Conservatives who want to repeal the new health reform law—in particular, Reps. Steve King (R-IA) and Wally Herger (R-CA), as well as Minority Leader John Boehner (R-OH) and other members of the Republican leadership—would return our nation to the untenable status quo. Repealing the Affordable Care Act would enable insurance companies to continue discriminating against individuals with preexisting conditions. Repeal would mean that approximately 15 million Americans would do without the help they need to pay for their health insurance premiums, while another 15 million will be denied Medicaid coverage, simply because their family makeup or modest incomes disqualify them for public health insurance coverage. And repeal would mean that health care costs would continue to grow at an untenable rate, while patients would continue to experience chaotic, episodic, and poorly coordinated care.
What happens if the Affordable Care Act is repealed and conservative policymakers can pursue their own health reform agenda? The elected officials and health policy experts who have offered up policy solutions to this crisis are often criticized for proposing only “small ideas” in response to our nation’s serious health care crisis. These criticisms correctly identify a grab bag of ideas, common to virtually all conservatives engaged in health care reform, which are intended to make coverage more affordable for small segments of the population. These proposals do nothing to tackle the large, interconnected problems that plague our current health care system.
Consider conservatives’ most cherished reforms: Enabling health insurance companies to sell coverage outside of their licensing state, medical malpractice reform, and enabling small businesses to purchase coverage through business or professional associations. All three proposals are unlikely to make a significant difference in health care costs for the average American family with health insurance or make a meaningful dent in the numbers of Americans without health insurance. And they carry significant risks for patients, small businesses with older and sicker workers, and others.
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