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Public Policy professor analyzes what repealing Affordable Care Act could mean for Rutgers community

A copy of Obamacare repeal and replace recommendations (L) produced by Republicans in the U.S. House of Representatives sit next to a copy of the Affordable Care Act known as Obamacare as U.S. Health and Human Services Secretary Tom Price addresses the daily press briefing at the White House in Washington, U.S. March 7, 2017.   REUTERS/Carlos Barria
A copy of Obamacare repeal and replace recommendations (L) produced by Republicans in the U.S. House of Representatives sit next to a copy of the Affordable Care Act known as Obamacare as U.S. Health and Human Services Secretary Tom Price addresses the daily press briefing at the White House in Washington, U.S. March 7, 2017. REUTERS/Carlos Barria

With Congress set to vote on a Republican alternative for the Affordable Care Act today, some members of the Rutgers community are sharing their opinions on what this means for students and staff alike. 

Distinguished Professor Joel Cantor is speaking out on what the GOP’s replacement health care plan could mean for members of the Rutgers community.

As a distinguished professor in the Edward J. Bloustein School of Planning and Public Policy, Cantor has been analyzing New Jersey’s health care system and serving as an advisor to the state for many years.

Naturally, the long-standing Republican campaign promise to repeal and replace the Affordable Care Act (ACA) has garnered much of his attention as a professional, and he said such changes may have serious impacts on our country.

Cantor said that the problem with broad repeal and replace is that there is no consensus about what to replace it with, even among Republicans in Congress.

“There are a lot of ideas on the table from various parties in Congress and from the Trump administration, none of which meet the stated goals of making sure people don’t lose coverage under whatever changes are implemented," he said. "There’s a huge risk that if they start unwinding parts of the law, without having a solid replacement ready, that it’ll cause more problems than we have now.”

The bill significantly restructures Medicaid and allows states to require able-bodied adults to work if they want to be eligible for the program, according to CNN.

The GOP bill still includes some pieces of the ACA, including protections for people with pre-existing conditions, though insurers would be allowed to charge higher premiums to individuals whose coverage has lapsed. The bill also remains to let children stay on their parents' insurance plans until the age of 26, according to CNN.

Cantor said while the ACA certainly has its imperfections, it is, in many ways, unfairly blamed for not fixing problems such as high premiums in the United States health care industry that has long predated the ACA itself. It also had an impact on former President Barack Obama’s election.

Critics of the GOP replacement plan continually point to the positive effects of the Medicaid expansion. For example, around 10 million people gained coverage that otherwise would not have been able to afford health insurance.

“Medicaid is the program for low-income people, and under the Affordable Care Act, the states were in effect given the option of expanding Medicaid eligibility to many more people, low-income people. Some in the GOP just want to repeal that, but there are more than 10 million people who gained coverage, “ Cantor said.

Other Republicans have discussed potentially retaining some aspects of the ACA, and doing away with parts of it that they believe are unfavorable.

David Chapman, a part-time lecturer at Rutgers in the Department of Music, and the secretary of the part-time lecturer's chapter American Association of University Professor-American Federation of Teachers (AAUP-AFT), said that to only keep certain aspects of the ACA is unacceptable and will lead to a collapse of the entire system.

“It’s a carefully crafted piece of legislation. If you remove the mandate, then nobody has to buy insurance, and then no one’s covered, and premiums will skyrocket. If you take away other parts of it, about tax breaks and things of that nature, that’s going to also affect the way that it’s paid for. If less people can access the pool, then it’s not going to be affordable anymore," Chapman said.

He said the GOP has failed to propose anything that would effectively address the real problems within the American healthcare system.

“Although it does have some problems, I think that abolishing the ACA would be a terrible idea, especially with a replacement plan. If we could just fix a few problems in it, it would probably be better for the country,” said Neil Mullengada, a Rutgers Business School first-year student, and a member of the Rutgers University Democrats E-board.

Cantor said health care is extremely critical for college students and Rutgers students will certainly feel the effects of the ACA repealed and replaced.

“Serious mental illness, for example, tends to manifest in early adulthood, and the ACA, for the first time, requires health insurers to cover mental health care. There’s research that shows that this has been a hugely important thing for young people, to have early access to treatment to mental health services, as it can prevent a lifetime of disability," Cantor said.

Cantor also said that for those students without a parent who has an employer-sponsored policy that they can receive coverage from, health care costs could be very low or even free under the Medicaid expansion or the ACA, which would then be a non-option if the GOP moves forward with its plans to dismantle the ACA.

For many part-time lecturers, like Chapman, and part-time employees at Rutgers who rely on the ACA, broad changes to the system pose daunting threats to their future coverage, he said. 

“Currently part-time lecturers teach 30 percent of the courses at Rutgers. And a lot of those part-time lecturers are either not insured because they can’t afford it, or are covered through the ACA,” Chapman said. “Not just part time professors, but other types of part-time workers in general. If you’re not insured, if you’re not taking care of your health, you’re sick not going to get better, you’re often contagious — it’s just bad public policy all around.”

The defunding of Planned Parenthood, a highly controversial focal point, also presents threats to Rutgers students and staff, primarily low-income women for whom it is a valuable resource of quality reproductive and sexual health care.

“The money going to Planned Parenthood doesn’t go to abortions, it goes to birth control, screenings, breast and cervical cancer screenings, and it’s really essential health care for a lot of women. The kind of defunding that is being talked about is going to create huge barriers to women’s health care,” Cantor said.

Cantor said the ACA helped cover about 20 million people that would otherwise be uninsured.

There are absolutely fair critiques that the ACA does not solve the affordability problem because it is still very expensive, Cantor said.

“I don’t think the ACA has solved the affordability problem, but it made a huge dent in it. The proposals on the table would reverse a lot of those gains as opposed to fixing them, Cantor said.

Emma Fletcher is a School of Arts and Sciences junior. She is a contributing writer for The Daily Targum.

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