Congress appears poised to repeal much of the Affordable Care Act (ACA) early in 2017 before enacting a replacement plan for 2019 when the repeal would likely take effect. This repeal and delay approach threatens 1 million Georgians who stand to lose health coverage in 2019. Without the ability to see a doctor, many more Georgians face far greater risk of health problems or a financial crisis.
The majority of Georgians with health coverage at risk are now insured through a plan purchased in the federal marketplaces. Eighty-six percent of Georgians with federal marketplace coverage in 2016 received help paying for premiums through advance tax credits. The average credit amounts to $287 a month, or 75 percent of the total monthly premium for a comprehensive plan. Without this financial assistance, many low- and middle-income workers and families are likely to find coverage unaffordable.
Georgia also stands to lose a significant amount of federal money if the ACA is repealed with no replacement. Georgia stands to lose $1.8 billion in federal marketplace subsidies and $953 million in federal Medicaid money due to projected lower enrollment without the ACA’s outreach and enrollment activities. With the loss in federal funding and more uninsured residents, Georgia’s health care system faces a worsening budget crunch. Hospitals already straining to provide uncompensated care to the uninsured will see even more patients who cannot afford to pay for care. Hospitals receive some federal money to help cover uncompensated care costs, but that help is set to decline starting in 2018. Even if this federal funding stays at the current level, hospitals and state and local governments will have to cover all of the additional costs of caring for the uninsured.
Repealing the ACA without a replacement plan also creates budget uncertainty for Georgia policymakers who use federal funds to help pay for Georgia’s health care programs. State lawmakers could struggle to budget for health care with this uncertainty. It is important for federal lawmakers to leave the ACA in place until a replacement is implemented that maintains health coverage for 1 million Georgians and sustains adequate federal financial support for the state’s health care system.