As the Republican-led Congress moves to repeal the federal Affordable Care Act, a new Massachusetts-based coalition is preparing to fight back.
More than 20 groups representing hospitals, doctors, insurers, employers, health policy experts, and consumer advocates are banding together to try to preserve the state’s near-universal access to health care.
Members of the new coalition said they fear what could happen if Republicans repeal the national health care law without a replacement plan. Massachusetts could lose crucial federal funding, they said, and many residents could lose access to Medicaid or subsidized private insurance.
Republicans in Congress this week began the process of repealing President Obama’s health law, which they have long opposed. President-elect Donald Trump has vowed to repeal the law but keep some of its provisions. Trump and lawmakers have yet to detail a new plan, but many in Massachusetts are bracing for the worst.
“If you care about the state budget, you have to be terrified about what they’re talking about in Washington,” said Brian Rosman, director of policy at the Boston advocacy group Health Care For All. “Anybody who’s anybody in health care [in Massachusetts] sees this as a big threat.”
The Affordable Care Act expanded Medicaid, the government program for low-income people, to about 300,000 additional Massachusetts residents. Coverage for these people is expected to cost Massachusetts about $2.1 billion this year, with the federal government covering 86 percent of the bill.
In addition, the federal government is paying about $580 million this year for subsidies and tax credits that defray the cost of health plans that about 180,000 Massachusetts residents buy on the state Health Connector. Rosman and others said those federal dollars could evaporate if the national law is repealed.
“If the ACA is repealed and if the federal government is looking to reduce the investments in health care across the country, we suspect that those dollars would be at risk,” said Audrey Shelto, president of the Blue Cross Blue Shield of Massachusetts Foundation, which studies health coverage.
Health Care For All and the Blue Cross Foundation are leading the new local effort, called the Massachusetts Coalition for Coverage & Care. It is similar to a group that formed in the early 2000s to support health reform in Massachusetts. The state passed a landmark health care law in 2006, which helped expand insurance coverage here, but that law does not fully shield Massachusetts from changes in national health policy.
Shelto said the Blue Cross foundation will hire a consultant to help coalition members understand the full effects of a repeal. The group plans to meet at least twice a month and discuss strategies for responding to a repeal.
The coalition will not lobby lawmakers, but many of its members are planning to employ their lobbyists to fight against a repeal.
Coalition members include the Massachusetts Association of Health Plans, the Massachusetts Health and Hospital Association, the Massachusetts Medical Society, Partners HealthCare, Boston Children’s Hospital, Associated Industries of Massachusetts, and the Service Employees International Union, Local 1199.
The employer group Associated Industries of Massachusetts opposes some aspects of the Affordable Care Act, but spokesman Christopher Geehern said employers don’t want to see big disruptive changes to the law either.
“When you’re talking about repealing either all or a significant part of the ACA, you start to get worried about the implications,” he said. “The repercussions are going to be pretty significant.”