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Out with Obamacare? That’s Okay, There’s Still the Affordable Care Act

Out with Obamacare? That’s Okay, There’s Still the Affordable Care Act

Posted Jan 19, 2017 by Jenifer Dorsey

A Look at Healthcare Reform Fact, Fallacy, Fate as 'Repeal and Replace' Moves Toward Reality

There’s a facebook exchange circulating online that essentially boils down to this: One user celebrates the imminent repeal of Obamacare only to reveal that he thinks his own health insurance is safe because he isn’t covered by Obamacare, he’s covered by the Affordable Care Act.

The problem is Obamacare doesn’t really exist; it is a nickname for the Affordable Care Act. Consumers, insurers, politicians and the media have used the terms Obamacare, Affordable Care Act, and ACA interchangeably since before the healthcare reform law was passed in 2010 and its individual shared responsibility provision (i.e., mandate) took effect in 2014. As such, scenarios like the one above were playing out long before the 2016 election and Trump administration.

Stories such as these may elicit chuckles and eye-rolls, but the truth is conversations in social media, real life, the comments sections of news articles, and even news articles themselves are rife with confusion. It can be difficult to tell fact from fiction, and the truth is that nobody knows with any certainty what is about to happen as the incoming Trump administration prepares to repeal and replace Obamacare.

Here is what we do know:

What’s happened so far

Through a process known as reconciliation, the Trump administration’s promise to repeal and replace has been set in motion with the following votes:

January 12 – Senate approves a budget resolution by a final vote of 51-48[1]

January 13 – House passes budget by a final vote of 227-198[2]

However, there has not yet been an official repeal and a replacement has not yet been proposed. Furthermore, no timeline has been proposed, which means everything currently remains business as usual with the ACA.



Fact or Fallacy? What’s really at stake

Here, we look at the accuracy of five remarks you may have overheard, read or even thought yourself.

1. If Obamacare goes away, the Affordable Care Act will remain in place.

False. Obamacare and the Affordable Care Act are the exact same thing. Obamacare is a nickname. That means if what you call Obamacare is repealed, then so is the ACA and vice versa.

2. Obamacare is government health insurance.

False. Regardless of what you call it, Obamacare or the Affordable Care Act, it is not government health insurance—even though federal and state governments operate exchanges that sell coverage and taxpayer dollars are used for subsidies that lower monthly payment and out-of-pocket costs.

Private health insurance companies sell the individual plans you buy on or away from the ACA’s state-based and federally facilitated exchanges (i.e., HealthCare.gov, the Health Insurance Marketplace). The ACA is federal regulation that such companies must follow, including the requirement that nobody can be denied coverage based on health history and the inclusion of specific benefits, among others.  

3. I don’t buy health insurance from HealthCare.gov, so a repeal won’t impact me.

False. All major medical insurance plans sold on and away from the ACA’s state-based, partnership and federally facilitated exchanges are subject to the law’s key provisions, including essential health benefits, guaranteed-issue coverage, and the inclusion of certain preventive services at no extra cost.



4. A repeal means your health insurance subsidy will go away immediately.

It depends. Currently, the law remains in place as does its funding. A repeal and delay likely means subsidies (i.e., premium tax credits and cost-sharing reductions) remain in effect until a replacement plan is passed. A repeal and replacement could mean they go away immediately, depending on the final replacement plan. However, as CNN Money reports, “the House now will likely have to support the cost-sharing subsidies since killing them would wreak havoc in the individual market.”

All we know for certain is subsidies remain available and your 2017 subsidy is still in effect, as of January 17, 2017.

5. There’s no need to enroll in a health plan since everything will change when Trump takes office.

False. Of course, the decision is yours to make, but keep in mind that the ACA remains in effect, which means if you are not exempt from the individual shared responsibility provision (i.e., mandate), you may owe a tax penalty for going without minimum essential coverage. Of course, the threat of a tax penalty is not the only reason to obtain major medical insurance. Major medical plans help you pay for healthcare—expected and unexpected. Without it, you may have to pay all medical bills entirely out of pocket.

Premium tax credits and cost-sharing reductions remain available. You may be eligible for one or both of these subsidies if you qualify based on income, apply for them, and purchase your health plan through a state-based, partnership or federally facilitated exchange.


Estimate your 2017 subsidy


What happens next

The ACA could be repealed with a delay or with a replacement, as explained by Money magazine. The former would mean key aspects of the repeal would be delayed and many ACA provisions would remain as-is for a few years until a replacement plan is passed.[3] In the latter outcome, the ACA would be repealed and a replacement would take effect as soon as possible.[4]

A lot still needs to be sorted out and, as reported by The Atlantic, the Senate committee must draft the reconciliation legislation in a process linked to the passage of the budget.[5] Politicians are divided on what should happen, even within their own parties.[6]

Right now, all any of us can do is stay informed, contact our elected officials to weigh in with how we’d like them to proceed, and buy coverage for this year. Open enrollment for 2017 health insurance plans runs through January 31.


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[1] Kurtzleben, Danielle and Ailsa Chang. “Senate Takes First Step to Repeal Obamacare – So What’s Next?” NPR. Jan. 12, 2017. http://www.npr.org/2017/01/12/509441874/senate-takes-first-step-towards-repeal-of-obamacare

[2] Weyl, Ben. “House Takes Major Step Toward Obamacare Repeal.” Politico. Jan. 13, 2017. http://www.politico.com/story/2017/01/house-budget-obamacare-repeal-233589

[3] O’Brian, Elizabeth. “Obamacare Repeal: What You Need to Know Right Now.” Money. Jan. 17, 2017. http://time.com/money/4633181/obamacare-repeal-what-now/

[4] Ibid.

[5] Newkirk II, Vann R. “The Limits of Using Reconciliation to Repeal Obamacare.” The Atlantic. Jan. 13, 2017. https://www.theatlantic.com/politics/archive/2017/01/reconciliation-obamacare-repeal-gop-strategy/513059/

[6] Kurtzleben, Danielle and Ailsa Chang. “Senate Takes First Step to Repeal Obamacare – So What’s Next?” NPR. Jan. 12, 2017. http://www.npr.org/2017/01/12/509441874/senate-takes-first-step-towards-repeal-of-obamacare

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