Is Health Care in America too sick to revive?

The health care system is currently one of the most divisive issues in America. At the center of all the controversy is the Affordable Care Act. According to an article from Pew Research Center, last month 82% of Democrats approved of it, while among Republicans 91% were not in favor of it. Independents were even more split with a 46% approval rate. One of the current concerns with the law is the rising cost of premiums, the cost you pay upfront monthly to have insurance. An article from NPR reported that premiums are expected to increase 22% in 2017. This overall leads to an increase in out-of-pocket costs for premiums, co-pays, and deductibles.

Although the current system is working to provide subsidies to cover this, and has a maximum out of pocket expense for customers using the Affordable Care Act, these may not continue for long under the Trump administration. As Aaron E. Carroll of the New York Times states, “It’s also unlikely that the Trump administration would cover more people’s out-of-pocket payments with federal money. To argue suddenly that people should be shielded from the expense of health care would be a sea change for conservative health insurance design.”

Although the current system is working to provide subsidies to cover changing premiums and has a maximum out-of-pocket expense for customers using the Healthcare Marketplace, these subsidies might not continue for long under the Trump administration. Aaron E. Carroll of the New York Times suggests that, “it’s also unlikely that the Trump administration would cover more people’s out-of-pocket payments with federal money. To argue suddenly that people should be shielded from the expense of health care would be a sea change for conservative health insurance design.”

One possible cause of this could be the lack of competitive markets in some areas of the United States. An analysis done by the McKinsey Center for U.S. Health System Reform for The Upshot found that in 2017 17% of Americans who could sign up for health care under the Affordable Care Act may only have one choice of provider, an increase from 2% of Americans facing this dilemma last year. This increase in out-of-pocket cost affects one group of people particularly hard, those with chronic illnesses such as asthma. Research by the JAMA Pediatrics revealed that 32% of families avoided office visits for their children due to higher costs of being insured, hindering prevention efforts. Additionally, 19% of families had to visit the Emergency Room for their child’s asthma. However, for families on Medicaid, where out-of-pocket costs are low, only 7% skipped office visits and less than 1% visited emergency rooms for asthma-related problems.

It is very likely that the look of healthcare in America will change under this new administration. According to Paul Krugman, if the Affordable Care Act is repealed, many Americans could lose their access to health care, including approximately 5.5 million Trump supporters.