NORTHAMPTON — President Donald Trump called on Congress Tuesday to repeal and replace the Affordable Care Act with reforms that expand choice, increase access, offer lower costs and provide overall better health care.
“Obamacare is collapsing, and we must act decisively to protect all Americans,” Trump said.
With talk of repealing Obamacare, concern over the future of health care locally sparked a community forum on the topic Wednesday.
“The title of this event is ‘Health Care and Coverage in Massachusetts: What’s Next?’” organizer Deborah Levenson said to a crowd of 50 at the Northampton Friends Meetinghouse. “One thing I can tell you is we will not be able to answer that question.”
But University of Massachusetts Amherst economics professor Gerald Friedman has a theory: Within two years, the ACA will be dead and insurance companies will be broke.
Friedman gained national attention last year for an analysis estimating the economic impact of programs proposed by Vermont Sen. Bernie Sanders during the presidential primary season.
On Wednesday, Friedman was a panelist on the forum along with Jackie Wolf, co-chairwoman of Mass-Care: The Massachusetts Campaign for Single Payer HealthCare, and Cheryl Zoll, executive director of Tapestry Health.
“There’s a lot of talk in the newspapers about the Republicans backing away from the repeal and replace,” Friedman said. “They don’t need to repeal, they can destroy the ACA by not enforcing the mandate.”
Trump said Tuesday “mandating every American to buy government-approved health insurance was never the right solution.”
But by not enforcing the mandate, Friedman said, many young people and others who think they are healthy will stop buying insurance, causing premiums to rise to cover an older and sicker pool of people. In time, more people will drop out due to high premiums, creating a “death spiral,” Friedman said.
“Within two years, without any significant legislative action, the ACA will be dead,” he said. As for insurance companies, Friedman said, they will go broke.
For Tapestry, Zoll said there are three sources of federal funding that affect services offered at the centers — Title 10, Medicaid and the ACA.
Zoll said a big focus on the ACA is addressing not only the health care provided by a doctor, but also the social determinants of health — looking into factors of everyday life that can impact their health.
“Do they have housing? Do they have food? Jobs?” Zoll said.
Ever since the ACA, Zoll said, payment models at Tapestry have been shifting, so that patient care goes beyond the doctor’s office.
Zoll said if the ACA is even “tinkered with” the specialized care could be lost.
But panelists say a solution to health care issues is creating a single-payer health care system.
“In simple terms, everyone carries one health insurance card and you are given access to health care providers, treatments, facilities as you need them,” Wolf said.
Some members of the crowd agreed with Wolf on the single-payer health care system.
Alice Swift, a member of Mass-Care and the League of Women Healthcare Committee, has been pushing single-payer health care for about two decades. She said the system would save huge amounts of money.
Greenfield resident Judy Atkins agrees.
“Health care is a human right and everyone should access to publicly funded health care,” Atkins.
Caitlin Ashworth can be reached at cashworth@gazettenet.com.