January 20, 2011 (updated January 24) - The U.S. House of Representatives voted yesterday on legislation to repeal the landmark health reform law, the Affordable Care Act (Public Laws 111-148 & 111-152), in its entirety. All Republicans voted in favor and all but three Democrats voted against the bill, and the legislation, H.R. 2, passed on a roll-call vote of 249-185. The vote was, however, largely symbolic as Senate Democrats have promised to prevent the bill's passage, and President Obama has declared that he will veto any bill that seeks to repeal the historic health reform law.
The consequences of repeal are dire. Individuals with mental illnesses would continue to experience insurance discrimination and lose important consumer protections, access to coverage and quality services, and face high health care costs without aid. Some of the critical provisions (many of which have already gone into effect) that would be lost include:
- A prohibition on denying coverage because of pre-existing conditions, setting annual and lifetime limits on coverage, discrimination based on health status, and allowing dependent children to remain on their parents' insurance until age 26;
- The establishment of an essential benefits package that requires mental health and substance use disorder services to be covered at parity, and premium subsidies to help low-income individuals to buy insurance;
- The expansion of the Medicaid to offer coverage to all individuals with incomes at or below 133% of the federal poverty level, including adults without children, and the provision of increased federal funding to assist states in this expansion of their Medicaid programs;
- New options for the provision of long-term services and supports that will help people with mental illnesses remain in their homes and communities, including the Community Living Assistance Services and Supports (CLASS) Act and improvements to the 1915(i) State Option to provide home- and community-based services;
- Improvements to the Medicare Part D program that will eventually eliminate the "Donut Hole;" and
- Provisions that encourage more coordinated primary care and specialty mental health care, promote preventive services, foster workforce development initiatives, and make other changes designed to improve the quality and availability of services that people receive.
In addition to its adverse impact on access to critical health care services, a preliminary analysis by the Congressional Budget Office (CBO) highlights the economic consequences of repealing the health reform law. According to the CBO, repeal would increase the federal deficit by over $230 billion over 10 years. In contrast, full implementation of the health reform law would result in a deficit reduction of approximately $130 billion by 2019.
The Bazelon Center will continue to monitor and oppose efforts to repeal the health reform law as new strategies and attacks on the law, such as funding cuts and repeals of individual provisions, come forth. Please see the Bazelon Center's resources page for Affordable Care Act analyses, resources, and implementation information.