The Michigan counties most vulnerable if Obamacare is repealed

Hundreds of thousands of state residents would likely be affected by a repeal of the Affordable Care Act, including those in counties that went hard for the law’s critic-in-chief, President-Elect Donald Trump, according to a Bridge Magazine analysis of government data.

The implications of an immediate repeal of the ACA could be felt by nearly 1-in-10 Michigan residents, and as much as 13 percent of the population in places as different from one another as the Detroit-area and rural Emmet County.

Consider: In Wayne County, dominated by Democratic-heavy Detroit, 12.7 percent of county residents receive health care through a combination of ACA enrollment or Medicaid expansion. In Cheboygan County, at the top of the mitt, where Trump trounced Democratic nominee Hillary Clinton by a 2-to-1 margin, 13.1 percent of residents depend on ACA coverage or Medicaid expansion.

If the Republican-led Congress, with a likeminded president, also change the way that traditional Medicaid is funded, as many as two million Michiganders could be impacted by Washington’s dramatic health-care changes, enrollment data show.

Impact of ACA repeal in Michigan

Congress is considering repeal of the Affordable Care Act and major changes to Medicaid. Nearly a million people in Michigan get their health coverage through the ACA or Medicaid expansion, helping cut in half the percent of people who don't have health insurance. Click or tap on a county or congressional district to see how many people are covered by Medicaid expansion and the ACA.

By county

By congressional district*

*Estimates based on county-wide numbers. Some counties are split among two or more congressional districts. Source: State and federal health data on Medicaid and the ACA enrollment.

Trump is pushing Congress to immediately repeal “Obamacare” and congressional leaders have already begun taking votes to dismantle President Obama’s signature domestic legislative achievement.

It remains unclear whether Congress can agree on a plan to replace it immediately or at some point in the future. That uncertainty could leave many Michiganders facing the prospect of losing their health coverage, at least temporarily.

Bridge asked the state’s congressional delegation whether and how the ACA should be changed or repealed. Republicans, who hold 9 of the state’s 14 congressional seats, generally indicated they would move quickly to dump the law though, notably, no Republican spelled out whether they are willing to ditch Obamacare without a concrete plan to replace it.

“The president’s health-care law has led to double-digit premium increases, rising deductibles, and dwindling choices for consumers,” said one, Rep. Tim Walberg, R-Tipton, in a statement. “Obamacare is collapsing and families who are hurting need relief. To fix this broken system, we need to repeal Obamacare and have a stable transition to patient-centered health care solutions that give families more choices and lower costs.”

Half the state’s delegation – four Republicans and three Democrats – responded to questions posed by Bridge this week. Both U.S. Senators, Democrats Gary Peters and Debbie Stabenow, defended the ACA and, like others in their party, said they do not favor repeal but largely agree that the ACA can be improved, though they too weren’t terribly specific on how.

“The Affordable Care Act must be preserved. The evidence of its benefits are clear in our state,” Rep. Sandy Levin, D-Royal Oak, said in statement. “The protections in the law are also vital so that no one can be denied coverage because of a pre-existing condition or women are not charged more for their care.”

Republican congressmen Fred Upton of St. Joseph, Mike Bishop of Rochester and Paul Mitchell of Dryden sent general answers that criticized the ACA but offered no specific plans on how best to repeal, replace or change any elements of it.

Dems: Repeal not the answer

Since the ACA went into effect in 2013, the percentage of state residents without health insurance fell from 11 percent to 6.1 percent, according to U.S. Census data from 2015. It’s likely even lower today though, as Republicans are quick to note, premiums for ACA-bought policies continue to rise.

“The Affordable Care Act is not perfect but it has provided a significant benefit to working families across Michigan,” Rep. Debbie Dingell, D-Dearborn, said in response to Bridge’s inquiry. “We cannot afford to go backwards, and I will be fighting tooth and nail to protect the health care coverage” of those receiving coverage through the ACA.

More than 630,000 people were added to the state’s Medicaid rolls since early 2014, when the Michigan Legislature voted to expand coverage for the poor. The ACA offered additional federal funding to states to cover those making up $33,000 for a family of four or $16,000 for a single person. (The limit for traditional Medicaid is just below $25,000 for a family of four and $12,000 for an individual.)

The plan, approved by the Michigan Legislature with the vast majority of Democratic legislators and a minority of Republicans, went into effect in early 2014 and has seen hundreds of thousands sign up across the state. In many northern Michigan counties, the expansion doubled the number of people eligible for Medicaid.

Then, beginning in 2014, residents were able to buy private health insurance through the federal exchanges. As of late last year, more than 345,000 Michigan residents were covered by ACA-bought policies.

To ACA supporters, the number of beneficiaries – nearly a million across the state – should give Congress pause before it makes major changes to a program that benefits so many in Michigan and across the country.

“One would hope that the congressional delegation is responsive to its constituents,” said Marianne Udow-Phillips, director of the Center for Healthcare Research & Transformation, a nonpartisan health care research center based at the University of Michigan.

Rep. Debbie Dingell, D-Dearborn, says she will fight “tooth and nail” to maintain ACA coverage for her constituents

Benefits from…somewhere

Udow-Phillips, a former director of the Michigan Department of Human Services, acknowledged that the ACA has problems, including premium increases averaging nearly 17 percent, and needs to be amended. But she said it might get more support if more of its beneficiaries were aware of who they are. She said some who benefit from Medicaid expansion don’t know that they are benefitting from “Obamacare” in part because Michigan calls its expansion program Healthy Michigan” with no mention of Medicaid or the ACA.

“A lot of people didn’t realize they got coverage because of the Affordable Care Act,” she said. “Communication around this law has been terrible by advocates for the law.”

Indeed, news stories have appeared around the country indicating that some recipients don’t know the coverage they now have is a result of the ACA.

“I guess we really didn’t think about that, that he was going to cancel that or change that or take it away. I guess I always just thought that it would be there,” Debbie Mills, a Trump voter in Kentucky, told Vox. “I was thinking that once it was made into a law that it could not be changed, but I guess it can? Yes?”

The Senate took the first steps toward repeal this week, voting 51-48 to use the budget process to begin defunding the law. However, no plan to replace it has emerged, although individual pieces of a potential new health-care structure have been talked about for years. Republicans in charge of writing legislation to defund the ACA say no final decisions have been made, despite a Jan. 27 action deadline set by the incoming administration.

A vote for change

In Michigan, some counties with the highest Medicaid expansion and ACA usage gave Trump some of his largest victory margins (he won the state by just over 10,000 votes).

In Oscoda County, between Grayling and Lake Huron in northern Michigan, more than a quarter of residents get Medicaid – traditional or through the expansion – or bought a policy through the ACA. It’s one of the highest rates in the state. So too is the support it gave Trump, who received 70 percent of the county vote; Trump performed better in only two other Michigan counties.

Conversely, urban areas like Wayne County, where more than 30 percent of residents get Medicaid (traditional or through expansion) or bought an ACA policy, went for Democratic nominee Hillary Clinton in big numbers. She promised to preserve the ACA.

Charles Gaba, a Bloomfield Hills web developer, began collecting and disseminating data on the ACA in 2013 and has become a reliable source for ACA data to both the media and politicians. He estimates that two-thirds of those who bought a private policy through the ACA and all of those who are on the Healthy Michigan plan could be directly affected by repeal.

And that doesn’t count roughly one million state residents who benefit from traditional Medicaid coverage, which could also see substantial changes. Georgia Republican Rep. Tom Price, Trump’s pick as secretary of health and human services, has advocated turning Medicaid into a block grant program similar to welfare, which would send money to the states while giving them greater flexibility on how to spend it.

Those plans make some advocates for the poor nervous, in part because of how states, including Michigan, have historically handled other block grant programs. Bridge wrote last year about how some block grant money for the poor ended up funding scholarships at private colleges in the state for more affluent students.

Rep. Tim Walberg, R-Tipton, says he favors Obamacare’s repeal and a move toward a system that’s less expensive and with more options for families.

Change is coming

For critics of the ACA, Trump’s election has created an opportunity to focus on those who’ve been harmed because their premiums rose sharply, their insurance shifted to higher deductibles, or they lost job opportunities because of high insurance costs.

“It’s very easy when you talk about the possibility of repeal that you’ll be able to identify and swing a camera and find some people who would lose their coverage. It’s true and unfortunate. (But) right now the existence of the law has some very serious negative effects on a lot of people,” said Robert Graboyes, a senior research fellow focusing on health care at the Mercatus Center, a market-oriented research center at George Mason University in Virginia.

Noting that the plan has been far more expensive than expected, Graboyes said he is hopeful the ACA’s successor will tackle cost.

If regulatory controls on new drugs and treatments are altered, pharmaceutical costs could fall, he said. If hospitals are allowed to compete more, other costs could come down. He said savings from a “market approach” could pay for the health care coverage of millions. Instead, he said even Republican solutions are focused largely on how bills are paid – through insurance – rather than how those bills are comprised.

“And as long as all we talk about is insurance and the demand side we’re not going to get out of it,” Graboyes said. “But I’m confident that ultimately we will. To some extent we don’t have a choice.”

No clear proposal has emerged from the Republicans on what they plan to do. Price hasn’t been confirmed yet and Trump isn’t inaugurated until Jan. 20. Until they do or until a bill gets enough support in Congress, what happens next is almost anyone’s guess.

“I think it’s very, very hard to know at this point exactly what they’re going to propose,” Udow-Phillips said. “I don’t think they know what they’re going to propose yet.”

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Thu, 01/12/2017 - 1:20pm

We need to do everything we can to make sure that the insurance companies get to keep their huge salaries. Seems like the millions of dollars they make is not enough. And remember they are financing our politician's elections. Don't ya love greed?

Fri, 01/13/2017 - 4:21am

Great points. But wheres the part where my insurance went from $303 (policy canceled by ACA) to $557, just shy of my mortgage payment?. And the part where my old Bcbs policy had a deductible of $2000 but paid 80/20 until the deductible was met. With ACA my $2000 deductible is now up front, as in they pay ZERO until i pay 2k. So my last MRI under my $303 policy cost me roughly $200. The one my doctor wants me to get now will cost me over $1000. Needless to say, that MRI isnt getting scheduled soon. I wouldn't mind paying the $557 a month to help someone out, if I COULD ACTUALLY AFFORD TO USE MY INSURANCE.

Thu, 01/12/2017 - 1:45pm

HHS Home - Impact of the Affordable Care Act in MichiganImpact of the Affordable Care Act in Michigan (Dec. 3, 2016)Hundreds of thousands of Michiganians have gained coverage, and millions more have had their coverage substantially improvedToday, the U.S. Department of Health and Human Services released an extensive compilation of state-level data illustrating the substantial improvements in health care for all Americans over the last six years. The data show that the uninsured rate in Michigan has fallen by 51 percent since the Affordable Care Act (ACA) was enacted in 2010, translating into 618,000 Michiganians gaining coverage. And, in addition to residents who would otherwise be uninsured, millions more Michiganians with employer, Medicaid, individual market, or Medicare coverage have also benefited from new protections as a result of the law.\'93As our nation debates changes to the health care system, it\'92s important to take stock of where we are today compared to where we were before the Affordable Care Act,\'94 said Secretary Sylvia M. Burwell. \'93Whether Michiganians get coverage through an employer, Medicaid, the individual market, or Medicare, they have better health coverage and care today as a result of the ACA. Millions of Americans with all types of coverage have a stake in the future of health reform. We need to build on our progress and continue to improve health care access, quality, and affordability, not move our system backward.\'94Highlights of today\'92s data release include:Employer Coverage: 5,876,000 people in Michigan are covered through employer-sponsored health plans. Since the ACA was enacted in 2010, this group has seen:\'95An end to annual and lifetime limits: Before the ACA, 3,547,000 Michiganians with employer or individual market coverage had a lifetime limit on their insurance policy. That meant their coverage could end exactly when they needed it most. The ACA prohibits annual and lifetime limits on policies, so all Michiganians with employer plans now have coverage that\'92s there when they need it.\'95Young adults covered until age 26: An estimated 73,000 young adults in Michigan have benefited from the ACA provision that allows kids to stay on their parents\'92 health insurance up to age 26.\'95Free preventive care: Under the ACA, health plans must cover preventive services \'97 like flu shots, cancer screenings, contraception, and mammograms \'96 at no extra cost to consumers. This provision benefits 4,543,547 people in Michigan, most of whom have employer coverage.\'95Slower premium growth: The average premium for Michigan families with employer coverage grew 3.5 percent per year from 2010-2015, compared with 6.8 percent over the previous decade. Assuming Michigan premiums grew in line with the national average in 2016, family premiums in Michigan are $3,300 lower today than if growth had matched the pre-ACA decade.\'95Better value through the 80/20 rule: Because of the ACA, health insurance companies must spend at least 80 cents of each premium dollar on health care or care improvements, rather than administrative costs like salaries or marketing, or else give consumers a refund. Michiganians with employer coverage have received $63,103,476 in insurance refunds since 2012.Medicaid: 2,300,958 people in Michigan are covered by Medicaid or the Children\'92s Health Insurance Program, including 941,328 children and 252,704 seniors and people with disabilities covered by both Medicaid and Medicare. The ACA expanded Medicaid eligibility and strengthened the program for those already eligible.\'95181,000 Michiganians have gained coverage through Medicaid: An estimated 181,000 Michiganians have health insurance today because Michigan expanded Medicaid under the ACA. Coverage improves access to care, financial security, and health, resulting in an estimated 21,000 more Michiganians getting all needed care, 25,800 fewer Michiganians struggling to pay medical bills, and 220 avoided deaths each year.\'95Thousands of Michiganians with a mental illness or substance use disorder are getting care: Thanks to expansion and improved access to treatment, an estimated 17,000 fewer Michiganians are experiencing symptoms of depression.\'95Michigan is saving millions in uncompensated care costs: Instead of spending $190 million on uncompensated care, which increases costs for everyone, Michigan is getting $1 billion in federal support to provide low-income adults with much needed coverage.\'95Children, people with disabilities, and seniors can more easily access Medicaid coverage: The ACA streamlined Medicaid eligibility processes, eliminating hurdles so that vulnerable Michiganians could more easily access and maintain coverage.\'95Michigan can better fight opioids: Under the ACA, CMS provided technical assistance that is giving Michigan the opportunity to strengthen Medicaid services for people struggling with opioid abuse or other substance use disorders (SUDs). For example, Michigan received support to: better identify individuals with an SUD; expand coverage for effective SUD treatment; enhance SUD care delivered to beneficiaries; and develop payment mechanisms for SUD services that incentivize better outcomes Individual market: 313,123 people in Michigan have coverage through the Marketplace. Individual market coverage is dramatically better compared to before the ACA:\'95No discrimination based on pre-existing conditions: Up to 4,394,173 people in Michigan have a pre-existing health condition. Before the ACA, these Michiganians could have been denied coverage or charged an exorbitant price if they needed individual market coverage. Now, health insurance companies cannot refuse coverage or charge people more because of pre-existing conditions.\'95Tax credits available to help pay for coverage: Before the ACA, only those with employer coverage generally got tax benefits to help pay for health insurance. Now, 275,080 moderate- and middle-income Michiganians receive tax credits averaging $233 per month to help them get covered through\'95Women pay the same as men: Before the ACA, women were often charged more than men just because of their gender. That is now illegal thanks to the ACA, protecting roughly half the people of Michigan.\'95Greater transparency and choice: Before the ACA, it was virtually impossible for consumers to effectively compare insurance plan prices and shop for the best value. Under the ACA, Michigan has received $10 million in federal funding to provide a more transparent marketplace where consumers can easily compare plans, choosing among 62 plans on average.Medicare: 1,947,787 people in Michigan are covered by Medicare. The ACA strengthened the Medicare Trust Fund, extending its life by over a decade. In addition, Medicare enrollees have benefited from:\'95Lower costs for prescription drugs: Because the ACA is closing the prescription drug donut hole, 212,075 Michigan seniors are saving $249 million on drugs in 2015, an average of $1,176 per beneficiary.\'95Free preventive services: The ACA added coverage of an annual wellness visit and eliminated cost-sharing for recommended preventive services such as cancer screenings. In 2015, 949,718 Michigan seniors, or 74 percent of all Michigan seniors enrolled in Medicare Part B, took advantage of at least one free preventive service.\'95Fewer hospital mistakes: The ACA introduced new incentives for hospitals to avoid preventable patient harms and avoidable readmissions. Hospital readmissions for Michigan Medicare beneficiaries dropped 3 percent between 2010 and 2015, which translates into 1,767 times Michigan Medicare beneficiaries avoided an unnecessary return to the hospital in 2015. \'95More coordinated care: The ACA encouraged groups of doctors, hospitals, and other health care providers to come together to provide coordinated high-quality care to the Medicare patients they serve. 25 Accountable Care Organizations (ACOs) in Michigan now offer Medicare beneficiaries the opportunity to receive higher quality, more coordinated care.

Rick A. Gardner
Sat, 01/14/2017 - 6:39pm

These are great points in your post. Now lets simplify all of this. We have 55.5 million Medicare recipients in this country and 73.8 million Medicaid recipients. This is 129,300,000 of the 325,000,000 people in this country. Since CMS [Centers for Medicare and Medicaid] are insuring nearly half of the country, why don't we expand coverage to everyone and write a health care bill that says, "if you go to a doctor or any medical facility you are covered. Remit all bills to CMS for payment." [1] Why do we need different policies that provide different coverage? [2] Why do we need thousands of pages of legislation to go to a doctor? [3] Why isn't everyone covered with the same standard of health care? [4] Why don't we just go with a single system such as the already established CMS and pass a federal sales tax for funding. A sales tax would require everyone to pay for health care, and everyone would be covered.

Thu, 01/12/2017 - 2:50pm

Susan, you touched on a huge point in all of this. The insurance companies and Big Pharma helped write the ACA. Who were they looking out for? Not me or you! Their profits and exec's salaries are obscene, if there is one thing in this country that NEEDS to be regulated it's Healthcare insurance and big Pharmaceutical. The ACA is 2700 pages long with over 20,000 pages of regulations concerning the ACA, absolutely out of control. There are good parts to the ACA which I believe will stay no matter what, the other 2690 pages need to go. The fear mongers are out in full force right now saying 20 million will lose their insurance, really? How many of them have insurance because it is required by the ACA. I do not believe for one minute there will be a repeal without a replacement ready to go.

Thu, 01/12/2017 - 6:58pm

I don't know why you wouldn't believe it, since it's happening right in front of our eyes.

Thu, 01/12/2017 - 3:11pm

Those who are not using the ACA do not understand the good it's doing. As the mother of two children with pre-existing conditions who will be severely harmed by the repeal of the ACA, I cannot tolerate ANYONE who says it should go before something at least as good is in place. Repealing this law will kill people (I am NOT fear mongering, this is my childrens life) or cause great detriment to their welfare. Without the ACA, my children would have hundreds of thousands of dollars in debt because insurance companies could refuse to insure them. They happily pay the outrageous (yes we agree on that) premiums because they overjoyed to have healthcare. Anyone who thinks the ACA should be repealed without considering these circumstances is utterly inhumane.

Thu, 01/12/2017 - 3:23pm

I'd be interested to know the statistics for Michigan residents who lost (i.e. refused to buy because of high costs) insurance at the onset of the ACA. If someone can point me to a resource for this I'd be appreciative.

Lola Johnson
Thu, 01/12/2017 - 6:18pm

The ACA subsidizes premiums for those who can't afford them. Not for those who just don't want to, but prefer to force taxpayers to cover their care through indigent care, increased charges for those who do have insurance and by declaring bankruptcies. If you do not have employer-provided insurance, don't qualify for healthy Michigan, and must pay more than 8% of your income for premiums, there is a subsidy for you, unless you earn more than $80,000/year. If you earn a good living and still don't want to pay your own way through life, there is a fine. Sucks to be poor, rich you, I guess.

tom adams
Thu, 01/12/2017 - 7:42pm

If they had'nt let the insurance companies write the law we wouldn't be in this mess, it would work for everybody !!

Rick A. Gardner
Sat, 01/14/2017 - 4:32pm

More Choices??? How many choices do you need to go to a doctor for an illness, injury, or disease? The mentality of our elected officials never ceases to amaze me. I get sick to my stomach listening to these educated idiots with their choices about health care, How many choices do you need to go to a doctor for a broken arm of leg? We don't need any choices, all we need is a health care system that covers "everything." Furthermore, since our highly talented elected officials can't figure out what to do about our health care system, I will simplify it for them. [1] We go to a doctor or medical facility for treatment. [2] We receive our treatment. [3] The doctor or medical facility remits the bill for payment, [I.E. They send the bill to Medicare, Medicaid, or an Insurance Company] Now, is that all that difficult? Why does our elected officials have so much trouble paying a medical bill?

Doug Andridge
Thu, 01/12/2017 - 9:31pm

You are spot on Tom.

Doug Andridge
Thu, 01/12/2017 - 9:30pm

I as I have said before. Trump voters were duped. They hate to hear it but facts are facts. You were duped.

Big Fish
Sun, 01/15/2017 - 10:18am

Here's the best one pager on this mess of a H/C system: the last line : "Nobel Prize winner Angus Deaton stated clearly what is wrong. The American health care system \'93seems optimally designed for rent seeking and very poorly designed to improve people\'92s health.\'94 And nothing is going to get better until we tackle that problem head on."

Fri, 01/13/2017 - 7:57am

Why only list percentages?This article would be much less of a propaganda piece if it listed actual numbers. As if 13.1% of Emmet County is remotely comparable to 12.7% of Wayne County.This article is a prime example of how the media uses deliberately selected statistics to "prove" their pre-established opinion.Figures don't lie, but liars figure, is totally appropriate for this opinion piece.

Sun, 01/15/2017 - 11:49am

Interesting that if you overlay a map by congressional district that voted for Thrump, it shows that those who voted for Thrump (or didn't vote at all) are most at risk of losing ACA benefits. Is it possible for the Bridge to post a graphic of this?DD

David Zeman
Fri, 01/13/2017 - 10:55am

Don, Thank you very much for your opinion piece. What Bridge's reporting shows are facts, not opinions. And that includes the raw numbers that you say the package lacks. If you click on any county on our map you will see the percentages of residents who get the ACA, Medicaid expansion and traditional Medicaid, along with the raw numbers for each. I'm not sure what else we could have done to give readers a straightforward snapshot of the people impacted in every county across the state. Would love to hear what you see in this article that constitutes editorial opinion. The writers do not pass judgment on the pros or cons of the Affordable Care Act, nor do they suggest in their writing whether retention, repeal, replacement or come combination thereof is the right way to turn. The basic point that this article makes is that repeal without replacement will bring uncertainty to a wide swath of residents across many parts of the state, which is undoubtedly true, whatever you think of Obamacare and whatever your political perspective. David ZemanBridge Editor

Kevin Grand
Sat, 01/14/2017 - 8:45am

Mr. Zeman,While I'm not jumping in the opinion v. fact debate regarding this article, there is one point that even The Bridge cannot refute: Exactly what difference would it make if the ACA were repealed by President Trump <a href=" rel="nofollow">or the ACA were to collapse due to its own built-in instability?</a>The end result would still be the same in either scenario, Mr. Zeman.

Fri, 01/13/2017 - 8:22am

Our medical system is based on two problematic ideas, the consumer/patient should have any and every treatment they desire and someone else should pay their bill with no distinction in care. Health care companies like this and will fill the demand and voters/workers like it as long as it's added to the deficit/federal debt/ or their employers expense column. This is incentive hell. Without addressing these basics we are doomed. The ACA doesn't touch these problems, Will any other plan? I doubt it.

Jack M.
Mon, 01/16/2017 - 2:06am

Does Anyone Really Expect Politicians To Fix This Mess?They Have Their Health Care Paid For By US...For Life.I Have Benefited From The Healthy MI Plan.My...Question IS....Why Can't They Be Put On Their Own POLICY?We as Taxpayers Could Use The Savings To Help Those Who are Less Fortunate...Instead Of Paying The Politicians HEALTH Care For Life.

Keith D Cameron
Fri, 01/13/2017 - 9:29am

The ACA was ridiculous for me. I had a great 'Child only' plan that cost me $58.00 a month on a kid that's never had or needed anything other than check-ups and immunizations (She's a healthy kid). My Monthly premium went up by 600% the first year of the ACA. My Deductible went from $1,000 to $5,000. Now I'm not sure what kind of spastic dreamland you have to live in to considered that "Affordable" but I sure wish I could have kept the plan I had and loved and was affordable.I don't know what the Republican reboot of Heathcare will be, but it can't be worse than what I had force fed to me under the ACA.

Mon, 01/16/2017 - 10:41am

These people who voted for Trump and are dependent on the social Democratic welfare state for basic needs like health insurance, food assistance, section 8 housing, disability, supplemental security income,\'85 well, they are in for a big surprise when that Safety net is dismantled by the Republican machine that wants to deregulate banks, rape our environment for profit. But no worries, there will be plenty of employment opportunities in the fast food, temp services, and hotel-motel tourist industry. But you better not get sick...environment for profit. But no worries, there will be plenty of employment opportunities in the fast food, temp services, and hotel-motel tourist industry. But you better not get sick...

David Waymire
Fri, 01/13/2017 - 10:36am

Hope that kid stays healthy. Because if will be asking for donations at the local gas station, like we used to see all the time for kids with cancer, lost of a limb, head injury after playground accident, etc. You are betting on a good outcome. Betting is the key word here.

Debra Navarro
Fri, 01/13/2017 - 2:32pm

The problem with Obamacare is that it was left in the hands of for profit insurance companies. When you think of the number of people who live in the U.S. , if everyone paid a lousy 10 dollars a month we could afford to treat everyone who is sick. I'm not saying we could cover things like elective surgeries but legit illnesses could be.I'm pretty sure all Americans would be happy to pay that much. Of course you would have to also get the drug companies under control too.

Mon, 01/16/2017 - 12:39pm

There is no accountability held for healthcare/pharmaceutical companies. Therefore Doctors, facilities (rehab, nursing home) Pharmaceutical) medication and durable medical equipment) are priced at whatever they want, insurance companies decide what there. Ask reimbursement is going to be, so they pay and then the balance from deductible, copay or and out of pocket goes to patients. AmericaOnce the riches and free country can't take care of our own people old, young, sick and mental but we are keep taking in more?

Fri, 01/13/2017 - 8:36pm

$10 a month?? You must be Berning something.

Rick A. Gardner
Sat, 01/14/2017 - 4:36pm

How about a Single System with a Federal Sales Tax on Everything? Then everyone pays, and everyone is covered.

Kevin Grand
Sun, 01/15/2017 - 9:35am

That's an easy question to answer Mr. Gardner, no one in their right mind should ever want it <a href=" rel="nofollow">because single payer cannot work</a>.Contrary to what you may have heard from ACA (or single payer) proponents, people will eventually have to pay something for their healthcare, so ultimately, it's back to square one.

Mark Whelan
Mon, 01/16/2017 - 1:08pm

I find it very interesting that you do not mention that many of the 345,000 people you quote as having bought ACA insurance policies were forced to by the law because their policies were cancelled even though the President said dozens of times this would never be the case. He even admitted to purposefully lying about it as did the architects of the plan.. Most if not all of these people ended up paying many thousands more for less coverage and vastly higher deductibles. The Democratic leaders also agree that the ACA is flawed and broken and have known it from the beginning but did nothing when they controlled the House and Senate to fix it. They even now have no suggestions for how to fix it, just condemnation because "CHANGE IS COMING" and they do not like it.

Tue, 01/17/2017 - 3:01pm

The article says people may be temporarily without healthcare insurance when ACA is repealed. That is completely FALSE. There will be a transition period (probably until at least 2018) where you will still have your old coverage, until your new coverage begins.

Tue, 01/17/2017 - 10:45pm

If you're thinking that repeal of the Affordable Care Act (AKA Obamacare) doesn't affect you or maybe that it will be better to just start over from scratch, you might want to think about what you--yes, you!--have to lose. Just a reminder that even if you are "safely" ensconced behind employer-provided insurance, the protections set forth in the ACA apply to you, too--and if those protections are repealed along with the rest (or any part) of the program, you will also be affected. That means you may be trapped in a job, because your pre-existing condition may mean you will not qualify for new insurance offered by another employer, and the cost of private insurance would be prohibitive. If your employer shuts down, lays you off, or even changes insurers, well, you are out of luck. (The Senate GOP voted this week that they would not require an eventual ACA replacement to protect against discrimination for pre-existing conditions, which was the standard before the ACA.) It means that you (a young adult under the age of 26) or your adult children (over 18) may find yourselves without the protection of insurance, as the Senate GOP voted last night that an eventual ACA replacement will not be required to allow young people to remain on their parents' insurance up to the age of 26. It means that if you have a high-risk pregnancy, or life-threatening illness such as cancer, you may not be able to afford all the care you need, because you may hit lifetime or annual caps. If you have an infant born with any kind of severe medical condition, or premature, they may hit their lifetime insurance cap before they are old enough to walk. The Senate GOP voted last night that an eventual ACA replacement program would not be required to prohibit lifetime insurance caps. It means that if you are a struggling parent who is un- or underinsured, you will no longer be able to count on at least your kids getting the routine medical and dental care they need under the Children's Health Insurance Plan (CHIP). The Senate GOP voted that CHIP is not required to be protected by an eventual ACA replacement. These provisions of the ACA affect everyone in this country, not just those without insurance through their employers. If you are not okay with these changes, call your representatives and let them know what's important to you. Nothing has been set in stone yet, but our legislators have shown us a map of what they plan to do if constituents don't make their voices heard loud and clear.

Tue, 01/24/2017 - 6:45am

I for one do not want single payer. If you want single payer be prepared to see half or more of your paycheck go to taxes to fund it. All the countries that have it have extremely high taxes.