Pennsylvania would be among the hardest hit states if Obamacare were repealed | News | Pittsburgh | Pittsburgh City Paper

Pennsylvania would be among the hardest hit states if Obamacare were repealed

The Affordable Care Act, aka Obamacare, is not as safe from being repealed as Americans might think. Even though the law survived several appeal attempts by Congressional Republicans, the ACA is still under attack in federal courts.

The 5th Circuit Court of Appeals in Texas is due to rule on the Republican-backed Obamacare challenge soon, which could strike down the law. Legal experts expect the case ruling, whatever it is, to be appealed to the U.S. Supreme Court with an ultimate ruling possible in the middle of 2020.

And if the courts were to strike down Obamacare, Pennsylvania would be one of the hardest hit states, according to a 2019 study from the Urban Institute.


According to the study, 858,000 Pennsylvanians would lose coverage if Obamacare is repealed. Pennsylvania would have more than 1.5 million people without health insurance, instead of the 644,000 currently uninsured.

Losing Obamacare would lead to a 133% increase in the uninsured rate in Pennsylvania. This would be the eighth highest percentage drop in health insurance coverage of any state.

In total, about 20 million Americans would lose health insurance if the ACA is repealed.

Pennsylvania would also have high spikes in demand for uncompensated care under a repeal. Uncompensated care, when people are treated by lack health insurance or can’t make payments, is funded by federal, state, and local governments, as well as the hospitals themselves.


Demand for uncompensated care in Pennsylvania would increase by $1.8 billion, a 116% jump, which is well above the projected 89% U.S. average increase.

“Funding for uncompensated care is not guaranteed to increase to meet this additional demand; consequently, a significant share of this increased demand could translate into further unmet medical need,” reads the study, which notes that Pennsylvania is among the states most affected because of Medicaid expansion, which the commonwealth expanded in 2015 under the direction of Gov. Tom Wolf (D-York). “ACA Medicaid expansion states with large low-income populations and narrower pre-ACA Medicaid programs would be among the states experiencing the largest increases in demand for uncompensated care.”

The administration of President Donald Trump has been supportive of legal efforts to repeal the ACA. And actions by the Trump administration have likely had an effect on decreasing health insurance coverage for Americans, even before any potential repeal of Obamacare.

According to a September report from the U.S. Census Bureau, the number of Pennsylvanians without health insurance rose by nearly 7,000 between 2017 and 2018. That means 699,000 Pennsylvanians were uninsured in 2018, compared 692,000 in 2017.
After Obamacare was signed into law in 2010, the Pittsburgh area was actually one of the most successful regions in the country in getting people insured, decreasing the region's uninsured rate from 9.5% in 2012, before the ACA marketplace was created in 2014, to 4.5% in 2016.

Since taking office, Trump has drastically cut advertising funding for the ACA, and shortened the window in which people have to apply for health-insurance coverage.


Rates for the ACA have also risen under Trump. ACA marketplace premiums in Pennsylvania increased significantly between 2017 and 2018, with the average lowest-cost bronze premium option jumping from $286 monthly to $365. The lowest-cost silver premium also increased more than $100, from $371 in 2017 to $494 in 2018.

A 2018 analysis from the Henry J. Kaiser Family Foundation found that the consistent attacks on the ACA would lead to nationwide premium rates increase by 6-16%.

The deadline to enroll for 2020 ACA health-insurance coverage is Dec. 15, 2019.

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