Affordable Care Act Replacement Proposals – Concerns and Resources

The Administration and the Republican Congress threaten to repeal the Affordable Care Act (ACA), and have suggested various ideas about what a replacement to ACA would include. To better understand these proposals we’ve compiled a list of ACA replacement materials available from colleagues and partnering organizations.

Though there is no consensus about what an ACA replacement plan would include,[1] a few common themes have emerged from the various proposals. Several of the plans being discussed would include, at least in theory:

1. Establishing new tax credits for health coverage;
2. Allowing insurers to sell across state lines;
3. Advancing access to Health Savings Accounts (HSAs);
4. Creating state High Risk Insurance Pools;
5. Covering people with pre-existing conditions only when they maintain continuous coverage.

The Center for Medicare Advocacy and many other organizations have expressed grave concern about how older people and people with disabilities would be harmed by repeal of ACA. We continue to urge the rejection of any legislation to repeal ACA unless it includes a detailed replacement plan that provides equal or improved access to high-quality, affordable health coverage. As is clear from the analyses below, the proposals being discussed would not meet that threshold.

Kaiser Family Foundation:

• Comparison of Medicare Provisions in Recent Bills and Proposals to Repeal and Replace the Affordable Care Act (January 2017): http://kff.org/medicare/issue-brief/comparison-of-medicare-provisions-in-recent-bills-and-proposals-to-repeal-and-replace-the-affordable-care-act/
• Proposals to Replace the Affordable Care Act — Speaker Paul Ryan’s Proposal (January 2017): http://kff.org/report-section/proposals-to-replace-the-affordable-care-act-speaker-paul-ryan/
• Proposals to Replace the Affordable Care Act — Rep. Tom Price’s Proposal (January 2017): http://kff.org/report-section/proposals-to-replace-the-affordable-care-act-rep-tom-price/
• What Are the Implications of Repealing the Affordable Care Act for Medicare Spending and Beneficiaries? (December 2016): http://kff.org/health-reform/issue-brief/what-are-the-implications-of-repealing-the-affordable-care-act-for-medicare-spending-and-beneficiaries/

Center on Budget and Policy Priorities:

• Trump Proposals Could Make Marketplace Coverage More Expensive, Less Accessible (February 2017): http://www.cbpp.org/blog/trump-proposals-could-make-marketplace-coverage-more-expensive-less-accessible
• ACA Repeal Would Jeopardize Treatment for Millions with Substance Use Disorders, Including Opioid Addiction (February 2017): http://www.cbpp.org/research/health/aca-repeal-would-jeopardize-treatment-for-millions-with-substance-use-disorders
• Roth HSAs in Cassidy-Collins Plan: Little for Most Workers, Tax Shelters for the Top (February 2017): http://www.cbpp.org/research/health/roth-hsas-in-cassidy-collins-plan-little-for-most-workers-tax-shelters-for-the-top
• Senators’ ACA Replacement Won’t Likely Give States, Patients the Choices They Seek (January 2017): http://www.cbpp.org/blog/senators-aca-replacement-wont-likely-give-states-patients-the-choices-they-seek
• GOP False Promises Primer: How Affordable Care Act Replacement Proposals Fall Short (January 2017): http://www.cbpp.org/gop-false-promises-primer-how-affordable-care-act-replacement-proposals-fall-short

Families USA:

• Republicans' ACA Replacement Proposals Fall Short of Providing the Protections and Care People Currently Enjoy Under the Affordable Care Act (February 2017): http://familiesusa.org/product/republicans-aca-replacement-proposals-fall-short-providing-protections-and-care-people
• Eight Ways to Judge Republican ACA Replacement Plans (January 2017): http://familiesusa.org/sites/default/files/product_documents/ACA_BaselineReport_final.pdf

Urban Institute:

• Implications of Partial Repeal of the ACA through Reconciliation (December 2016): http://www.urban.org/research/publication/implications-partial-repeal-aca-through-reconciliation
• The Cost of ACA Repeal (June 2016): http://www.urban.org/research/publication/cost-aca-repeal

Healthinsurance.org:

• 50 ways to lose your coverage: As the saying goes, you don't know what you've got until it's gone. Here's a helpful list of what you'd lose if the GOP repeals Obamacare (February 2017): https://www.healthinsurance.org/blog/2017/02/10/50-ways-to-lose-your-coverage/
  • Andy Slavitt, former Acting CMS Administrator, Twitter Retweet, 2/12/2017

February 15, 2017 – K. Kertesz