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4 Things We Would Lose If Congress Repealed Health Reform

The House of Representatives plans to vote tomorrow on a bill to repeal the Affordable Care Act — that is, health reform.  As with previous repeal votes, we think this is a good time to look at key provisions that are already having an impact.

1. Health insurance for 3.1 million young adults. Health reform requires insurers and employers that offer dependent coverage to allow parents to include children up to age 26 on their insurance plans.  As a result, 3.1 million more young adults had health insurance in December 2011 than in September 2010, according to the Department of Health and Human Services (HHS).

In the past, most insurance companies dropped children once they turned 19 or a few years later if they were students.  That’s one reason why nearly a third of all young adults lacked insurance in 2010 — a larger share than any other age group.

2. Free preventive care for tens of millions of Americans. Insurance companies now have to cover preventive care services at no charge, and Medicare provides preventive services for free now, too.  As a result, nearly 87 million Americans received a free preventive health care service last year, according to HHS:  54 million through private insurance and 32.5 million through Medicare.

Preventive care includes screenings for chronic illnesses like diabetes and cancer, routine vaccines for adults and children, and other recommended care for kids, such as regular doctor visits.

Better access to preventive care will help millions of families with their budgets and likely produce other benefits, such as fewer unnecessary deaths from disease, less spending on costly and avoidable illnesses, and a healthier population overall.

3. Protections for children and adults with serious illnesses. The Affordable Care Act bars insurance companies from denying coverage to children with pre-existing health conditions like cancer, autism, or diabetes.  As a result, for the first time in most states, families with children with serious illnesses, chronic conditions, or special health care needs can buy coverage for their children in the individual health insurance market.

Also, insurers can no longer cut off care for people with serious illnesses who need expensive medical care.  The Affordable Care Act bars insurers from imposing “lifetime limits” on benefits.  Now, people who get cancer or another illness that requires expensive treatments won’t have to worry that their benefits will run out or that the expensive treatments will push them into bankruptcy — or worse, that coverage limits will prevent them from getting lifesaving care.

4. More affordable prescriptions for more than 5 million seniors. Health reform has begun to close the “doughnut hole,” the gap in Medicare prescription drug coverage that many seniors experience once their annual drug costs exceed $2,930.  Before health reform, seniors had no additional coverage until their costs hit about $6,658.

Last year, seniors received a 50 percent discount on brand-name drugs and a 7 percent discount on generic prescription drugs while they were in the coverage gap.  This year, the generic discount jumps to 14 percent.

More than 5 million Medicare beneficiaries saved more than $3.2 billion in 2010 and 2011 as a result of these changes, according to HHS.  The law will close the entire doughnut hole by 2020.

More improvements to the nation’s health care system will take effect in the months and years ahead.  Tomorrow, we’ll look at five important benefits of the Affordable Care Act that won’t take effect if Congress repeals health reform.