Q. If I need health insurance right now, can I get it through an Obamacare exchange or are they gone?
Nope, still here. Nothing has been repealed yet. If you have just lost insurance because you left a job, moved to another state, used up your COBRA entitlement, were divorced, got kicked off your parents’ plan, or if you need to cover a new baby, you’re entitled to a Special Enrollment Period to get new insurance even though it’s not annual Open Enrollment time. Start at HealthCare.gov, and follow the prompts. The site is still up and functioning.
Q. Have Republicans given up on repealing the Affordable Care Act?
Unclear. The best-informed political reporting suggests that they don’t have the votes to pass any of the bills they’re considering, but Senate leaders are insisting they’re continuing to negotiate behind the scenes and plan to vote on something next week.
Q. Did you say “bills”? I thought there was just one.
We have the original Better Care Reconciliation Act, which has now been amended twice. And we have another bill, the Obamacare Repeal Reconciliation Act, a duplicate of one that Congress passed in 2015, which President Obama promptly vetoed.
The Better Care Reconciliation Act (BRCA)
The nonpartisan number-crunchers at the Congressional Budget Office estimate that like the previous versions, this BCRA would leave 22 million Americans uninsured by 2026 compared to the current law.
Premiums for individual insurance would be lower by 2026, but only because the law would allow plans to cover a smaller percentage of health care costs than ACA plans. This means the average deductible would shoot up to $13,000—literally half the income of someone earning 175 percent of the federal poverty level, who pays an average deductible of $800 today under the ACA.
Obamacare Repeal Reconciliation Act
This essentially repeals every part of the ACA that has to do with taxes and government spending. But because of Senate rules limiting what can pass with a simple majority of votes, it doesn’t touch Obamacare’s consumer protections, the most important of which prevent insurers from discriminating against people with pre-existing conditions or selling plans that don’t cover a minimum set of Essential Health Benefits.
The budget office has weighed in on this one, too, and it’s not pretty.
Because the law would repeal Obamacare’s penalty for going uninsured and take away subsidies to help people buy and use insurance, healthy and low-income people would drop their insurance. Insurers would be forced to raise premiums to cover the expenses of the sicker people who were left, causing what’s known as a “death spiral.”
By 2026, the budget office projects that an extra 32 million Americans would be uninsured and premiums on the individual market would double. That’s assuming coverage is available at all; facing spiraling losses and shrinking enrollment, the CBO expects many insurers would simply leave the market. By 2026 individual health plans would not be available at any price to about 75 percent of the population, the budget office estimates.
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