Healthcare spending accounts for 18 percent of the US economy. Congress has acted to eliminate funding of the Affordable Care Act (ACA) without a way to finance a replacement. If approved, the repeal will have significant negative consequences for Colorado businesses, individuals, government and the economy. Colorado hospitals will be hard hit as the number of uninsured seeking emergency room care skyrockets. An Urban Institute analysis of a 2016 repeal bill shows insurance marketplaces for individuals and small businesses would likely collapse due to loss of premium supports from the ACA.

Reduced ER Visits
Before the ACA, hospital emergency rooms were overcrowded with patients who could not afford to go to a doctor. The federal anti-dumping law requires hospitals to treat anyone seeking emergency care. Since the ACA was approved in 2010, more than 22 million uninsured Americans have gotten coverage. With access to preventive care, citizens could get treatment sooner from community physicians. This reduced needless ER visits that

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generated financial losses for hospitals.

The ACA financed healthcare expansion by taxing profitable healthcare corporations, including drug, insurance and medical device companies. It raised the Medicare tax on people making more than $250,000 a year, extending Medicare’s solvency by 10 years.

A 2016 repeal bill eliminated the individual and employer mandates (which removes the incentive for young and healthy people to get insurance). This would create an older and sicker insurance pool. It eliminated the Medicaid expansion and taxes on high wealth individuals. Congressman Paul Ryan wants to cap Medicaid spending and turn responsibility over to the states. This would prohibit Medicaid from covering higher numbers of people who lose their jobs in the next recession and increase the financial burden on cities and states.

Expansion was Paid For
These taxes were crafted as part of a grand bargain among all sectors of the healthcare system, negotiated over many months. Hospitals and physicians agreed to forego payments for uncompensated care in exchange for the Medicaid expansion. If the Medicaid expansion is repealed, all hospitals will see their uncompensated care skyrocket with no offsetting federal aid. Rural hospitals are even more vulnerable to such drastic cuts.

The Urban Institute estimates the number of uninsured Americans will double by 2019, from 29.8 million to 58.7 million. States, local governments and healthcare providers will be at risk for an extra $1.1 trillion in uncompensated care over 10 years.

This opinion-editorial was first published by the Denver Business Journal Jan. 23, 2017. The full article Viewpoint: The Denver Business Journal