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Report: Obamacare repeal without replacement would eliminate health insurance for 18 million

New Hampshire Union Leader

January 17. 2017 9:49PM

MANCHESTER — A nonpartisan report said repealing Obamacare without a replacement would cost 18 million people their insurance in the first year, one of the red flags raised by New Hampshire’s U.S. senators even as President-elect Donald Trump promises “insurance for everybody.”

The Congressional Budget Office report Tuesday was based on a study of a Republican bill in 2015 to repeal the Affordable Care Act’s mandate penalties and subsidies, while leaving market reforms in place.

Without subsidies, the fear is that the market will fall apart, which will only further complicate efforts to improve affordability, said Beth Roberts, vice president for Harvard Pilgrim Northern New England, during a roundtable discussion Tuesday at Dartmouth-Hitchcock Manchester. U.S. Sen. Jeanne Shaheen, D-N.H., and U.S. Sen. Maggie Hassan, D-N.H., heard from eight health care professionals and shared their concerns.

The CBO report said the GOP plan, without replacement, would increase the number of uninsured to 32 million by 2026, including previously proposed elimination of Medicaid expansion under the law. Premiums for individual policies through the marketplace would increase 20 to 25 percent in the first year and double by 2026, according to the report.

Shaheen said the takeaway Tuesday is the importance of continuous coverage and concerns about gaps in insurance.

Trump, who has yet to release his plan, has rallied the GOP majority on Capitol Hill to move quickly to repeal Obamacare first, and then follow closely with a replacement. His comments in an interview with the Washington Post that his plan would include “insurance for everybody” is at odds with some Republicans in Congress.

The CBO report can be viewed below:

Hassan, a former two-term governor, said the fate of the “New Hampshire Health Protection Program,” established while she was governor, hangs in the balance.

“When the Congress, the Republican majority in Congress and the President-elect, talk about repealing the Affordable Care Act they are talking about repealing our bipartisan Medicaid expansion program,” Hassan said.

She said Medicaid expansion provided coverage for more than 50,000 Granite Staters, including thousands with access to behavioral health and substance misuse services.

The health care professionals at the Dartmouth-Hitchcock clinic discussed their experiences before and during the Affordable Care Act’s rollout, with agreement that the federal law needs improvements in terms of affordability and access.

Jennifer Frizzell, of Planned Parenthood of Northern New England, said that before Obamacare there was no plan offered in New Hampshire on the individual market that included maternity care as standard coverage.

Tess Kuenning, executive director of the Bi-State Primary Care Association, said a repeal would disproportionately affect low- and moderate-income families.

Linda Paquette, head of New Futures, worried about a rollback in addiction services, including for people who continue with coverage. There is uncertainty, which is a deterrent for providers who are considering increasing capacity, she said.

Shaheen, in an interview, said she expects Congress to work together on proposed coverage. She has not seen Trump’s proposal, but noted she has for years supported efforts to lower prescription drug costs, something Trump has highlighted.

“I certainly hope we are going to hold Donald Trump’s feet to the fire,” Shaheen said. “He says he’s got a plan — I want to see the plan, I want to see what’s in the plan, make sure nobody gets hurt by it.”

Politics Obamacare

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