For the first time since 1993, the U.S. life expectancy has declined, according to a National Center for Health Statistics report issued Thursday. In 2015, death rates increased for eight out of 10 of the leading causes of death, such as stroke, suicide, heart disease, and drug overdoses. The overall death rate rose 1.2 percent.
Yet Republican leaders have continued to move forward with plans to replace the Affordable Care Act. If Americans lost the mandate preventing insurers from denying coverage to people with preexisting conditions, this would greatly exacerbate the national health crisis.
Low-income people would be even worse off if the ACA were replaced, because the Republican plan would offer a lot less protection for those with preexisting conditions. It also makes the high risk pool larger, mixing unhealthy people with even less healthy people, which ensures that premiums are higher, leaving people unable to afford them, Chad Stone, chief economist for the Center on Budget and Policy Priorities, explained in U.S. News and World Report earlier this month.
If there weren’t an individual mandate that nudges everyone to get covered, many healthier Americans wouldn’t seek coverage. Those in the insured pool would be sicker and more expensive to cover, creating a cycle where premiums keep going up as healthier people leave the insured pool to avoid rising costs.
Life expectancy in the U.S. is far behind other wealthy nations. A 2013 report from the nation’s leading health research institutions found that the average life expectancy for American men was the lowest of the 17 countries — including Canada, Australia, and many Western European countries — researchers reviewed. U.S. women were ranked second lowest in life expectancy. In terms of the per capita share of people covered by health insurance, the United States ranked 33rd among high-income OECD countries in 2015.
But the number of insured Americans has increased significantly since Obamacare took effect. The uninsured rate fell from 16 percent in 2010 to 9.1 percent in 2015.
The national hospital industry is concerned about what will happen under a repeal of Obamacare. On Tuesday, two large trade groups for U.S. hospitals sent a letter to President-elect Donald Trump and congressional leaders, warning of “an unprecedented public health crisis.” The groups wrote that an increase in uninsured patients would cost hospitals $165 billion, The Washington Post reported.
Insurers also communicated their concerns to Republicans this week. Insurers said they needed a Trump administration and congressional leaders to keep offsetting costs for low-income people, since state marketplaces are already in a financially precarious position,The New York Times reported. Insurers want to keep parts of the ACA that encourage young people to sign up and cover people who have expensive medical conditions. Insurers are already leaving marketplaces where they are losing money.
Although Republicans disagree on the timing of a repeal — it could be anywhere from six months to three years — they are in agreement that it should repealed. Democratic leaders said they are not going to stand with Republicans in their repeal of Obamacare. On Tuesday, Senate minority leader Chuck Schumer said the Republicans will have to endure the political fallout on their own.
“If they repeal without a replacement, they will own it. Democrats will not then step up to the plate and come up with a half-baked solution that we will partially own. It’s all theirs,” Schumer said to reporters.