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American health at risk from Affordable Care Act repeal

Opponents in Congress and the new presidential administration are working to destroy the Affordable Care Act, potentially leaving millions without health coverage. Here are just a few components of the ACA they want to change, and who will be affected.


  1. The House and Senate passed a fiscal year 2017 budget resolution that includes instructions to develop legislation to repeal significant portions of the ACA and leave millions without health care coverage.
  2. Members of Congress have rejected amendments to the new budget, giving them free reign to repeal significant portions of the ACA and leave millions with insufficient or a complete lack of health care coverage.
  3. Despite Congress' repeated efforts to repeal the ACA, a new poll by NBC News and The Wall Street Journal shows that the law is more popular now than it ever has been before.
  4. Congress is planning to use a process called budget reconciliation to repeal significant and critical parts of the ACA. The process ensures that opposing members cannot filibuster to delay any proposed repeals and only requires a simple majority to pass in the Senate.
  5. Congress can only repeal portions of the ACA that are related to the federal budget through the budget reconciliation process. Studies by the Congressional Budget Office and the Urban Institute and the Commonwealth Fund, however, show that these efforts will increase the number of uninsured Americans by 18 million in the first year, and 32 million by 2026. Repealing the ACA will also lead to a 20 to 25 percent increase on individual premium prices and a loss of 2.6 million jobs during the two years it will take to "repeal and replace" the law.
  6. Repeal of the ACA threatens to eliminate the Prevention and Public Health Fund, which makes up over 12 percent of Centers for Disease Control and Prevention's total funding and finances crucial public health programs.
  7. In a letter to senators on Nov. 23, APHA Executive Director Georges Benjamin, MD, detailed the importance of the fund, noting that it "is absolutely necessary to improve the health of people across the nation and slow the rise of health care costs."
  8. If Congress repeals the ACA without a viable and adequate replacement plan, millions of Americans will lose the affordable and comprehensive health coverage that took public health supporters so long to achieve. The repeal will increase health disparities, premature deaths and significantly reduce access to crucial preventive health care services, weakening public health overall throughout the country.
  9. Repeal of the ACA would eliminate funding, putting these — and many other — programs at risk:
  10. Immunization for children and adults

  11. Without money from the Prevention and Public Health Fund for immunizations, the CDC will be hampered in its work to detect and respond to infectious diseases that are vaccine-preventable. Vaccinations are of vital importance for children, health workers, pregnant women and adults in general.
  12. Lead poisoning prevention

  13. Over 535,000 children in America have blood lead levels high enough to cause significant health damage, including stunted growth and learning difficulties. With support from the fund, CDC performs blood-lead surveillance tests for over 2.4 million children a year and reduces lead sources for children with high risk of lead exposure. No blood level of lead is safe for children, according to CDC.
  14. In addition to loss of preventive health services by CDC, the threat to repeal major portions of the ACA without a viable replacement plan endangers continued funding and access to health services.
  15. Reproductive health

  16. Under the ACA, access to contraception, preventive exams and annual checkups are provided without copay through insurance.
  17. The full range of reproductive health services is a fundamental right and integral to the health and well-being of women and to public health, according to APHA.