Sunday, December 25, 2016

The Coming Harm

Posting this here, because I don't think my local newspaper will actually publish it.


To the Editor;

The Republican leadership in congress and President-Elect Trump have pledged to repeal the Affordable Care Act (ACA) as soon as they are able. They make this pledge without any plan to replace the ACA, though they have conveniently set a date for  repeal to go into full effect after the 2018 mid-term elections so as to avoid political exposure from the harm that will occur upon the ACA's repeal. In Virginia, repealing the ACA risks 685,000 Virginians' losing their health insurance coverage, and 319,000 losing the Federal subsidies that help them afford health insurance purchased on the ACA's exchanges. These changes risk reversing the 26% decrease in uninsured Virginians since the ACA went into effect. Congress and the President-Elect have spoken of their desire to retain important protections in the ACA (such as guaranteed issue, which removes the risk of denial of coverage for preexisting conditions), but have not presented any plan to do so that would keep insurance affordable or accessible to the average person. Some of those who voted for Mr. Trump may have done so believing that his call to repeal the ACA was political bluster, and that now that Americans are seeing benefits from the law, it could not be repealed. If so, they committed an awful error: the Congressional leadership has been voting to repeal the law since its passage, and now will have a sympathetic ear (and pen) in the White House. The vote to to repeal the ACA will come as soon as the first week in January, and millions of Americans will face the coming harm on their own, hoping an already stressed safety net may help catch those who again fall through the gaps. Physicians and health care providers like me will do our part to help those caught in an unnecessary trap of our politicians' own creation, while those politicians celebrate a political victory without regard to the harm they will have done. All Americans deserve that our politicians do their part and present a planned replacement for the ACA before thousands are harmed by its repeal.