The First Victims of Repealing Obamacare will be the Sick and the Poor
he would roll back the expansion of Medicaid that has benefitted millions of poor families and return the country to a system where private insurers have little incentive to cover high-risk individuals.
.. If Trump’s real goal is to return to a market-based health-insurance system, with all the inequities and gaps in coverage that such a system inevitably entails, Price’s plan presents a possible blueprint for how to get there.
.. Under Price’s plan, reversing the post-2010 expansion of Medicaid alone would mean that about fifteen million people would lose their health-care coverage overnight. These people—members of families whose earnings are above the poverty line but less than forty thousand dollars a year
.. Even now, it is hard to see exactly how he will be able to both follow Price’s lead and keep his pledge to people with preëxisting conditions.
.. Under Price’s plan, insurers would still be legally obliged to offer coverage to sick people, but they could charge much higher premiums to anybody who hadn’t maintained continuous coverage—a loophole that could potentially affect millions.
.. The health-care economy that emerged from the Affordable Care Act is a Rube Goldberg contraption with many interlocking parts: laws, taxes, subsidies, public mandates, and administrative directives, along with the expansion of existing features, particularly Medicaid. Some of these pieces may have appeared to be superfluous, but they were designed to work together and support each other. If someone comes along and fiddles with one of them, such as the subsidies or the individual mandate, it can affect the entire system.