With President-elect Donald Trump’s inauguration one day away, congressional Republicans are setting in motion the repeal of the Affordable Care Act. One issue particularly relevant to us — which Sen. Tim Kaine (D-VA) spoke of last Friday at the Medical School — is whether we will continue to remain under our parents’ health insurance coverage plans until the age of 26, a key provision under the ACA.
Fortunately, this ACA item, along with one that prevents insurers from denying coverage to those with pre-existing medical conditions, receives support across party lines, including the president-elect. However, the individual mandate, which makes the more popular provisions sustainable by insuring generally healthy individuals and introducing them to the risk pool, has stood in the crosshairs of Republican politicians and rightwing commentators for years now. Republicans should look for ways to improve the ACA rather than trying to isolate its provisions which are unworkable by themselves.
Unfortunately, GOP leaders have not yet coalesced around a unified vision for what a reformed health care plan will look like in practice. Some have advanced a continuous coverage mandate which would prevent higher insurance premiums for individuals with pre-existing conditions, as long as they have no gaps in coverage. But with underinsurance already a problem for about 30 million Americans, and with a reduction of insurance subsidies proposed by Republican leaders, it’s hard to see how many will be able to maintain continuous coverage.
Other Republicans have proposed slashing the 10 categories of essential benefits that insurers are required to provide, ranging from maternity and newborn care to mental health care. While this would improve profit margins for insurers, it would result in less comprehensive health insurance plans for Americans. Cost-cutting measures may support coverage of more young adults, but preserving popular ACA provisions should not come at the expense of guaranteeing basic health services that those of us in college will one day need.
There’s no silver bullet to solving health care in America. It’s hard to achieve the trifecta of lower costs, better quality and broader coverage, and it’s no secret that the ACA needs improvement. With “repeal and replace” looming, however, students should take an active role in holding our government accountable to not only letting us stay on our parents’ insurance longer, but also to ensuring continued and better coverage for everyone.
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