Sunday, November 28, 2010

Repealing the PPACA Could Harm Vulnerable Communities

I have already posted some observations that, in my opinion, the calls to repeal the Patient Protection and Affordable Care Act (PPACA) are politically motivated, and that the public does not agree with the call for wholesale repeal.  I thought it would be interesting to look at how the proposed repeal could impact vulnerable communities, as outlined in this article.

The article notes that African-Americans are more likely to live under the poverty line (26%) and are uninsured a higher rate than the overall U.S population (21%, as opposed to 14-15% overall).  Those calling for repealing the PPACA have not put forward any measures that would address this lack of access to health insurance, they have not proposed any process to address the lack of primary care physicians working in medically-underserved communities, and have no plan to promote preventive care--all of which are addressed in the PPACA.  In essence, the call for repealing the PPACA would entrench the status quo that already results in significant health care disparities in minority and poor communities.

As an aside, I think it is interesting that the call for repeal embodied in the Republican "Pledge to America" states it will ensure that insurance companies cannot refuse care to those with pre-existing conditions.  This is interesting because the Republicans oppose the main mechanism for reaching this goal (the individual mandate that everyone would need to purchase health insurance) and because this requirement would involved significant government regulation (something the Republicans claim to oppose).

As it stands, then, the Republicans aim to repeal the PPACA's reforms that actually protect patients and that could improve access to care for marginalized communities while having no mechanism in place to fix the problems that already exist--even as evidence increases that the public does not support the call for repeal

I think the Republican's insistence in pushing for this unpopular proposal for repeal will end up changing nothing and serving as nothing more than an opportunity for political grandstanding.  As a result, the House will waste time engaging in showmanship when they could be working to effect fixes in the bill that would strengthen it and that could address areas of concern.  In that case, we all lose.

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