As if gutting Medicaid wasn’t enough…

Republicans in Congress aren’t satisfied with just slashing Medicaid, so they are now looking at using reconciliation to repeal large swaths of the Affordable Care Act (ACA) to pay for tax breaks for billionaires, big corporations and campaign donors.

These days, everyone has heard of “Obamacare,” the landmark 2010 law that for the first-time created consumer protections like no discrimination based on pre-existing conditions and gender, and no annual or lifetime caps on coverage.

The Affordable Care Act turned 15 earlier this year and, despite a rocky start and endless “Repeal and Replace” attacks from Republican opponents in Congress and President Donald Trump, it has persisted and is more popular than ever. While the march towards quality, affordable health care for all remains a long one, the political battle to pass the ACA by the narrowest of margins was huge, and we now face another huge fight to maintain the gains we’ve made in healthcare access and equity so that progress isn’t lost.

Under the current administration and Republican-controlled Congress, the ACA, including Medicaid coverage, are at risk once again. Congress is marking up its long-awaited committee bills to achieve the $1.5 trillion in spending cuts outlined in April’s budget resolution to hand out tax breaks to billionaires, big corporations, and campaign donors.

The budget resolution outlines significant cuts to Medicaid, squarely threatening Medicaid expansion which covers more than 160,000 West Virginians. Among the included provisions are harsh work reporting requirements for adults between the ages of 19 and 64, increased paperwork and red tape for all expansion enrollees, and increased cost sharing and co-pays for some adults.

A recent report by the West Virginia Center on Budget and Policy estimates that roughly 40,000 West Virginians would lose their health care coverage as a result, including more than 23,000 residents in Congresswoman Carol Miller’s district and 17,000 in Congressman Riley Moore’s.

In addition, these coverage losses would result in the loss of hundreds of millions of dollars in federal funding that currently goes to hospitals and providers in West Virginia. As a result, thousands of jobs in the state would be lost and rural providers have warned that hospitals operating on the margins would be at risk of closure.

Also, this resolution does not extend the enhanced premium tax credits that have helped more people get affordable coverage since 2022. More than 50,000 West Virginians get their health coverage through the Affordable Care Act’s health insurance marketplace, with over 95% receiving a tax credit subsidy to help make their monthly premiums more affordable. As part of the American Rescue Plan Act (ARPA) and then the Inflation Reduction Act (IRA), Congress increased the amount of financial assistance available to families who get their health coverage through the ACA marketplace. In West Virginia, this resulted in marketplace enrollment more than doubling.

West Virginia residents saw the most benefit from the increased ACA subsidies, as our state has the highest health care costs in the country. If allowed to expire at the end of the year, the 50,000 residents who get their health coverage through the Marketplace would see their monthly premiums increase by 140 percent.

We’ve been down this road before. Taken together, the renewed Republican effort to repeal key parts of the ACA will threaten coverage for upwards of 25 million Americans, and that doesn’t include coverage losses resulting from their attacks on Medicaid.

These policies are highly unpopular — even among Republican voters. If Republicans get their way, costs will go up, hardworking families will lose their coverage, and the entire health care system will be thrown into chaos.

This means that Republicans, after promising to lower prices and improve the economy for working Americans, are set to do the very opposite: take food and health care away from working class families to make the richest people even richer.  It’s up to us to stop them.

 

Ellen Allen, Executive Director of West Virginians for Affordable Health Care

Originally Published May 29, 2025 in West Virginia Watch.