Two student groups from the University of Michigan Law School, the Michigan Health Law Organization and the Law School Democrats, hosted a talk Thursday morning concerning the repeal of former President Barack Obama’s health care law, the Affordable Care Act, and its replacement, the American Health Care Act.
The panel, which included Public Health Prof. Marianne Udow-Phillips, Terry Campbell, regional manager of Sen. Debbie Stabenow’s office, and multiple law students, addressed the impact the ACA has had on them personally and on the United States, as well as what the new American Health Care Act legislated under the President Donald Trump’s administration will mean for people previously covered by the ACA.
The discussion began with Udow-Phillips explaining the groundwork of the Affordable Care Act. She emphasized the centrality of Obama’s push for coverage.
“Health care is a social good, and should, in fact, be provided by government in some way, shape or form,” she said.
Still, for decades, presidents current and former have struggled with the issue of how health care should be provided.
Udow-Phillips stated there are essentially only two ways to accomplish universal coverage: a national service or tax system, such as Medicare or Medicaid, or an employment-based system or mandate. The ACA, she said, is a combination of the two.
There is difficulty not only in creating, but also in overcoming the technical issues of implementing it effectively. According to Udow-Phillips, when former President Bill Clinton’s health care plan was first drafted, Republicans were opposed to having everyone pay into the health insurance system because they might not directly be paying for themselves. This is something Udow-Phillips opposed.
“If everybody just paid a little bit into the system, then we could pay for the people who are sick at that moment.” Phillips said. “Then, when those healthy people get sick, those other dollars are there to pay for them. That is the fundamental principle of insurance.”
The talk continued with an explanation of what the Affordable Care Act accomplished. According to Phillips, though Democrats were against the idea of the responsibility for insurance being left to the individual, they agreed it might be a start to a comprehensive and bipartisan health care plan in coming years. “Obamacare,” she explained, aimed to expand Medicaid coverage to as many people as possible, as well as lower the cost of individual insurance.
Since the implementation of the ACA, Phillips said, Congressional Republicans have stuck with the idea of “repeal and replace.” And until Trump was elected to the presidency, it seemed that this wasn’t a likely possibility.
Now, with the creation of the ACHA, many Americans are at risk of losing their health coverage. The ACA offered tax credits based on income to provide those with lower income access to health care. The ACHA shifts credits from being based on income to age, and the elderly, low-income people and people with pre-existing conditions face the possibility of no longer having easily accessible health insurance.
During the talk, Campbell expressed concern that those covered under the ACA will become vulnerable to increased costs under the ACHA.
“The plan coming out of the House right now is a big mess," she said. "And leaves millions of Americans with pre-existing conditions at the mercy of insurance companies yet again.”
She also mentioned the possibility that the ACHA will fail to be approved by Congress if changes are not made. However, Campbell noted this is not a death sentence for the ACHA, and if changes that appeal to different voting blocs are introduced, it could pass in the U.S. House of Representatives.
The talk concluded with several law students sharing their personal stories of how the Affordable Care Act has impacted their lives. Emmanuela Jean-Etienne, a third-year Law student, recalled an experience in which the ACA saved her uncle thousands of dollars after she had to make a late-night visit to the emergency room.
“The ACA was an attempt to allow families to not think about the financial burden that taking care of their health would have on them,” she said.
Jean-Etienne spoke about her belief that health care is a civil rights issue because those who could lose coverage may be among the most vulnerable and disproportionately affects people of color.
“If implemented properly, it would be the poor, the sickest, the students of color who would be gaining access,” she said.
Along with several of his peers, first-year Law student Stephen Rees felt hearing the perspectives of other students was extremely valuable.
“I’ve been fortunate enough to be on my parent’s insurance, so I haven’t had to deal with the issues that a lot of other students are going through,” Rees said. “I thought that was useful to understand and empathize with the stress that people are under, and appreciate the accomplishment of the ACA — not just lives it’s saved, but stress and other burdens as well.”