the current government. The triple and quadruple deductibles are something that ACA CREATED! This new healthcare will likely change that, and correct the issue. Democratic and liberal Payscale, you’ve lost another follower. You should’ve been a lot more neutral on the subject. Premiums are going to go down because of the repeal of ACA not go up. They’ve already went up.

Johnny bags

What a crock… oooo spooky- put out some more fake news and lies on the internet- could of would possibly. How disingenuous, I am so hoping these lousy media outlets go out of business.


Obamacare has cost me significantly more than prior to Obamacare. My premiums are more than double, copay went from $25 to $65, my deductible went from $1500 to $2500 plus 30% coinsurance and basic prescriptions went from $3 to 30%. And I’m just your normal everyday guy. I’m very happy for Trump to repeal, however I think a responsible replacement should be in place and I believe that will happen.


Wow,,, So disappointed. What a hit piece. I especially like where the headlines says “Will Affect you” then in the body she back peddles and says,,, “maybe,,, likely, ” Fear Mongering 101. Insinuate in the headline, waffle in the body. But boy you get everyone riled up! I expect the health system to be much better and equitable in the end. Give it some time,,,, I did,,, 8 years.

tired of the slant
I won’t go so far as to say “democrat fear-mongering propaganda.” But I will say that it is a slanted piece of writing with aspects of untruth. This is not something that pay scale should be ‘publishing’ and definitely not something to be pushed out to the masses via email. I’ve seen more people hurt by ACA (like Gwen mentioned in her comment) than I have seen truly gain. And when I say gain, I’m not talking about the 24 year old “freelancer” who still wants birth control under mommy and daddy’s insurance plan. And the last point, “you might… Read more »
Good Will
See, once government “hooks” you on their socialist bullshit, then they can use scare tactics (like this) to control you (as if Republicans want ALL THESE THINGS to happen). The truth is MOST of these things weren’t going to matter, because the ACA WASN’T workable! It was “front-loaded” with taxes paid (even though benefits weren’t received) to pay for benefits promised that could never be delivered without MASSIVE increases in taxes. That’s why NO REPUBLICAN voted for it! It’s a scam! But you go ahead and contact your elected leaders and say “Don’t take away my unicorns and fairy dust!”… Read more »
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