March 19, 2024

Kim Scorza, MSW, LMSW

Seasons Center for Behavioral Health, President/CEO

The Affordable Care Act has made good-quality health insurance available to thousands of Iowans who could not otherwise afford coverage. The benefits have been felt statewide, including in rural communities. In fact, according to a recent report for the Iowa Fiscal Partnership, Iowa’s rural counties saw an even greater decline in the share of uninsured residents – falling from 9 percent to 5 percent – than metropolitan counties did from 2013 to 2015.

Last week, House Republican leaders presented an outline of their plan to replace the Affordable Care Act. If the ACA is repealed without an adequate replacement Iowa stands to end up even worse than before the law went into effect, with about 230,000 Iowans, including 25,000 children, losing health coverage in 2019. The proposed plan also called for a radical reconstruction of the way the Medicaid program is structured and financed. These changes would place severe fiscal pressures on Iowa and threaten patient access to care, jeopardizing the coverage of nearly 1 out of every 3 children in O’Brien County who receive coverage through Medicaid.

Repeal of the ACA could also create chaos in Iowa’s health care system and the state budget. Over a 10-year period, Iowa would lose $7.4 billion in federal funding to meet the health needs of its residents. In addition, growth in the number of uninsured residents would triple the costs of uncompensated care to $1.2 billion annually.

Keeping our children and families healthy is key to many of the Iowa’s educational and economic goals. Asthma, diabetes, even tooth decay can keep children home from school. Sick children can keep parents home from work. Healthy communities are prosperous communities, vital to Iowa’s economic success.

The stakes are too high for us to hope this time will be different. Voting to repeal the ACA without a replacement plan attached is not responsible governing; it’s a risky step that threatens the health of children and families.

Our elected leaders in Washington, D.C. should show responsibility and forethought by not rushing forward to repeal the Affordable Care Act before they have done the hard work to negotiate and approve a replacement plan that provides equal or better coverage for Iowans. They owe us that much.