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Authorizing Council’s Committee on Public Health and Human Services to hold hearings on the impact of the repeal of the Affordable Care Act on the residents of the City of Philadelphia, and particularly on low-income and elderly populations, and further investigating the City of Philadelphia’s preparedness to address the increase of those who would be without adequate healthcare insurance.
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WHEREAS, The Affordable Care Act (ACA) is a federal law that provides health insurance for 20 million Americans and protects millions more from discrimination for pre-existing medical conditions, ends lifetime caps on insurance coverage and allows children to remain on their parents’ insurance policies until age 26. More than 11.5 million people nationwide had signed up for health insurance or been automatically re-enrolled under the ACA as of December 24, 2016, an increase of 286,000 from the same time last year; and
WHEREAS, According to the Philadelphia Department of Public Health the ACA has provided health insurance coverage to over 220,000 people in Philadelphia through a combination of Medicaid expansion and the availability of insurance through the Federal Insurance Marketplace; and
WHEREAS, As one of their first official acts, the United States Senate on January 12, 2017 adopted a budget reconciliation resolution that clears a path for eliminating the tax-and-spending provisions of the ACA by simple majority vote; and
WHEREAS, On January 20, 2017 President Donald J. Trump issued an Executive Order directing members of his administration to take steps that will facilitate the repeal and replacement of the ACA; and
WHEREAS, While there are some components of the Affordable Care Act that are very popular, in particular the removal of denying claims for pre-existing conditions and allowing children and young adults up to aged 26 to remain on their parents’ insurance policies, keeping those provisions while repealing most of the other aspects could be very difficult as the law’s requirements are interdependent; and
WHEREAS, Policy experts warn that taking away the government subsidies and the mandate to buy insurance, while keeping the harder-to-change provisions, would destabilize the insurance market. Eliminating premium subsidies would put health insurance out of the financial reach of millions of Americans who now have coverage. Both the subsidies and the mandate are needed to keep young, healthy people in the insurance pool to help pay for older, sicker customers. Without them, the companies would have to raise premiums, and millions more could be priced out of insurance; and
WHEREAS, Repealing the Medicaid expansion component of the health law could affect millions of poorer Americans. Rolling back the expansion, which gave more people Medicaid coverage in 31 states, would leave more than 10 million without health insurance. In Philadelphia, after Governor Wolf accepted Medicaid expansion funding (something rejected by the prior Republican governor), the percentage of adults who had trouble accessing health care because of cost began to decrease; and
WHEREAS, The Congressional Budget Office has estimated that 22 million people nationwide could lose health insurance if key parts of the law are removed. The Pennsylvania Budget and Policy Center estimates that more than 1.1 million Pennsylvanians will lose their health insurance due to the repeal of key parts of the ACA which include Medicaid expansion and the tax credit subsidies for insurance on the health care exchanges. Furthermore, the repeal of the ACA will cost over 137,000 Pennsylvanians their jobs, reduce the state’s gross domestic product by over $75 billion and cut state and local tax revenues by $2.4 billion over a five year period; and
WHEREAS, Proposals from the new administration and Congressional leadership include an intent to move Medicaid for both traditional and newly eligible recipients to a block grant or per capita cap program, which would severely limit the amount of funding the state would receive to provide Medicaid benefits and could also restrict the coverage that is available for vulnerable populations and the newly eligible; and
WHEREAS, While the City of Philadelphia has an excellent network of public health clinics that serve all residents regardless of insurance status, and is the home to many prestigious hospitals, medical schools and research centers, the addition of more residents losing adequate health insurance could place extreme challenges on our health care delivery system; and
WHEREAS, The repeal of the ACA provides a critical opportunity for the City to consider alternative approaches and best practices in other jurisdictions for assuring adequate and affordable healthcare for its residents; now, therefore, be it
RESOLVED, THAT THE COUNCIL OF THE CITY OF PHILADELPHIA, Hereby authorizes Council’s Committee on Public Health and Human Services to hold hearings on the impact of the repeal of the Affordable Care Act on the residents of the City of Philadelphia, and particularly on low-income and elderly populations, and to further investigate the City of Philadelphia’s preparedness to address the increase of those who would be without adequate healthcare insurance.
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