- In tonight's closer look, how some medical doctors are eyeing
the repeal of the Affordable Care Act?
This week, Wisconsin Physicians for a National Health Program
spoke out about their concerns.
Dr. Melissa Stiles is a member of that group.
Doctor, thanks very much for being here.
- You're very welcome.
- Well, you say that you have concerns about the rapid repeal
of the Affordable Care Act without a proven plan in place.
What are those concerns?
- Yeah. Significant concerns.
My main concern is that we don't go backwards.
We did make some tremendous strides with the Affordable Care
Act in terms of expanding coverage, and I think fixing
some of the inadequacies of our health care system.
And my fear is we go backwards in terms of coverage and
potentially losing coverage for 20 million Americans in the
first year of the repeal and up to 30 million in the second is
not the right direction.
- Now, Obamacare, as we've come to call it, was not a proven
plan when it was put in place either.
So why this call, you know, for this new plan,
whatever it might be, that it be proven?
- Sure.
Obamacare had some proof because it was -- a lot of the major
tenets of the plan were based on the Massachusetts plan.
So there was some evidence that it did work.
So there was a demonstration.
When we look at what's being put forth, and, as you know, we
don't have a plan put forth yet, but we could predict that ones
put forth by Ryan and also Price in the past, of high deductible
plans coupled with health savings accounts, there is no
demonstration project for that, not even in a city, in a region,
state or any other nation that has done that.
- Now, when you note Price, you mean the incoming DHSS Secretary
nominee, Dr. Tom Price, and he has a plan that really closely
mirrors -- Speaker Paul Ryan's plan with some of those prongs
of which you speak.
So how would the repeal, getting closer to the ground, of the
Affordable Care Act affect your patients?
- Potentially the major -- the people that were most affected
by this were people that had small businesses -- and I
practiced in a small community, Belleville, for 25 years, had a
number of dairy farmers.
A lot of those couples had to have a second job for health
insurance.
I gave an in-service on the Affordable Care Act
one evening in Belleville.
It was packed.
People finally saw the light that
they could have health insurance without being tied to a job.
There were people there with pre-existing conditions
that now could get insurance.
So those are the main people affected.
I think when we also look at the 20 million people that
potentially will lose insurance, those people were the most
vulnerable.
They couldn't -- they didn't qualify for Medicaid
and they were in this gap.
And so now they had subsidies
that they were able now to get insurance.
- And there's a certain number of those people in Wisconsin
as well.
- There is.
And the estimate is about 225,000.
- So what about the uncertainty of all of this for people who
just got kind of used to the Affordable Care Act, for
physicians and hospitals and, again, patients?
- And a lot of organizations are calling for caution.
The Wisconsin Hospital Association on their blog, on
their website, calls for caution as we move forward.
And the concern is not so much if we do repeal, not so much
what we repeal it with.
The concern is as much as how we do it.
When you look at how everything is intricately involved, all now
the pillars of what I consider our health care currently,
Medicare, Medicaid, the Affordable Care Act,
and employer-based insurance,
are all affected by any repeal of the ACA.
When we look at the assurances that the ACA gave in terms of --
you wouldn't be denied for pre-existing conditions.
You would not have your insurance cut off
if you developed an illness.
You had to wait up to 12 months if you had a job with a
pre-existing condition to get insurance.
Those same assurances are also for employer-based plans, along
with no out-of-pocket costs for preventive services.
So this affects not just people that are getting insurance, but
the subsidies, it affects all of us.
For Medicare, there are tremendous research going on in
terms of how we really should look at value-based care.
Also, close the loophole, what we call the doughnut hole for
Medicare prescriptions, which is so vital for our patients.
- Also very important and very changeable right now.
Dr. Melissa Stiles, thanks very much.
- Thank you.