Ever since the Affordable Care Act was passed in 2010, congressional Republicans have been waiting to repeal it. Despite promising to follow through with this plan for the past six years, Republicans have not come up with a replacement and have failed to prove how repealing the ACA will be better for everyone. Unfortunately, attempting to repeal the ACA without a replacement will have detrimental effects on not only the 22 million people currently covered by the ACA, but also the economy of the country and North Carolina.
Eliminating health care for 22 million people will come with substantial human and economic costs for jobs, state budgets, and hospitals. By 2019, ACA repeal would eliminate $61 billion nationally in tax credits from those who currently depend on these subsidies to afford health insurance. Repeal also would cut $78.5 billion in federal grants to states for the expansion of Medicaid, potentially wreaking havoc on state budgets.
Researchers estimate a loss of approximately 2.6 million jobs nationwide due to repeal by 2019, with a loss of 76,200 of those jobs in North Carolina. The job loss will first hit the health care sector, then ripple out to other sectors as a result of lost wages and reduced purchasing of goods and services.
Eliminating the health insurance provided by the ACA will reduce revenue to hospitals, community health centers, physician practices, and other providers. In 2019 alone, these providers will lose $146 billion nationwide. Meanwhile, they will be expected to deliver $88 billion in care to people no longer able to pay their bills. The only way for hospitals and doctors to avoid such costs would be to deny care. Both urban and rural hospitals expect to be especially hard hit, with some hospitals facing possible closure. North Carolina’s hospitals and physician practices will see their income reduced by $3.78 billion. North Carolina’s hospitals would see an increase of $818 million in uncompensated care and physician practices would see an increase of $410 million in uncompensated care.
Repealing the ACA would eliminate significant infusions of federal dollars into state economies and budgets – which also support schools, roads and other services – while loss of business output resulting from the withdrawal of ACA funds would additionally depress state and local tax revenues. Between 2019 and 2023, the loss of these funds will cost North Carolina residents $24.9 billion in federal funds. It will cost almost $1.2 billion in state and local tax revenue.