For the past five years, Republicans have been attacking the Affordable Care Act, or ACA, spreading misinformation that the law is failing. GOP presidential candidates Wisconsin Gov. Scott Walker and Florida Sen. Marco Rubio, in particular, bemoaned how “people have lost their insurance” because of the ACA and that “more Americans have lost health insurance than gained it under Obamacare.” But if Walker and Rubio were truly concerned about Americans losing health insurance, they would embrace the ACA and work to strengthen it. Instead, both men introduced proposals that threaten to throw millions of Americans off their health care plans.
Walker and Rubio’s proposals would repeal the ACA notwithstanding the fact that it’s working. Since the ACA went into full effect, it has successfully brought quality, affordable health insurance coverage to nearly 16 million Americans. It has given the 129 million Americans with pre-existing conditions peace of mind—no longer will they have to worry about losing health coverage or face significant premium increases because of a pre-existing condition. Because of the ACA, the uninsured rate in the United States has also dropped almost 6 percentage points, to 11.4 percent in the second quarter of 2015.
Despite the undeniable success of the ACA, both Walker and Rubio are adamant about repealing the law. According to the Congressional Budget Office, or CBO, repealing ACA would result in 19 million people losing their health coverage in 2016 alone. It would also increase the federal budget deficit by $137 billion over 10 years.
In addition to kicking people off of their health plans and increasing the federal deficit, repealing the ACA would also cause millions of people to lose tax credits needed to help them afford health coverage. Because of the ACA, 8.7 million people are receiving insurance premium tax credits. Although Gov. Walker proposes giving Americans some form of tax credit to pay for health care coverage, Walker’s tax credits at the level proposed “would not begin to cover the cost of decent coverage.” Sen. Rubio’s plan also gives no indication that his proposed tax credit would be sufficient to pay for good health care coverage, certainly not of the quality offered by the ACA.
Furthermore, instead of proposing ways for Americans to retain the health care they now have because of the ACA, Walker and Rubio rehash the same old, stale health care ideas advanced by conservatives for years. For instance, both men support converting Medicaid into a block grant, an idea that Rep. Paul Ryan (R-WI) has proposed in his budget for years and an idea that former Massachusetts Gov. Mitt Romney endorsed in his unsuccessful 2012 bid for president. Block granting Medicaid would cripple a vital program that in 2014 provided health coverage to 80 million Americans. Although neither Walker nor Rubio provide much detail on their block grant proposals, the amount of money provided to states through block grants typically increases each year with population growth and inflation. This is far “slower than the projected growth in health care costs,” meaning that Medicaid would just get squeezed more and more, threatening health care coverage for millions of Americans. The Kaiser Family Foundation projects that block granting Medicaid could throw 14 to 20 million people off of Medicaid; that’s in addition to the 8 million people that the CBO estimates would lose coverage if Medicaid expansion under the ACA were repealed.
As noted above, the ACA protects those with pre-existing conditions from discrimination by insurance companies that otherwise may charge them extremely high premiums or deny them coverage all together. Instead of protecting these individuals, Walker and Rubio endorse the use of high-risk pools to cover them. Under Walker’s plan—unlike in the ACA—people with pre-existing conditions would only be protected if they maintained “continuous” coverage. If these people somehow lost their health care coverage and went uninsured for a month or two, then insurers would be free to discriminate against them. Rubio’s plan provides less detail, but like Walker, he endorses the use of high-risk pools for individuals with pre-existing conditions. High-risk pools, however, are not a feasible alternative to the ACA as they generally cover the population with the most serious health conditions such as cancer, cardiovascular disease, and rehabilitative care. This makes high-risk pools extremely expensive to maintain while covering few people. According to a CBO report, a U.S. House of Representatives health care proposal, which relied on high-risk pools, would have covered only 3 million people.
After five years of partisan fighting, more than 50 repeal votes, and two Supreme Court cases, Walker and Rubio should recognize that the ACA is working for millions of people. The majority of American people support it, the Supreme Court has upheld it, and efforts to undermine it only continue to show how Republicans prioritize party politics over access to affordable health care. Instead of stripping health care from millions, the GOP presidential hopefuls should propose plans that guarantee the remaining uninsured citizens can take full advantage of the ACA and that states take actions such as expanding Medicaid to ensure that Americans have the health coverage they need and deserve.
Anna Chu is the Vice President of Policy and Research at the Center for American Progress Action Fund.