MU professors state concerns over possible repeal of ACA

Associate law professor Sam Halabi: “I think that it is going to be very difficult to come up with a compromise that involves a repeal."
MU Student Health Center. Recent talk of repealing the Affordable Care Act has MU professors talking about the effects it will have for community members. Maneater File Photo

When the Affordable Care Act was passed in March 2010, Catherine Armbrust was able to afford health insurance for herself and her late husband for the first time in 15 years.

Armbrust is an adjunct professor in the art department and the director of the George Caleb Bingham Gallery. As an adjunct professor, she is considered a part-time employee of the university, so she is not provided insurance through MU.

"I was extremely grateful when it became available and took advantage for myself and for my late husband,” Armbrust said.

She use the preventative care visits for women, which include mammograms and other exams, prescription assistance and visits to the doctor that she believes have saved her life and could have saved her husband’s.

In spring 2015, Armbrust came home to find her husband dead from a heart attack after exercising. The irony of the situation, she said, is that he had an appointment the very next day to address issues pertaining to his heart.

"We had been so used to not having insurance that it was sort of an oddity to take advantage of it,” she said. “I had been encouraging him to make a doctor's appointment because we could now do that. In my thoughts, the ACA could have saved him."

The Patient Freedom Act was introduced by U.S. Sens. Bill Cassidy and Susan Collins in January and is a possible replacement for the ACA. The bill keeps numerous aspects of the ACA intact, including provisions that do not allow insurers to deny coverage based on a preexisting condition and allowing children to remain under their parents’ insurance until age 26. However, Armbrust is concerned that the replacement plan is inadequate.

“I understand that there are quirks and issues with this system that can probably be worked out,” she said. “I think the best case scenario is that they have a satisfactory replacement that they implement immediately upon the repeal of the ACA.”

Associate law professor Sam Halabi worked with those who negotiated the ACA in Congress and worked with aspects of former President Barack Obama’s transition into office. Halabi said his position has been almost exclusively academic and he never gave legal advice regarding the ACA. He believes the repeal process will prove difficult.

“I think that it is going to provoke deep divisions within the GOP,” Halabi said. “I think that it is going to be very difficult to come up with a compromise that involves a repeal.”

The current proposal circulating in the Senate involves giving health savings accounts to those who use the ACA, which would substitute for the care that ACA provides. Health savings accounts were created so that “individuals covered by high-deductible health plans could receive tax-preferred treatment of money saved for medical expenses,” according to the Treasury Department’s website. They can be used for out-of-pocket medical, dental and vision care, but cannot be used to pay health insurance premiums.

Halabi believes the primary issues with the ACA come from its cost and the individual mandate it imposed.

“It's interesting that that was such a call to opposition, because the idea of an individual mandate really started with conservative think tanks and policy analysts who thought that you could replicate something like automobile insurance, where you have the mandate to purchase it through legal compulsion,” Halabi said.

The issues with cost came from the idea that the ACA would place a financial burden on both the states and taxpayers. However, opposition to the individual mandate has been focused on more than issues over cost, Halabi said.

Halabi said anything that can be marketed as a repeal of the ACA will reflect positively on the Republican party and President Donald Trump.

“I think the GOP can do very little policy and statute-wise and come away with a political win,” he said. “ … For uninsured individuals who have obtained insurance through the affordability made possible through tax subsidies, the best case scenario is either those systems are kept in place, or they are replaced with something else that would provide similar coverage.”

Dr. Karen Edison, director of MU’s Center for Health Policy, said making predictions about what the GOP will do is premature.

“It really depends on what they have planned and that is just beginning to take shape,” Edison said in an email.

Edited by Kyle LaHucik |

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