With open enrollment scheduled to close tomorrow, people buying health benefits on state and federal health insurance exchanges may be thinking ahead to the medical coverage they’ll have in 2017. Others are thinking ahead to what the health insurance market might look like without the Patient Protection and Affordable Care Act as a possible repeal of the 2010 federal health care reform law looms.
 
A number of think tanks and special-interest groups released reports in the past week that attempt to measure life with and without the ACA and its health insurance mandates for individuals and employers.
 
The first report, issued by the Kaiser Family Foundation, estimated that 9.4 million people who bought health plans over state and federal health insurance exchanges this year will receive about $32.8 billion in tax credits to help offset the cost of their health benefits plan.
 
“A repeal of the health law would eliminate these subsidies,” the report said.
 
In Minnesota, the 47,266 people who bought health plans over MNSure, the state’s insurance exchange, this year will receive about $115.1 million in tax credits to help pay for their coverage, the report said.
 
The second report, issued by the Urban Institute, estimated that the number of uninsured Americans will rise by 29.8 million people to 58.7 million people by 2019 from a repeal of the ACA. Of the 29.8 million newly uninsured, 22.5 million, or more than three in four, would lose their benefits from the elimination of tax credits, Medicaid expansion and the individual mandate, the report said.
 
“This scenario does not just move the country back to the situation before the ACA,” the report warned. “It moves the country to a situation with higher (uninsured) rates than was the case before.”
 
In Minnesota, the number of uninsured would more than double to 690,000 people by 2019 from 309,000 currently, according to Urban Institute estimates.
 
The third report, also issued by the Kaiser Family Foundation, estimated that 52.2 million non-elderly adults, or 27 percent of that segment of the U.S. population, have pre-existing medical conditions that would make it difficult to obtain coverage from the individual health insurance market without the underwriting protections of the ACA. Under the ACA, carriers that sell health plans over state and federal insurance exchanges can’t deny coverage based on a pre-existing medical condition like history of cancer or heart disease.
 
“To what extent people with pre-existing health conditions are protected is likely to be a central issue in the debate over repealing and replacing the ACA,” the report said.
 
In Minnesota, some 744,000 people, or 22 percent of the state’s non-elderly adult population, have pre-existing medical conditions that may make it difficult for them to obtain health insurance benefits from the individual health insurance market without the ACA, the report said.
 
Finally, the American Hospital Association and the Federation of American Hospitals said the nation’s hospitals would lose at least $165.8 billion in revenue from 2018 through 2026 from treating people who lost their health coverage because of a repeal of the ACA.
 
“Losses of this magnitude cannot be sustained and will adversely impact patients’ access to care, decimate hospitals’ and health systems’ ability to provide services, weaken local economics that hospitals help sustain and grow, and result in massive job losses,” the AHA and FAH said.
 
The hospital groups’ report did not break down the projected hospital revenue losses by state.