UCLA community weighs in on impact of possible Affordable Care Act repeal

Congress voted to begin the process of undoing the Patient Protection and Affordable Care Act last week, the 2010 law which expanded and mandated health insurance for all U.S. citizens.

President-elect Donald Trump, who will be inaugurated Friday as the nation’s 45th president, urged Congress last Tuesday to repeal and replace the act with Republican-backed programs as quickly as possible. But the economic impacts of a repeal have elicited concern from the law’s supporters and beneficiaries, including 3.7 million low-income Californians who became newly eligible for health insurance under the act’s Medi-Cal expansion.

President Barack Obama signed the act into law seven years ago, expanding medical coverage for about 20 million U.S. citizens. It also established insurance subsidies for low-income families, prohibited insurance companies from excluding customers with pre-existing conditions and created a fine for those who lacked insurance.

The House of Representatives approved a budget resolution last Friday to repeal parts of the act and begin drafting new legislation. But Congress is divided on how soon to get the job done. Although the original resolution possessed a Jan. 27 deadline, five senators later introduced an amendment to push the date to March 3.

Shana Charles, a faculty associate at the UCLA Center for Health Policy Research, said she thinks an actual repeal and replacement could realistically take months.

Charles said the governors of the 32 states who expanded state insurance programs, including Republican governors, generally support programs made under the act. This difference of opinion between Republican state officeholders and Republican congressmen creates a split within the party, she added.

“It’s hard for me to see how (Congress) would go on President-elect Trump’s business timeline of a few weeks,” Charles said. “That’s living in Fantasyland. That’s not how legislation happens. The system is designed to let everybody have a voice.”

Charles said constituencies can and have fought for political action on the issue by writing letters and attending protests, including last Sunday’s Our First Stand – Save Health Care rally hosted by the California Democratic Party near USC.

“The hashtag #OurFirstStand is part of a nationwide movement by Democrats to show support for the Affordable Care Act,” Charles said. “I’ll certainly be following how Republicans will vote, especially as they’re facing pressure from their own constituencies.”

Possible legislative changes include the elimination of subsidies and Medicaid expansions, she added. However, she said she thinks some health care laws will remain the same, including a federal law that allows children to stay on their parents’ insurance plan until the age of 26.

Neel Patel, a second-year neuroscience student, plans to do just that. But he said changes to the act may economically harm his parents, whose combined income of less than $36,000 qualified them for L.A. Care Covered, an insurance program established by the act. Patel’s family switched to L.A. Care Covered from an expensive private insurance, decreasing their copays for medical visits from $70 to nothing.

Patel’s mother, who is anemic, was previously reluctant to treat herself at the hospital because appointments were so expensive, Patel said.

“Now, because of L.A. Care, my mom is more willing to make hospital visits even when she has little concerns, to make sure she’s healthy,” Patel said. “(Without the act) the cost of medication will go up.”

John Bollard, chief operations officer of the UCLA Arthur Ashe Student Health and Wellness Center, said legislative changes will not affect coverage under the University of California Student Health Insurance Plan. Student health insurance is funded by UC administration and overseen by an executive oversight board.

The directors of the Ashe Center and the Center for Counseling and Psychological Services similarly expressed in a letter to the Daily Bruin that election politics would not impact the benefits available under UCSHIP, including family planning, contraception and STI testing services.

Though the Ashe Center has not yet finalized 2017-2018 UCSHIP coverage, its policies will remain similar to this year, Bollard said.

“Even if the ACA is completely repealed, we still have sole proprietary decision-making over what’s covered and what’s not covered,” he said. “Anybody purchasing UCSHIP wouldn’t be adversely impacted by the repeal.”

About 90 percent of the 26,000 UCLA students covered by UCSHIP rely on it as their only source of health insurance, Bollard said. Many will likely return to their parents’ plans after they graduate, he added. But the Ashe Center and its insurance office provide online resources for students who are searching for new sources of coverage.

Bollard said he is concerned about the people who might lose access to affordable health care if considerable changes do happen.

“(The act) is not perfect – it costs a lot of money to run,” he said. “But it’s really established access for a large group of people who didn’t previously have it. I hope whatever replaces the act accomplishes these two things: access to healthcare (and) a fairly robust set of benefits.”