A full repeal of the ACA in 2019 would result in an increase in uncompensated care and a decrease in federal healthcare spending, according to a report from the nonprofit think tank Urban Institute.
For its analysis, the Urban Institute estimates state-by-state implications if the U.S. Court of Appeals for the 5th Circuit upholds a Texas judge's ruling repealing the federal health law. Plaintiffs in the case argue that the tax law signed by President Donald Trump in December 2017, which eliminated the law's individual mandate penalties, made the mandate unconstitutional and the rest of the ACA invalid.
The Urban Institute used 2019 ACA marketplace enrollment and premiums, as well as recent Medicaid data, to estimate state-by-state implications should the appeals court rule in favor of the plaintiffs. The estimates consider elimination of the entire ACA and the reinstatement of pre-ACA Medicaid expansion waivers.
If the ACA is repealed, the report estimates that:
1. The nation's uninsured rate would climb by 19.9 million, or 65 percent.
2. Federal healthcare spending would decrease by 35 percent, compared to ACA-level spending on marketplace subsidies and Medicaid/Children's Health Insurance Program acute care for the nonelderly.
3. State spending on Medicaid/CHIP would decrease 6 percent compared with ACA-level spending on acute care for the nonelderly.
4. Demand for uncompensated care would increase 82 percent compared with ACA levels.
Access the full report here.
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