ACA Repeal – Good or Bad for Doctors?

As Trump is sworn in as the 45th President of the United States, the Republican-led Congress is making strategic moves to repeal the Affordable Care Act (ACA), a.k.a. “Obamacare.” Despite their promises to immediately replace the ACA with a new plan, no solid details have been given out by Trump or Republicans.

 

The effects of the ACA on the lives and practice of doctors has been complex, and opinions as to whether the law has been good or bad for doctors are clearly divided along party lines. There is high anxiety surrounding the proposed repeal from patients and doctors alike. Without a clear plan in place, it’s hard to know how a repeal would affect doctors and the future careers of current med school students.

 

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Here are some concerns when considering the repeal:

 

  • Fewer patients in a smaller insurance pool – The ACA has enabled roughly 22 million previously-uninsured Americans to purchase health insurance or obtain it through expanded Medicaid programs. The ACA also has rules in place that end pre-existing condition exclusions for children, allow young adults under the age of 26 to be covered under their parents’ insurance and prohibit arbitrary withdrawals of insurance coverage. If repealed with no immediate replacement, millions of people could be dropped from their plans and left unable to purchase new plans. Fewer people with insurance equals fewer patients seeking regular treatment from physicians.

 

 

  • Reduction of red tape for doctors – Limiting regulation and the burden it places on small business (including doctors’ offices) has been a major platform of Trump’s campaign. Additional paperwork and non-clinical duties take doctors away from time with their patients. Even before the ACA, independent practices were being bought up by hospital networks and larger corporations. Physicians have widely reported that the additional administrative burdens imposed by regulations such as the ACA, have been a substantial roadblock to creating and running profitable physician-owned doctors’ offices. A replacement for the ACA could conceivably take steps to reduce the red tape and give incentives to independent practice.

 

  • Handing regulation to the states – An idea that is gaining ground is the possibility of handing responsibility over to the states. This could create an environment of experimentation in healthcare by allowing different types of policies to be tested and evaluated simultaneously. This solution could even give doctors themselves a stronger voice in shaping the policies within their own states.

 

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With all the uncertainty around the “repeal and replace” movement, one thing is certain:  doctors are on the front lines when it comes to the effects of policy changes on the ground. The evolving legislature will impact the profession for years to come. It’s essential that doctors and almost-doctors communicate with elected officials, professional organizations and the media to help shape the future of healthcare policy.

 

If you need to study up on the ACA, here is a great primer.

 

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Laurie Breen

Laurie Breen is a freelance writer well-versed in research communications and grant writing. She received her Bachelors Degree in Psychology from Smith College and has worked previously at the University of Queensland's Centre for Clinical Research in Brisbane, Australia. Her favorite conversational topic is "antibiotic-resistant bacteria," making her a big hit at parties.