Concerns Over Possible Affordable Care Act Repeal

By David Cruz

It seems inevitable that the Affordable Care Act as we know it, Obamacare, will look different before too long as the president and the Republican-controlled Congress look to back up campaign rhetoric that called the ACA “a total disaster.”

But what would replace the ACA? While most Republicans are on the spectrum between repeal and replace and mend, but don’t end, concrete proposals have been slow to emerge, but that hasn’t stopped critics from predicting gloom and doom (literally) if Congress kills the ACA. Ray Castro is with New Jersey Policy Perspective, a left-leaning think tank, which has just issued a new report detailing the effects of an ACA repeal.

Over 1 million residents would lose benefits, according to the report. The state would lose over $4 billion a year in federal funds; 86,000 jobs would be lost and, most dramatically, the report says almost 800 would die as a result.

“This is what would happen if they repealed and did not replace it,” said Castro. “Unfortunately, we don’t know what they’re going to be replacing it with, but what we’ve heard so far is that it’s not really going to help. In fact, it could make matters worse. For example they’re talking about block granting Medicaid, so Medicaid served a lot of different people including children and seniors in nursing homes, so all of them would be vulnerable to further cutbacks in this replacement, so we’re very concerned about that.”

But Assemblywoman Holly Schepisi, a Republican from Bergen County, says she’s not exactly buying all the apocalyptic predictions.

“I think we would need to ensure that people who do have pre-existing conditions continue to have those conditions covered. I think that’s, for me, a non-starter,” she said. “That’s something that, just from a being human perspective, you want to ensure that people aren’t going to die.”

Schepisi also supports keeping children under 26 on their parents’ health care. But, after that, Schepisi says she’d like to see some more reform, including a hard look at overall health care costs. She also points to the public sector employee health plans, which she says will cost the state dearly in penalties under the ACA.

“Those plans would be designated what’s known as Platinum Plus,” she noted. “As a result of those Platinum Plus plans, what the implication would be if the ACA were to stay in effect is a $750 million fine to the state of New Jersey, under the Cadillac tax.”

Castro says he expects Congress to repeal the ACA, but fears that without a consensus on replacement, almost everybody in New Jersey will be adversely affected.

“We expect that there’s going to be a replacement,” he warned. “Like I said, they have not come to an agreement. There’s a lot of disarray in Washington right now, which is why we’ve asked them to wait before they repeal the legislation until they get their act together. I think that the public has a right to know what they’re going to replace it with.”

The ACA is close to the top of agenda items across the country as members of Congress head back to their districts to hold town halls, although, here in New Jersey, only one Republican member of Congress — Leonard Lance — is doing that. He’s expecting an earful on the ACA, immigration and more.

Mary Alice Williams: That “earful” is being described as “congressional recess rage.” David Cruz is standing by at Representative Leonard Lance’s town hall. David, do you expect the same hostility from constituents here that we’ve seen in other states?

Cruz: We’ll put that question to Congressman Lance, who joins us now. Thanks congressman.

Lance: Thank you for having me David.

Cruz: So they’re calling it recess rage. What do you expect here tonight?

Lance: I hope we can have a civil discussion. I try always to be respectful of constituents and I would like to hear the points of view of my constituents and I hope that I’m permitted to respond. And that’s what I expect. This is a well educated congressional district. It is my honor to serve the district. And we’ve tried to have a venue where as many constituents as possible are able to participate. And we’re having a second town hall meeting back here at Raritan Valley Community College on Saturday morning.

Cruz: You do about 10 of these a year I’m told. This, I imagine, is going to be one of the more interesting ones.

Lance: I think they’re all interesting and I have had a large town hall meeting here in the past when I was first in Congress. I do 40 or so over the course of eight years in person and 40 or so on the telephone and undoubtedly we will be doing telephone town hall meetings as well this year. But this is the first district work week in a while and I’ll be back in Washington for six weeks and I thought it was important to do live town hall meetings this week.

Cruz: Some of your congressional colleagues here in New Jersey have been criticized because they’re not facing voters directly. Is that a fair criticism?

Lance: I think it’s the responsibility of each member of Congress to decide what’s best for his or her district. I enjoy town hall meetings and I hope we can have a civil dialogue tonight. I recognize that many people are concerned and I want to assure the constituents in this district that I favor a repair of Obamacare, the Affordable Care Act. Repeal and replace, not just repeal. And I’ve always been opposed just to repeal. I do not want to go back to the status that existed before the enactment of the law in 2010.

Cruz: The ACA is going to be probably, I would imagine, number one on the agenda item here for residents. Your goal here is to reassure them that you’re not one of those Republicans who wants to just repeal.

Lance: That’s correct. I’ve run for election on the issue that I favor replacing it and those are my considered views and I think there will be other issues of importance — fundamental tax policy, the international situation, our relationship with Russia, our relationship with NATO, the actions of the new president and, for example, the very important matter of confirmation of a potential Supreme Court justice. There are lots of issues that I hope we can discuss this evening.

Cruz: You’ve been in public service for several decades now. I have to ask you what you think of the reaction to this president and your reaction to this president.

Lance: I supported the entire Republican ticket last autumn. I know some people are disappointed. The president did not carry New Jersey, Secretary Clinton carried New Jersey. I certainly was disappointed when Gov. Romney was not elected president, so I know what it’s like to be disappointed. Certainly I have constituents who are very much in favor of President Trump, but I recognize sometimes people are disappointed with an election outcome and I think it’s important for all of us to work together in a bipartisan capacity. And I certainly will support the president when I can, but when I disagree with him I will not be afraid to criticize him. For example, I thought his immigration order regarding the countries in the Middle East was poorly drafted. I certainly don’t think it should’ve considered those with green cards or those who may have been translators or interpreters in the Middle East. And of course he has pulled it back to some extent. It’s in the courts. And I hope that he redrafts it.

Cruz: All right, we’ll leave it there. We’ll let you get ready for tonight. Mary Alice, it should be an interesting night here tonight.

Watch our live stream of Congressman Leonard Lance’s town hall.