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Wishing it were so

Ten days ago, Gov. Andrew Cuomo traveled to Trump Tower in Manhattan to deliver a clear message to the man who two days later would take the oath of office as U.S. president.


Question: Was Donald Trump listening?


The key point of Mr. Cuomo’s message was that repeal of the Patient Protection and Affordable Care Act would have a devastating impact on New York, the new president’s home state. By the governor’s estimates, repeal would cause 2.7 million New Yorkers to lose health care coverage. In addition, the state would take a direct budget hit of $3.7 billion, and nearly $600 million of federal funding that goes to New York counties would be lost.


Yet one of the first actions Mr. Trump took after he moved into the White House was to sign an executive order designed to launch the repeal train down the tracks.


The governor surely is right that much is at stake. With the NY State of Health exchange in operation, New York has cut the percentage of uninsured residents in half, to 5 percent from 10 percent.


If Mr. Cuomo’s estimates are accurate, more than 75,000 Monroe County residents risk losing health coverage if the ACA is repealed with no replacement. In the surrounding counties, nearly 40,000 more people are at risk. In terms of the potential loss of federal funds, he estimates Monroe County alone could lose $13 million. 


The best hope to derail Mr. Trump’s repeal effort might be an alternative plan put forth by several Republican senators in Washington, D.C. Their measure, the Patient Freedom Act, would allow states to decide if they want to remain with Obamacare. Or states could receive roughly the same amount of money they currently get and allow patients to decide what level of coverage they want in a new market-based system.


It might be a slim hope, though: Conservatives and liberals alike apparently dislike the bill, for different reasons.


At least for now, it seems best to assume that the president really intends to repeal the ACA—and has the votes on Capitol Hill to do it.


1/27/2017 (c) 2017 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or email rbj@rbj.net.


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