Until he qualified for Medicare a year ago, Tucsonan James Bier bought his health insurance on the Affordable Care Act’s online marketplace.
“I wasn’t working so I didn’t get it through my employer,” Bier said. “”I wasn’t old enough or disabled, so I wasn’t on Medicare. I wasn’t poor enough for Medicaid. And I had preexisting conditions. So I basically couldn’t get insurance until the Affordable Care Act came along.”
Bier, a Tucson native who worked as an editor in journalism and publishing, obtained coverage shortly after plans became available and said that thanks to subsidies based on his income, “it was very affordable.”
Bier is among the local supporters of the ACA, which was signed into law by President Barack Obama on March 23, 2010. But as the law’s 14th anniversary arrives, the congressional Republican Study Committee this week released a budget policy blueprint calling for the ACA’s repeal and on the campaign trail, presumptive GOP presidential nominee Donald Trump has been vowing to sign legislation eliminating the health insurance law if he returns to the White House.
The renewed calls to repeal Obamacare come after a record number of Americans purchased insurance plans through the exchange. New subsidies in the Inflation Reduction Act brought down the price of policies and more than 21.3 million people across the nation signed up for coverage before the 2024 enrollment period ended in January. In Arizona, that number topped 348,000.
A full repeal of the law would shut down the online marketplace where people can buy policies, allow insurance companies to hikes rates for or simply refuse to insure people with preexisting conditions, remove the current caps on out-of-pocket spending and no longer require insurance companies to allow children to stay on their parents’ policies until they are 26 years old, among other popular provisions.
U.S. Rep. Raúl Grijalva, a Democrat who represents Southern Arizona’s CD7, criticized the GOP’s proposed budget, which also calls for a increasing the Social Security retirement age to 69 over time and repealing a provision in the Biden administration’s Inflation Reduction Act that allows the Medicare officials to negotiate lower prescription drug prices with pharmaceutical companies.
“The House Republicans’ new budget rigs the system for the wealthy and powerful at the expense of everyone else,” Grijalva said in an emailed statement. “It rips away access to health care by increasing premiums, ending protections for people with pre-existing conditions, and decimating Medicaid and the Children’s Health Insurance Program. It raises the Social Security retirement age and increases the cost of living for Americans in order to pay for Trump’s tax cuts for the ultra-rich. It’s clear who House Republicans value — and it’s not hard-working Americans.”
U.S. Rep. Juan Ciscomani, the CD6 Republican who is a member of the Republican Study Committee, declined to say whether he supported the repeal of the ACA when asked about that provision in the Republican Study Committee budget blueprint.
“With any large coalition in Washington, there are a wide array of, and sometimes conflicting, points of view,” Ciscomani said via email. “The Republican Study Committee produces a number of commonsense provisions however I do not subscribe to every proposal they put out. What best reflects my perspectives are the votes I take, bills I introduced, and legislation I cosponsor.”
Democrat Kirsten Engel, who is seeking Southeastern Arizona’s CD6 seat after narrowly losing to Ciscomani in 2022, blasted the GOP’s push to dump Obamacare.
“As thousands of Arizonans struggle to afford the rising cost of health care and prescription drugs, it is unconscionable that Juan Ciscomani’s Washington group is working to gut the Affordable Care Act, end the ability of Medicare to negotiate lower drug prices, and remove the $35 a month cap on insulin for seniors on Medicare,” Engel said. “We need to lower healthcare costs for Arizonans by holding drug and insurance companies accountable, not give them free rein to gouge Arizonans so they can make larger profits.”
Dr. Ravi Shah, a Southern Arizona physician who sits on the Tucson Unified School District Governing Board, recalled that in the days before the ACA, he knew people who struggled to get insurance because of pre-existing conditions or people who lost their insurance because they lost their jobs.
“I can’t imagine going back to that reality,” Shaw said at a Friday press conference in Tucson celebrating the ACA’s 14th anniversary. “Unfortunately, former President Trump and Republicans want to go backwards.”
The Republican Study Committee plan calls for states to take various steps to deal with consequences of repealing the ACA, such as establishing high-risk pools to provide people with pre-existing conditions with health care, but two Democratic state lawmakers from Tucson said at Friday’s event that they were skeptical their GOP colleagues would step up to help those who lose insurance or legal protections against discrimination by insurance companies.
Sen. Priya Sundareshan of LD18 she had “no confidence” that a GOP-controlled Legislature would establish robust programs to help people who lacked insurance or who had preexisting conditions or other chronic health care conditions. She said in light of Supreme Court Justice Clarence Thomas’ suggestion that the high court revisit the landmark case that established a right to birth control, she had tried to persuade lawmakers last week that they should support a bill to ensure that all forms of contraception were legal in Arizona, but the legislation was blocked by a unanimous vote of her Republican colleagues.
“Unfortunately, Republicans at the state Legislature all voted no, against protecting that right to contraception,” Sundareshan said.
Rep. Stephanie Stahl Hamilton of LD21 remembered that then-Gov. Jan Brewer had to overcome opposition from nearly every Republican lawmaker to expand Medicaid in Arizona to 133 percent of the federal poverty level in 2013.
“That was at a time when the Legislature was a little more moderate,” Hamilton said. “We’ve got a disproportionate number of extremists in the Legislature now who are going to do anything they can to take away any kind of government assistance. So when Sen. Sundareshan says she doesn’t have any confidence, I absolutely agree.”
Hamilton remembered that her family struggled to find health insurance before the ACA became law.
“The anxiety and stress that comes with illness, injury, or with being uninsured can be debilitating,” Hamilton said. “When my three children were young, we were uninsured, and it was terrifying. Everything becomes a threat to your livelihood, your savings, your security. And you kind of want to encase your spouse and children in bubble wrap before letting them go outside, let alone play sports, which we all know is healthy for young, active bodies. That is no way to live.”
Bier, who relied on the ACA’s online marketplace for nearly a decade, said repealing the law would leave a lot of people in the lurch.
“Unless you have something better,” he said, “as far as I’m concerned, you’re just screwing the people who depend on it.”
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