DEANNA JULIAN: Affordable Care Act should be fixed, not gutted

Far too many Americans with disabilities are facing a future with the prospect of losing access to health care. Access to comprehensive, affordable health care coverage can make or break the lives of any American, but it is particularly crucial for people with intellectual and developmental disabilities (I/DD).

The Congressional Budget Office (CBO) released a report on Jan. 17 that estimated 18 million people would become uninsured if the Affordable Care Act (ACA), dubbed “Obamacare” by some, was repealed without a back-up plan. Albany Advocacy Resource Center and advocates around the state are asking legislators to fix, not gut, Obamacare.

The Affordable Care Act, which Congress is poised to repeal soon, has been a lifeline for people with intellectual and developmental disabilities. People with I/DD can require a comprehensive array of health services, including behavioral health, rehabilitation and habilitation, assistive devices, and long-term supports and services. The ACA, by increasing access to private health insurance, and by allowing states the option to expand their Medicaid program, has helped people with I/DD live healthy and independent lives.

In addition, the law also bans companies from imposing dollar limits on health benefits and provides support to states’ efforts to keep people out of institutions. Several provisions of the ACA were designed to assist states to rebalance their longterm support systems and invest in the community instead of costly and outdated institutions.

Repealing ACA would be devastating for all who have finally found coverage in the last seven years. It would also undermine the health and long-term supports provided by the Medicaid program. It will force states to make tough choices about eligibility and access to services, and it could cause substantial competition between diverse groups (children, people with disabilities, the elderly) for scarce resources.

States would also be faced with how to finance the cost shift from the federal government to the states and may look to beneficiaries, family members, providers, tax increases and other ways to make up the difference. Significantly increased cost-sharing is not affordable for people with I/DD who receive Medicaid.

The ACA has unquestionably improved access to care for people with disabilities and chronic conditions to help them live healthy, independent, and fulfilling lives. To eliminate the ACA without simultaneously replacing it with a functionally equivalent alternative, jeopardizes this progress and puts consumers’ ongoing access to comprehensive, affordable coverage at risk. It is critical that the I/DD community is a part of any discussion about repeal and replace to ensure that any changes meet the needs of people with disabilities.

DeAnna Julian is deputy director of the Albany Advocacy Resource Center.