Global Down Syndrome Foundation Obamacare Repeal and Replace Update

This week, Congress introduced legislation called the American Health Care Act that would repeal major pieces of the Affordable Care Act (ACA) also known as Obamacare.  We are closely monitoring these developments and are providing an update to our friends and supporters on how this legislation may impact individuals with Down syndrome.  As Congress begins debate on the bill, Global is engaged with our advocates in Congress to protect the interests of persons with Down syndrome.

Several big questions about the bill remain unanswered including how much the bill will cost the federal government and taxpayers, and how many individuals currently receiving coverage under the ACA may lose or gain coverage under the new proposal.  The Congressional Budget Office, a nonpartisan federal agency, is charged with reviewing legislation to answer these questions and is expected to share findings soon.  Below are several important provisions in the bill and our analysis of the impact.

• For individuals and families seeking health insurance – who don’t receive coverage from their work or through a government program like Medicaid – the bill would provide annual tax credits between $2,000 and $4,000 for individuals (more for families) that could be used to purchase health insurance.  There are concerns that these tax credits would be drastically less than those provided under the ACA and could make it more difficult for lower-income individuals and families to purchase private health insurance.
• Individuals and families who decide not to purchase health insurance would no longer have to pay a penalty to the federal government as part of their income taxes.
• Consumers who go more than 63 days without health insurance coverage would be required to pay a late enrollment fee if they want to buy a health insurance policy.
• Health insurers would still be prohibited from denying insurance coverage to individuals who have a “pre-existing” medical condition like heart disease, diabetes, cancer, and Down syndrome.
• Parents could keep their children up to age 26 on their health insurance policy.
• Under the ACA, states could expand Medicaid coverage with additional federal funding.  This would end in 2020 under the new proposal and many individuals receiving Medicaid coverage would lose coverage.
• Medicaid currently requires coverage for persons who qualify based on their income.  The bill would cap the federal contribution to state Medicaid programs which could result in persons losing coverage, and those maintaining Medicaid coverage seeing a reduction in covered medical services and higher out-of-pocket costs.

As evidenced by these proposed changes to the ACA, Republicans and Democrats have very different approaches to health care reform.  The Global Down Syndrome Foundation will continue to work with both parties, and our Down syndrome and differently-abled communities, to ensure that people with Down syndrome continue to have access to affordable, quality health insurance.  As this legislation is considered and amended, we will continue to closely monitor the evolving bills and offer our expertise and experience with a focus ensuring access to affordable and quality medical care for individuals with Down syndrome.  Given that Down syndrome is considered a pre-existing condition, the importance of this issue cannot be overemphasized and we urge Congress to seek common ground.