As Congress tries to jam through its newest version of ACA repeal, a new research report from RAND Corporation highlights one group who would be particularly wronged — veterans. Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA)’s latest version of repeal and replace resurrects — and worsens — the devastating cuts in coverage and benefits in prior proposals by ending Medicaid expansion, undermining protections for people with preexisting conditions and eliminating financial assistance that helps low- and moderate-income families purchase health care coverage. Adding insult to injury, the proposal also caps funding for traditional Medicaid, leaving states with budget shortfalls and forcing them to cut eligibility and benefits.
While many of us presume that all veterans can receive health care through the Department of Veterans Affairs (VA), many do not qualify or are unable to access VA care for a number of reasons. For example, veterans may not live near a VA health provider or may have a service-related disability or income level that disqualifies them from VA care.
The RAND report notes — and the Urban Institute reinforces — that the ACA’s Medicaid expansion and marketplaces helped address gaps in health insurance coverage and contributed to lower rates of uninsurance among veterans. In 2015, the ACA had successfully brought down uninsurance among veterans by about one-third, from 9.1 percent to 5.8 percent. This translates to a drop in the number of uninsured veterans from 980,000 in 2013 to 552,000 in 2015. Medicaid expansion, in particular, helped drive this shift since states that expanded the program saw the largest reductions in uninsurance. The RAND report further notes that repealing the ACA would have a significant effect on veterans’ health insurance coverage and would likely increase demand for health services through the VA. The report also highlights that one in three nonelderly veterans have a preexisting health condition, which means maintaining the ACA’s protections are especially important.
Protecting these gains in access to health insurance coverage is critical to improving veterans’ health outcomes. Urban Institute data shows that as uninsurance rates of nonelderly veterans decreased, “veterans experienced fewer unmet health needs, suggesting that increased coverage translated into improved access to care.” Unfortunately, the Graham-Cassidy proposal would undermine the improvements in veterans’ insurance coverage and health care access rates and make it especially difficult for veterans with preexisting conditions to get the care they need.
As veterans have fought so hard to defend us, we must fight to defend the health coverage they need and deserve.