Harrisburg, PA – Insurance Commissioner Teresa Miller today said Pennsylvania U.S. Senator Pat Toomey’s comment supporting repeal of the Affordable Care Act without a replacement health care plan in place puts the health care of millions of Pennsylvanians in jeopardy.
“Senator Toomey’s comment to Fox Business News Friday that he supports repealing the Affordable Care Act (ACA) without legislation to replace this vital lifeline is irresponsible and frightening. Sen. Toomey glibly assumes Congress will come up with a replacement health plan to provide coverage for his constituents by whatever arbitrary deadline is set, but in doing so, he ignores his own history and his constituents’ well-being” Commissioner Miller said.
“Sen. Toomey’s support for doing away with the ACA without a replacement is putting in jeopardy the health coverage 1.1 million Pennsylvanians now have through the individual market, and Gov. Wolf’s expanded Medicaid program. If the ACA simply goes away, so does expanded Medicaid, and the vital health care access it provides to 700,000 Pennsylvanians.
“This includes Anna, from York County, who recently told me her story of having two children with severe, chronic health conditions, and for whom expanded Medicaid provides a vital lifeline Her family has insurance, but the costs of continuing care for their children, even with private coverage, was forcing Anna’s family to choose between paying their monthly utility bills, and buying needed medicine for their children. Under expanded Medicaid, Anna’s family can now pay their monthly bills on time.”
Approximately 426,000 Pennsylvanians selected a plan for 2017 through the healthcare.gov exchange, with nearly 80 percent of these individuals getting subsidies to help pay their monthly premiums, and roughly 55 percent, those with lower incomes, receiving cost-sharing reductions to help pay deductibles, co-pays, and co-insurance. All of these subsidies and cost-sharing reduction payments would cease if the ACA ends, leaving health insurance unaffordable for most of these people.
“Even people with employer-sponsored coverage would be dramatically affected if the ACA simply ends, as this would also mean the end to mandated coverage of preventive services by their federally regulated plans,” Miller said. “These services include colonoscopies, annual screening mammograms, well-baby and well-child visits, among others. In addition, many employer-sponsored plans could revert to having annual and lifetime benefits limits, allowed before the ACA, which would mean huge out-of-pocket costs for people who hit those limits. These are often people with chronic conditions or expensive-to-treat diseases, such as diabetes, heart disease, and cancer.
“The ACA helps many families with employer-sponsored and individual coverage by allowing adult children to remain on these plans through age 26. These young adults may be completing their education, working part time, or in entry level jobs that don’t provide benefits, and this provision of the law gives them time to get their careers started and to begin paying down other expenses, such as student loans, without worrying about paying for health insurance.
“Another important provision of the ACA is the ban on excluding pre-existing conditions from coverage. Prior to the ACA, many plans would not cover pre-existing conditions, or would only cover them after a waiting period, or they forced those with pre-existing conditions into extremely expensive plans.
“Sen. Toomey needs to speak with Carl, from Cumberland County, who before the ACA, lost his insurance because a pre-existing condition spiked his premium from $400 to $3,400 a month in two years, forcing him to drop coverage and face potential financial ruin. Under the ACA, Carl, age 62, got affordable coverage because his pre-existing condition could not be excluded and could not affect his premium rate.”
Miller noted that before the ACA many policies considered pregnancy to be a pre-existing condition, and maternity care was often not included in policies.
“Placing a deadline before Congress and expecting its members to act by that deadline is far from a guarantee they will do so,” Miller said. “In 2013, Sen. Toomey was part of a group in Congress known as the “super committee” that was supposed to come up with a budget plan to avoid what is known as “sequestration,” or deep budget cuts to both domestic and military spending. The conventional wisdom was this deadline would force Congress to act to avoid this option. However, Sen. Toomey and his colleagues failed to come up with a plan that was even voted on and these budget cuts went into effect.
“Pennsylvanians need to keep this history in mind, and not allow their health care to be put in jeopardy with a vague promise that Congress will come up with something before an arbitrary deadline returns health insurance to the very consumer un-friendly situation that existed prior to the Affordable Care Act.”
She also noted Sen. Toomey was among 13 GOP senators who crafted the current Senate health care replacement proposal in secret. This plan, which has not come to a vote, would result in 22 million Americans losing coverage, keep the age tax to penalize older people needing coverage and would drastically cut subsidies and increase out-of-pocket costs.