Ted Boettner: Don't Squash the Biggest Investment in West Virginia History

Charleston Gazette - What if a company said they were going to invest over a billion dollars a year in West Virginia to create thousands of jobs, improve the health of our workforce, and save lives? Most would probably say that we would be foolish to turn down this company’s unprecedented investment in our state. But that is exactly what is going to happen if we repeal the Affordable Care Act (ACA) and fail to adequately replace it. The ACA, also known as Obamacare, represents one of the largest investments in human capital West Virginia – and the nation -- has ever seen. If the ACA repeal goes forward -- including the repeal of Medicaid expansion and health insurance premiums credits on the Marketplace -- and that money suddenly evaporates, every part of our state will feel the impact. According to a recent analysis by Commonwealth Fund and George Washington University, West Virginia would lose approximately 16,000 jobs by 2019, 43 percent of which would be in the health-care sector alone. The rest would come from construction, retail, real estate, finance and other industries. Between 2019 and 2023, West Virginia’s business output would drop nearly $16 billion in value – including $7.2 billion less in federal spending. West Virginia’s Gross State Product would fall by $9 billion. With this loss in economic activity, we would see $349 million less in state and local revenue at a time when the state faces a $500 million budget gap this fiscal year. The health-care sector was one of the only growing parts of our state’s economy over the last several years. Since 2014, West Virginia added 6,200 jobs in health care-related industries while private-sector jobs as a whole have declined by 5,400. The ACA has also led to steep declines in the amount of money health-care providers spend on the uninsured. Under repeal of the ACA, the Urban Institute estimates that uncompensated care in West Virginia would grow by $500 million, including $135 million from West Virginia hospitals alone, by 2019. Repealing the ACA goes well beyond the direct loss of money into our state. An estimated 184,000 West Virginians would lose insurance coverage, which would more than triple the number of uninsured in West Virginia. The decline would come from ending Medicaid expansion, federal insurance premium subsides, and the individual mandate requiring people to buy health insurance, creating chaos that would likely collapse the insurance Marketplace under the ACA. Hundreds of thousands of West Virginians would also lose critical patient protections under a repeal. This includes about 800,000 West Virginians – including 91,000 children – with preexisting conditions (e.g. diabetes or cancer) that could be denied coverage or face higher premiums. Over 500,000 West Virginians could see caps placed on the amount an insurer would spend over each person’s lifetime and the same number of people could lose access to free preventive care such as immunizations and cancer screenings. Women could be charged premiums as high as 57 percent more than men and 12,000 young adults in the state could be booted off of their parents’ health insurance plans. The ACA has been a lifeline to West Virginians who have either gained coverage from Medicaid expansion or insurance subsidies, or who have been protected from harmful practices banned by the ACA. And there is little doubt that our state’s economy has benefited tremendously from the large influx of federal funds that has boosted jobs and helped our local communities. It is no secret West Virginia has one of the unhealthiest populations in the nation, which not only means we have more premature deaths and higher health-care costs than most states, but is also one big reason why our economy struggles to prosper and why we have the lowest labor force participation rate in the country. That’s because a healthy workforce is a productive one. The last thing we should be doing is stripping away health care coverage from hundreds of thousands of West Virginians. Instead of reversing the progress that has been made through the ACA, Congress and President Trump should preserve and build upon existing success by lowering health-care costs and expanding quality health care to everyone. This could include negotiating lower prescription drug prices, a public option in the marketplace, or moving toward a single-payer system that is supported by a majority of Americans. Repealing the ACA without an adequate replacement would be a disaster for West Virginia‘s economy and its people.

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