With the enactment of the Affordable Care Act, Florida has made tremendous gains in health care coverage for working families, especially those with children. Congressional repeal of the Act, without substantial replacement of its provisions, endangers the families served through its programs. Families of modest means rely on these programs to preserve their physical health and financial well-being.
Congress passed a partial repeal of the Affordable Care Act (ACA) in January, 2016 which was subsequently vetoed by President Obama. The legislation would have eliminated Medicaid expansion, cost-sharing for coverage obtained through the insurance marketplace, and the individual coverage mandate. Congressional leaders have identified a similar repeal of the ACA as one of their highest priorities for 2017. With a new president, this legislation will not be vetoed.
A partial repeal of the Affordable Care Act (ACA) would potentially raise the number of uninsured Florida children from 228,000 to 596,000 by 2019, an increase of 161 percent, according to a new Report from the Urban Institute.
If a partial repeal of the ACA is accompanied by the elimination of the Children’s Health Insurance Program (CHIP), known as KidCare in Florida, the number of children who would go without health insurance would be 891,000, an increase of 663,000 children. Accordingly, the percentage of uninsured children would jump from 5.2 to 20.5 percent. This increase stands in stark contrast to the significant decrease in Florida’s uninsured children between 2013 and 2015. Florida had the second largest decline in uninsured children in the nation, from 11.1 percent in 2013 to 6.9 percent in 2015, partially attributable tothe ACA. Reversing this progress would only impose additional financial and health hardships on Florida’s struggling working class families with children.
Children with special health care needs are particularly reliant on Medicaid and CHIP, which covers expensive services and provisions that are usually not covered by private insurance. Numerous studies have documented the linkage between children’s access to health care and long-term academic success and economic mobility. Children with no access to health insurance and preventative care are more likely to go without services such as medical, dental, and vision care, as well as prescription medicine and glasses than children with health insurance. Further, children with no health insurance are six times more likely to go without medical care than those with private insurance. If health problems are not identified and treated early, it can affect a child’s cognitive, physical, behavioral, and emotional development.
Research reveals that Medicaid coverage of low-income pregnant women and children has contributed to a significant decline in infant and child mortality. It has also resulted in reduced disability and lower rates of hospitalization and emergency room visits later in life.
The number of Florida’s uninsured working parents would more than double, just from 451,000 to 1,008,000 according to the Urban Institute report. Lack of access to affordable health care services would become an additional stress point for working families, both emotionally and financially. Medicaid coverage protects families from financial strain by reducing catastrophic out-of-pocket Medical expenditures. It also eliminates unmet medical needs based on affordability. The coverage enables access to medical care by generalists and specialists, prescription drugs, medical tests, treatments and follow-up care. Moreover, the ACA provides coverage that would otherwise be unavailable or too expensive for families with pre-existing health conditions.
In closing, policymakers must consider the damaging impact of repealing the ACA without simultaneously replacing it with a comparably affordable, equitable, quality and sustainable health care program that covers hard-working, low-income families. Florida cannot afford a reversal in progress in providing health coverage for children. It cannot strand working-class adults without health coverage. Rather, the state has more to do to increase health care coverage for thousands of low-income families in the coverage gap.
 [i]Buettgens, Matthew et al. 2016. The Urban Institute. Partial Repeal of the ACA through Reconciliation: Coverage Implications for Parents and Children. p. 8.
 Alker, Joan and Alisa Chester. 2016. Georgetown University Health Policy Institute, Center for Children and Families. Children’s Health Coverage Rate Now at Historic High of 95 Percent. p. 8.
 Paradise, Julia. 2014. Kaiser Family Foundation The Impact of the Children’s Health Insurance Program (CHIP): What does the Research Tell Us? p. 4.
[5v] Alker, Joan. 2016. Georgetown University, Center for Children and Families. New Study Finds Severe Consequences for Children and Families If ACA Is Repealed: The Number of Uninsured Children and Parents Would More Than Double.
 Supra note at i and viii
 Supra note at i and viii
 Baicker, Katherine et al. 2013. The New England Journal of Medicine. The Oregon Experiment-Effects of Medicaid on Clinical Outcomes.
 Holahan, John et al. 2016. Health Care Access and Affordability among Low-and Moderate-Income Insured and Uninsured Adults under the Affordable Care Act. pp. 4-5 and 8