Health CareSave the ACA

Response to Repeal and Replace Talking Points

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Talking points in hand, Republicans think they’re ready for your tough ACA questions. They’re going to try to tell you that the ACA is a failure (it isn’t!), and that their plan is better (lol, what plan?). Here are their talking points, and a few suggested responses from the Indivisible Team.

Republicans say that Health Savings Accounts (HSA) coupled with high-deductible insurance plans are an acceptable replacement for the Affordable Care Act. This is wrong!

  • HSAs are good for rich people trying to shelter their income, but bad for middle-class people who want real protection from health care expenses. Seventy percent of money in HSAs, which are used to pay for health care expenses, today comes from those earning over $100k.
  • HSAs are designed to benefit the rich. The higher your tax bracket, the more tax benefit you receive.
  • Republicans have complained about high deductibles under the ACA but are now saying part of their solution is even higher deductibles, paired with HSAs. Don’t be fooled: high deductibles are a way to shift costs to families, who then have to pay more for their health care.

Republicans say that people with pre-existing conditions will be protected under their plans because they will have access to state high-risk insurance pools. Baloney!

  • High-risk insurance pools are not new. And they simply don’t work. In 2011, prior to the implementation of the ACA, 35 states had high-risk pools, where those who were too sick to get insurance in the private market could come for coverage. But only 226,000 people were enrolled in them. 48 million Americans were uninsured at the time.
  • This is because high-risk pools come with very high premiums, very high administrative costs, and very bad insurance policies that don’t cover much care.

Republicans say that cutting Medicaid is OK because it doesn’t work. Who are they kidding?

  • Medicaid is effective. Nearly 70 million Americans rely on Medicaid for their health insurance (often called a different name in each state, e.g., BadgerCare in Wisconsin, or Centennial Care in New Mexico). 65% of people covered say they think it’s working well.
  • Medicaid’s expansion as part of the ACA led to greater use of preventive care, fewer emergency department visits, and more reports of improved health than in states that did not expand.
  • 73% of Medicaid’s beneficiaries are children, seniors, and people with disabilities—our most vulnerable fellow citizens.
  • At the same time they want to cut Medicaid for millions of Americans, Republicans are trying to cut taxes for the rich, to the tune of $50k a year for millionaires. Just to give you a sense of their priorities.

Republicans say they want to replace the tax credit in the ACA with a universal tax credit of their own. It’s nowhere near as good as the one in the ACA!

  • Under Paul Ryan’s plan, the value of this credit would shrink over time, as the costs of health care grows. The ACA’s tax credit, which is currently used by over 10 million Americans, is tied to the cost of insurance.
  • Under Paul Ryan’s plan, the same amount of credit would be available to all Americans (adjusted only for age), including millionaires. The ACA’s tax credit is targeted at those who most need assistance: families (of four) making less than $95,400
  • Ryan’s plan would also cut out lawfully present immigrants who have access under the ACA.

Republicans will tell you not to worry, that they will come up with a plan so that everyone has health care. Oh, heck no!

  • Republicans have had nearly seven years to come up with an alternative to the ACA. Why should we believe them now?

  • Those who have seen the biggest improvements under the ACA (e.g., communities of color) are those who have the most to lose under a new, yet-to-be-announced system. Americans are rightly concerned about Republicans’ ill-defined “plan.”