What Is the Future of the Affordable Care Act?


What happens if the Affordable Care Act is repealed?

Sherry Glied, Dean of NYU Wagner, led a critical discussion of the newly imperiled reform and the future of the health insurance landscape in America, organized by Philanthropy New York, a regional association of grantmakers with global impact.

Dean Glied, a distinguished health policy expert, began by pointing out that before the ACA was passed in 2010, 51 million people could not afford coverage. In the wake of the law and the expansion of Medicaid in 31 states, the number of uninsured has declined by 20 million to 23 million "to the lowest it has ever been in history." At the same time, data show that access to healthcare has improved.

The new Senate, with a total of 52 Republicans, has laid the groundwork for a budget reconciliation process that would enable the chamber to get rid of the ACA's public subsidies with 50 votes, as opposed to the 60 required under a standard bill approval process (the ACA itself was approved through a reconciliation process). Dean Glied said the process does not permit a change of regulations, posing a difficulty.

"I think there is widespread agreement that getting rid of the subsidies without getting rid of the regulations would be pretty devastating," she said — leading to as many as 32 million more uninsured people according to the Congressional Budget Office.

The January 24 panel, also including David Sandman, President of the New York State Health Foundation, and James Tallon, President of the United Hospital Fund, provided needed perspective on these and other possible amendments on the horizon, and how they might affect healthcare consumers and, importantly, the entire philanthropic sector.

Watch the entire discussion