Repealing ACA would leave more Americans uninsured, says former ONC chief
What would happen if we repealed the Affordable Care Act? David Blumenthal, MD, president of the Commonwealth Fund, told attendees at Maine Health Management Coalition and Maine Medical Association Symposium on October 27.
If Medicaid funds remained the same, the country would lose about another 10 million insured, Blumenthal said. "Any way you put these proposals together, it results in more uninsured Americans."
Referring to the proposed health plan of presidential nominee, Donald Trump, Blumenthal stressed the changes would not create better coverage for Americans – especially in rural areas.
The former National Coordinator for Health IT also took to task the current state of the U.S. health system during the conference, through what he called an ‘annual check-up.' He analyzed quality of care, access, cost and equity of services.
The results are surprising. Hearing some of the discussions regarding healthcare today, you wouldn’t know there are a lot of positive things to say about today’s health system, Blumenthal explained.
From 2001 to 2013, the annual rate of improvement for quality measures have improved for the majority of patients, including a fairly dramatic reduction in hospital-acquired conditions over the last four to five years.
Further, as more people become insured, there have been a dramatic reduction in care quality gaps. And EHRs improve care quality through the reduction of adverse drug events.
But the health system is still riddled with flaws.
Far too many patients are being hit with high deductibles, with some facing deductibles of $3,000 or more. And the employed population is experiencing a cost shift that wasn’t there 20 years ago.
"These deductibles expose people to cost of care," Blumenthal said.
The U.S. health sector has the largest GDP when it comes to healthcare, at 17.4 trillion. It’s followed by China, with 10.4 trillion GDP.
"Providers are concerned about narrow networks and high deductibles," Blumenthal explained. "Rural and poor countries lack true competition because it’s not an attractive place to attempt to sell insurance - which is why the high deductibles are rising."
"There are plenty of ways to make the marketplace a success and improve enrollment," he added. "We’re just not doing it.
Blumenthal’s biggest disappointment, however, is in terms of the ACA. Only 31 states enrolled in Medicaid expansion. And it’s been proven that uninsured rates are very closely related to expansion.