Adam Ciminello | Executive Coordinator | The Financial Clinic
Today, the Senate Majority Leader Mitch McConnell announced he was formally postponing the previously anticipated vote on a full repeal and replace of the Affordable Care Act (ACA), the signature legislation of the Obama Administration from which more than 22 million Americans gained health insurance coverage. While the ACA contained notable imperfections and its long-term goal of making Americans more healthy is still undetermined, it nonetheless represents the most transformative and ambitious attempt towards guaranteeing health insurance as a basic human right afforded to all American citizens. Now, as has been loudly and frequently promised for more than 7 years, the GOP seems poised to complete their stated mission of repealing and replacing the Affordable Care Act – perhaps now as soon as early July – gambling with the security and health of millions of low-to moderate-income Americans with little regard for their wellbeing. The new bill, the Better Care and Reconciliation Act, has undergone multiple iterations and a formal assessment from the nonpartisan Congressional Budget Office, but the conclusion remains the same: more than 20 million people would lose healthcare coverage by 2026. There is little faith to be had or reason to believe that this reality will suddenly change whenever it is put before a Senate vote.
Not only would a repeal of this scale be a mistake in terms of personal health, it also has the potential to weaken financial security for these groups of Americans, a topic our friends and colleagues at the Center for Social Development at the University of Washington St. Louis explored extensively in a recent study released last week. In the study, findings documented that low-income Americans who gained health insurance – the vast majority of which came from the insurance marketplace – were much more likely to make their rent and mortgage payments, with the rate of home delinquency for households without access to employer insurance falling in some cases by 31%. This is consistent with previous studies tracking similar outcomes: fewer Americans have struggled to pay medical bills and bills in collections when personal health care costs have declined, providing Americans with the security to know that they can brace for a crisis in their personal health and reserve their entire focus for a full recovery.
“Housing stability contributes in turn to community stability”
These studies represent a reality at The Financial Clinic that we are committed to confronting; all forms of social well-being are interconnected. When Professor Michael Sherraden, Founder and Director of the Center for Social Development, writes, “Housing stability contributes in turn to community stability,” it underscores a basic principle that we unequivocally support: you cannot address a single barrier to opportunity effectively without addressing (or, at least, attempting to address) ALL barriers to opportunity. We know this to be true because we also know the opposite to be true: health insecurity contributes in turn to financial insecurity, contributing in turn to community insecurity. We see this firsthand in our work at the Clinic and the communities we are committed to supporting, like Mary (pseudonym), a Clinic customer who lost her job because of a high-risk pregnancy that made her physically unable to work. Her husband had left her with nothing, and as her medical debts continued to increase, she could no longer pay any of her bills and her credit score dropped to 454, falling into one of the lowest credit score levels. Shortly after giving birth to her daughter, she was evicted. Mary and her newborn were left with no home and over $7,000 in debt. Mary, like all too many uninsured Americans, deserves more from her elected officials and her story illustrates the need to expand coverage and assistance for those unable to afford insurance, not the other way around.
While today Americans can breathe a sigh of relief that the bill has been postponed, similar to the corresponding House bill, it will inevitably be put before a vote. When that disappointing day arrives, this bill will not only have a catastrophic effect on the ability for low-to moderate-income Americans to obtain healthcare, it will also have a larger ripple effect on the economy and the financial security of ordinary Americans. With more than 22 million Americans expected to be uninsured and enormous cuts to Medicaid, the impact that this single piece of legislation will have on all forms of social services could be enormous: families facing a medical crisis and unable to afford the care they need out of pocket could experience an inability to make their rent, afford food, or go to work as a result. In the strongest terms possible, The Financial Clinic condemns the Senate’s likely vote to repeal and replace the Affordable Care Act and – echoing the work from Professor Sherraden as a reminder of the holistic consequences this bill will fundamentally have on low income communities – implores the Senate to work to improve the ACA instead of dismantling it entirely.