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.
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:
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.
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.
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.
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.
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.
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.
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.