Affordable Care Act Repeal Would Jeopardize Coverage For 500,000 Massachusetts Residents

January 12, 2017

During event at the State House, consumers, healthcare providers and workers outline major health and economic risks to Massachusetts if Congress Repeals ACA

Boston, Mass. (January 12, 2017) - Healthcare consumers, workers and providers today outlined several priorities in the effort to fight the repeal of the Affordable Care Act (ACA) and to ensure that Massachusetts can protect the gains resulting from the state's near universal healthcare coverage.

During a press conference at the State House, a diverse and growing group of industry leaders, ACA beneficiaries, healthcare providers, advocates, insurers and others highlighted the potential health and economic impacts to Massachusetts if Congress repeals the ACA without an adequate replacement. 

Among the key concerns is the loss of coverage for nearly 500,000 Massachusetts residents if the ACA is repealed. The Commonwealth also risks losing millions in federal funding, which could threaten hospitals and healthcare jobs across the state.

"Massachusetts is a national leader in healthcare - pioneering the way forward through our state law a decade ago, and achieving new gains in access, coverage and equity because of the Affordable Care Act," said Stephen Rosenfeld, interim executive director of Health Care for All. "Unfortunately, the Commonwealth is not immune to the severe health and economic consequences that will result from the ACA's repeal. We need to communicate these risks and protect Massachusetts' access to care and funding in the event of any Congressional action."  

Massachusetts has achieved the highest rate of residents covered by insurance in the country with more than 97 percent of the population insured. That expansion has spurred economic growth, while also improving access to care and increasing health equity and financial security.

"People in my congregation, real people, have access to health care because of the work we have done together more than 10 years ago in Massachusetts and more recently under the ACA," said Reverend Burns Stanfield, a pastor at Fourth Presbyterian Church in South Boston. "Dismantling this crucial law that has helped so many people goes against all of our values."

In the coming weeks, leaders are planning to take steps to ensure that any attempt to repeal the ACA maintains coverage for the 30 million Americans insured through the law, covers those with pre-existing conditions, and preserves Medicaid expansion funding.

"In a matter of days, Congress could vote to take away the healthcare of millions of Americans without offering a plan to replace it, a reckless act that will threaten lives, jobs and the stability of many hospitals and healthcare providers in Massachusetts and across the nation," said Tyrék D. Lee, Sr., Executive Vice President of 1199SEIU United Healthcare Workers East. "We are coming together to make it clear that repealing the ACA without a viable replacement will create chaos across our entire healthcare system. It will place enormous strain on Massachusetts' largest industry, costing jobs, hurting hospitals, and making it much harder for vulnerable children, seniors and families to access critical care."

Across the nation, the ACA repeal could cost hospitals more than $165 billion between 2018 and 2026, according to estimates by the Federation of American Hospitals. Of particular concern in Massachusetts are provisions contained in the ACA that are not currently addressed with the state's landmark 2006 healthcare law (Chapter 58).

"The Affordable Care Act plays a significant role in Massachusetts and the Commonwealth will face substantial health and economic burdens if it is repealed," said John E. McDonough, DrPH, MPA, Professor of Public Health Practice in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and Director of the HSPH Center for Executive and Continuing Professional Education. "Much is at stake, and the repercussions will be felt across the state, as Massachusetts could lose billions in federal funding, jeopardizing coverage for hundreds of thousands of residents."

One of the key concerns is the federal expansion of Medicaid, which provides significant funding to Massachusetts and provides coverage for more residents than the state's original healthcare law. Enrollment in MassHealth is surging - now covering about 300,000 Massachusetts adults - as a result of the ACA's Medicaid provision.

Last fall, through its Medicaid program 1115 waiver, the federal government authorized $52.4 billion over the next five years, a major source of healthcare funding for 1.9 million Massachusetts residents that could be at risk. The waiver includes federal tax credits that enable more than 190,000 Massachusetts residents to afford their insurance and are more comprehensive than what is offered through the state law. The federal subsidies go to families with incomes up to four times the federal poverty level, while the Massachusetts law provided assistance to those with incomes up to three times the federal poverty level.

"I work at a prominent hospital that is on the front lines of caring for low-income and vulnerable communities, and I have seen firsthand that access to affordable health insurance saves lives," said Latia Holmes, a Boston resident and a healthcare worker at Boston Medical Center. "Our patients depend on us to provide quality care to treat everything from chronic conditions like heart disease, to mental health issues and addictions to opioids. Taking away their insurance and cutting the critical funds our hospitals need to care for them will endanger our patients' health and well-being. And it's just wrong."

"I went without health insurance for decades until I heard about Obamacare, and I applied to avoid the penalty. It was the best decision I made. I got access to subsidized coverage, and I ended up needing surgery for both my wrist and my foot," said Courtney Thomas, a Boston resident. "I am here today to ask Congress and the new administration to reconsider their promise to repeal Obamacare. Please don't take away my coverage and the coverage for thousands of residents in the Commonwealth."

Important insurance protections - affecting as many as 2.5 million privately insured Massachusetts residents - are also at risk. Employer-offered coverage is under federal jurisdiction so the state's insurance protections cannot legally apply to most of these individuals. The ACA also includes protections not in the state law, such as those prohibiting copays and deductibles for preventive care like reproductive health.

Many employers also face added costs, as the ACA includes a tax credit to help small businesses cover the cost of providing healthcare to workers.

Finally, the ACA closes a major Medicare prescription drug "donut hole," which saves 83,000 Massachusetts seniors and people with disabilities more than $1,000 in drug costs each year.

Despite probable action by Congress, consumers, workers and advocates will continue efforts to help minimize the negative impact of a potential repeal without an adequate replacement. They are encouraging Massachusetts residents to urge friends and family here and across the country to contact their Congressional delegations and urge them to share their plan to keep and improve healthcare for all Americans before voting to repeal it.