It took President Donald Trump just hours after taking the oath of office to sign an executive order directing federal officials to do what is possible to dismantle the Affordable Care Act.
And while experts differ on the impact of this action alone, Democratic leaders in New Jersey are wasting no time in spelling out what a repeal of the landmark law — or other federal reforms envisioned by the new president — will mean for the Garden State.
Senate President Steve Sweeney (D-Gloucester), Majority Leader Loretta Weinberg (D-Bergen), Budget Chairman Paul Sarlo, (D-Bergen,) and health committee chairman Joseph Vitale (D-Middlesex) announced Sunday afternoon they will gather in Trenton today to discuss some of the “costs and consequences” to New Jersey from “parts of the political agenda” of the new president and the Republican-led Congress.
Vitale, who has long championed efforts to expand healthcare coverage, has also started to assemble a task force of experts to address the impacts of ACA changes and help state officials evaluate their options to protect as many residents as possible.
Congressman Frank Pallone (D-Monmouth), a longtime advocate for the ACA, called the new president’s first action “deeply disturbing” and predicted it would result in healthcare “chaos” and “economic uncertainty.”
Sen. Cory Booker (D-NJ) took to Twitter from the Women’s March on D.C. to highlight a recent report from the nonpartisan Congressional Budget Office that predicted a repeal of the law would leave 18 million people uninsured in the first year and up to 32 million by 2026. The report also predicts insurance premiums will jump by up to 25 percent in one year and could double by 2026, if the law is ended without any replacement.
GOP pledges to “repeal and replace” the ACA have sparked widespread concern nationwide from patients who gained coverage from the 2010 law, healthcare advocates who have seen the benefits of its changes, and many in the healthcare industry who have spent billions of dollars adjusting to its reforms. Hundreds of New Jersey residents have taken to the streets in recent weeks to urge Republicans in Congress to vote with Democrats against any repeal.
Experts suggest up to 800,000 working-poor state residents could lose the insurance they gained in recent years under a repeal, while millions more could face higher insurance costs or less complete coverage. Budget analyses indicate ending the law could also leave New Jersey with a budget hole of up to $4 billion, if federal funding for the Medicaid expansion portion of the law were suspended. The state would also be saddled with an escalating tab for Charity Care, or hospital care for those without insurance, which it has cut by $350 million in the past year alone, thanks in large part to expanded ACA coverage.
Republican leaders in Congress approved a budget resolution last week that paved the way for an easier repeal and Sen. Tom Price (R-Georgia), a physician who is Trump’s pick to lead the federal Health and Human Services administration, has in the past advocated for major changes to both Medicaid and Medicare. However, Price appeared to hedge a bit during his confirmation hearings last week, suggesting no Americans would lose coverage under a reform. Trump had tweeted similar vague promises before he took the oath of office Friday, but observers said his first action in the Oval Office — the executive order signed that afternoon — could make this more complicated.
The single-page order — which was not available on the official White House website, as of Sunday — was seen as a powerful political statement by many, according to media reports, but observers differed on whether it was more symbol than substance. The EO directs members of his administration to use the powers they have under existing law to revise, waive, or delay provisions of the law they deem “overly costly for insurers, drug makers, doctors, patients or states,” according to the New York Times. It also directs officials to create a system that allows for insurance to be sold across state lines, something Republicans believe will help reduce costs and increase access, but provided little other detail regarding next steps.
Regardless of the order, the real work to repeal the existing law — and craft any replacement — lies with Congress, observers agreed. But regardless of the immediate impact, Pallone was among those who urged the president to reconsider: “This action only encourages Congressional Republicans to move forward with repealing the Affordable Care Act, which would strip healthcare away from millions of Americans, and increase costs, and limit benefits for millions of others. If President Trump really believes the dark picture he described in his Inaugural Address, he should seriously reconsider any actions that will create chaos in our healthcare system and economic uncertainty,” Pallone said.