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Is Pennsylvania ready for ‘drastic impact’ on health care if Obamacare is repealed?

A repeal of the 2010 Affordable Care Act would not only potentially cost more than 1 million Pennsylvanians their health care coverage, but other guarantees and consumer protections also would end.

It’s a situation health care and financial experts said could have a catastrophic impact on the state’s economy.

The U.S. Supreme Court building in Washington, D.C.

Here’s a look at what else could end if the Affordable Care Act is repealed.

Medicare Part D benefits improvements

Those benefits include reducing the so-called Medicare Part D drug coverage gap known as the “donut hole,” reducing the coinsurance coverage gap for prescriptions from 100% to 25% and requiring drug manufacturers to provide a 50% discount on the price of brand-name and biologic drugs in the coverage gap.

In 2015, about 297,000 Medicare beneficiaries each saved an average of about $1,000 on their prescription drugs, according to U.S. Health and Human Services Department data. Prior to passage of the ACA, Medicare beneficiaries paid 100% of the cost of their drugs when in the coverage gap.

The Pennsylvania Budget and Policy Center, a nonpartisan policy group, estimated that prescription drug costs in the state would rise $226 million for seniors without donut hole coverage.

The law also includes provisions that prohibit Medicare Advantage plans from imposing higher cost-sharing requirements than traditional Medicare for chemotherapy, renal dialysis, skilled nursing care, and other services deemed appropriate by the U.S. Secretary of Health and Human Services. This prohibition was extended to most Medicare-covered services

Medicare cost savings achieved in the Affordable Care Act would be eliminated, resulting in increased Medicare premiums and deductibles for beneficiaries and accelerate insolvency of the Medicare Hospital Insurance Trust Fund, according to KFF.  The Congressional Budget Office estimated repeal of the ACA Medicare Advantage payment changes would increase Medicare spending by about $350 billion over 10 years (2016-2025).

Prashant Tambe
Prashant Tambe
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