Analysis questions how health reform will be funded without ACA taxes
Repeal of the Affordable Care Act (ACA) would eliminate $680 billion in taxes to be collected over 10 years, according to a report published Monday by the Brookings Institution.
Eliminating this tax revenue would make funding a replacement plan difficult and could eventually lead to increases in the federal deficit.
- In the weeks since Donald Trump won the presidential election, industry experts have pondered what will happen if the ACA is repealed, particularly without a replacement plan in place.
The ACA made massive changes to the healthcare industry, as well as to the federal budget. Repealing the ACA, let alone replacing it, would mean more significant change is on the way.
The report highlights some ways Republicans could come up with the funds to replace the ACA. For instance, savings achieved through repeal could be set aside to fund a replacement plan. However, this approach would be unlikely to produce legislation as expansive as the ACA. "But while savings on the spending side can likely be banked, the revenue lost from the ACA’s tax increases would no longer be available to finance a plan to replace the lost coverage expansions," wrote Loren Adler and Paul Ginsburg. "Consequently, only about 40% of the $1.24 trillion cost of the ACA’s coverage expansion from 2019-2026 would be available."
Just as the healthcare industry was getting used to changes made by the ACA, it may have to prepare for another massive disruption. The uninsured rate could potentially double, leaving many providers to wonder if they'll be asked to deliver much more charity care in the near future.
To avoid putting this pressure on the healthcare industry, some have suggested Republicans work to fix the ACA rather than repealing it outright. Some Democrats have suggested they would work with Republicans on health reform if they elect to go this route. “If they want to change things around the edges, fix some of the things we agree ought to be fixed and call it Trumpcare, that’s OK,” Sen. Angus King (I-ME) told Politico recently.
- Brookings Institution Paying for an ACA replacement becomes near impossible if the law’s tax increases are repealed
- Politico Democrats open to replacing Obamacare
- Healthcare Dive GOP repeal-and-delay plans spell uncertainty for insurers
- Healthcare Dive Mass disruption: More reports paint grim picture for GOP's ACA plans