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Multiple reports suggest that any day now the United States Senate will vote on a bill to adopt a budget that begins to repeal the Affordable Care Act (ACA) before anything resembling a replacement plan is in place.

In spite of the countless times I’ve heard Donald Trump’s “repeal and replace” soundtrack, the only evidence in the proposed budget is to “repeal” but not "replace."

Doesn’t it seem irresponsible, if not immoral, for U.S. House of Representatives speaker Paul Ryan and others to insist that key provisions of the ACA will be retained without providing any evidence to back it up?

As a person with a disability, I have contacted my three Michigan representatives in Congress—Representative Bill Huizenga and Senators Debbie Stabenow and Gary Peters—urging them not to vote for any budget that leads to repealing the Affordable Care Act that does not also include a specific replacement.

If this is a concern you share, please contact your representatives before this vote takes place.

As the American Association of People with Disabilities (AAPD) and other respected disability organizations outline in detail, several key provisions within the Affordable Care Act support the health and well-being of people with disabilities, including:

  • Health insurers cannot deny someone health insurance on the basis of a pre-existing condition, including a disability or chronic condition;  
  • There are no arbitrary financial limits to how much healthcare an individual can receive in a year or in their lifetime;
  • More people with disabilities receive supports to live in the community of their choice rather than in an institution;
  • Some 20 million adults and children have health insurance through Medicaid expansion and health insurance subsidies;
  • The Money Follows the Person (MFP) demonstration program that helps people with disabilities transition from institutions to the community was reauthorized and expanded;
  • The Community First Choice option (CFCO) was established, which increased the Federal Matching Assistance Percentage (FMAP) for states that provide new or expanded home and community based services (HCBS);
  • The U.S. Access Board was authorized to develop accessibility standards for medical diagnostic equipment (MDE);
  • Millions of adults have been able to stay on the health insurance plan of their parents until age 26; and
  • Health insurers provide more people with the services they need, including mental health services and rehabilitation services and devices.

The ACA has improved access to care for people with disabilities and chronic conditions to help them live healthy, independent, and fulfilling lives. Any succeeding plan should as well. To eliminate the ACA or to eliminate the ACA without simultaneously replacing it with an alternative jeopardizes this progress and puts ongoing access to comprehensive, affordable coverage for people with disabilities at risk. Further, to repeal the ACA without a specific replacement plan could lead to higher premiums and out-of-pocket costs, and leave state governments and providers to cover the cost of care for those who lose coverage.

To learn more, including specifics when contacting your representatives, go to organizations such as the Consortium for Citizens with Disabilities, the National Council on Independent Living, or the AAPD.


  Unfortunately, since I live in Canada, I can't do much about this.  However, I have shared it on Facebook for my American friends.

My heart goes out to Mr. DeYoung. Some of those near and dear to me have disabilities so I can sympathize. Nevertheless, I would like to respectfully point out why I think this post is an excellent example of "good" and "not-good" in a church publication. It might have been useful to edit this item just a little before posting it. I think it's "good" to submit a list of features one might hope for in legislation; I think it's "not good" to attach that list to rumors, baseless accusations, and other such statements such as those in the first three paragraphs of this post, in a denominational magazine or website such as this.

This post begins with a vague "Multiple reports suggest..." and goes on to a derogatory comment about the President-elect well before the inauguration and follows that with an attack on Rep. Paul Ryan, Speaker of the House. (Ryan was depicted in political ads a few years ago pushing grandma over a cliff in her wheelchair, but some view him as one who lives his Christian beliefs, exhibiting the fruit of the Spirit.) This introduction concludes by questioning the morality of legislators in the early weeks of a new term for not providing evidence that legislation still being written will be completely satisfactory. This makes one wonder if it isn't just a tad politically oriented.

If we are going to have political statements here, perhaps we should seek some balance. Would the monitors consider a post that reported that, for the first time in history, a U.S. president spoke at the annual meeting of Planned Parenthood, leading abortion provider in the U.S. and dealer in body parts of aborted babies? This would be the same president who, as a state legislator stated that he trusted doctors performing abortions to provide necessary care for viable infants surviving abortions. These are doctors who believe a dead baby is the best solution to an unplanned pregnancy. As the adoptive father of two grown daughters, now the mothers of five terrific grandchildren, I beg to differ.

Ken, while personally I have many concerns about Donald Trump as president, even supporters acknowledge that he's made lots of claims and promises that do not include specifics, or that he's changed his mind about later.

I respect Paul Ryan and, like you, believe him to be grounded in the Christian faith. I wasn't attacking Ryan as much as summarizing what I have heard him say repeatedly — promises and claims lacking specifics. Whether he's a Christian or not, it remains troubling that details of an ACA replacement have been so long in coming. Along with many others, I'm still waiting for the evidence that Trump or the Republican Congress will come up with a plan that maintains the positives of the ACA and "leaves no one behind."

Here is a post by Ed Stetzer who writes a blog for Christianity Today on some of the implications of a "repeal without a replacement" approach.

And, just yesterday I received an email from another denominational disability organization — the Anabaptist Disabilities Network — noting that one of their field associates, Rebekah Flores, will be impacted if the ACA is repealed without a comprehensive replacement plan. Rebekah wrote, “I can only afford to see my doctor and pay for my medications to treat my Multiple Sclerosis because of the Affordable Care Act.”

I don't feel it's unreasonable to ask for a replacement plan before repealing.

Good post Terry, I share your concerns as a disabled person also. If there were some information or plan in place to support these concerns, I wouldn’t be writing this but there is nothing that I know of to replace what already exists! That does make me wonder what will happen! 

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