by matsuyuki/via Flickr

Nurses reflect the American population’s variety, and this means that many nurses support the Affordable Care Act (ACA) and many would like it repealed, whatever the replacement might be.

Like many Americans, nurses may have a broad ideological or analytical perspective on the pros and cons of the ACA or other health policy issues. Or they may choose for or against complex legislation on the basis of a single issue—like abortion funding, or insurance access for a husband or daughter with a preexisting condition, or whether they believe staffing issues can be blamed on their hospital administration or an ACA provision.

But it’s been my experience as an editor at AJN and a citizen that many people don’t really know that the ACA has multiple provisions that address quality and access issues at every level of health care.

The futures of these provisions are all in question as the Trump administration and a Republican-led Congress prepare to hack away at the ACA without a clear replacement plan.

With a kind of pre-obituary fervor, the media is beginning to pay attention to the changes the ACA brought about now that many may soon disappear—so, for seemingly the first time, are many Democratic politicians, who it’s now clear did very little to sell the ACA to their constituents. With that in mind, might it be time to just quietly stop calling the ACA “Obamacare”? If nearly half of the electorate voted for someone else, why agree to nickname an already controversial law by using one candidate’s name? Not only that, but the nickname doesn’t say anything about what kind of law the ACA really is.

Below find links to recent coverage focusing on important ACA provisions at risk plus some related issues to watch as the ACA repeal process takes shape.

  1. What replacement plan? While repeal measures are already underway in Congress, there’s still no clear agreement among Republicans on what an ACA replacement plan could look like. The ACA, flawed as it is by compromise, took years to hammer out. While President Trump is demanding quick action on a replacement, Republicans seem just as likely to do their best to ensure that the negative effects of any immediate repeal legislation don’t begun to be felt until at least the midterm elections.
  2. CBO: Huge drop in insured predicted. Republican repeal maneuvering is taking place against the backdrop of a new Congressional Budget Office report that predicts 18 million Americans would lose health insurance in the first year the ACA was repealed. The numbers go up from there.
  3. HHS nominee: conflicts of interest. Department of Health and Human Services nominee Rep. Tom Price, who has in the past advocated replacing Medicare with a voucher system for the elderly, among other health care policies, continues to face serious ethics accusations about conflicts of interest over his investments in health care stock. This, however, may not stand in his way, given current Republican majorities in the Senate and House.
  4. Effects of repeal on employer-sponsored coverage. Do you get free preventive care with your employer-sponsored health insurance? Do you have an annual out-of-pocket cap on covered expenses? Did you get a job recently and find you had no waiting period to join a plan? These and other protections exist because of the ACA, and they are all in danger.
  5. Other potentially disappearing protections: Before the ACA, you could have been denied new insurance coverage on the open market because you were taking any one of a long list of common medications for arthritis, diabetes, mental illness, cancer, HIV/AIDS, and heart disease? Have a look at Table 3 in this Kaiser Family Foundation report.

While the ACA story seems to be developing very fast, this may only be an illusion. We’ll soon know more.