✔ 最佳答案
When the ACA was passed, it represented a significant change to our health insurance system, Therefore repealing it would also be a significant change. And in any change there would be winners and losers. The GOP has said they want to not just "repeal" but "replace with something better". Since we haven't seen what that "something better" would be, its difficult to comment on who would win and who would lose under that scenario, but here are some of the pros and cons of the ACA: (at least in my opinion).
(Some of this is philosophical, so there aren't necessarily "hard lines" here.)
Pros:
1. No exclusion of pre-existing conditions
2. No lifetime caps on coverage
3. Allowed children to stay on parents plan till age 27.
4. Required all insurance to cover "essential benefits" like maternity care, mental health and substance abuse treatment, etc.
5. Limited insurance company profits
6. Expanded Medicaid coverage and provided subsidies for lower-income people to afford health insurance
7. Required employers with >50 employees to offer affordable coverage
8. The bottom line (for supporters at least), is that more people had coverage than before.
9. Could lead to a reduction in uncompensated care and medical bill bankruptcies for hospitals and individuals.
Cons:
1. Greatly expanded the role of government in healthcare. for some this is not an issue, but others, i.e. the "Congressional Freedom Caucus" believe that the government should not be involved at all, or at only a minimal level, so they are philosophically opposed to laws like the ACA, whether it helps people or not.
2. The ACA focused almost exclusively on health insurance, and did little to address the underlying cost of delivering healthcare. By mandating greater coverage, without doing much to reduce the cost of the coverage delivered, costs necessarily rose.
3. The ACA made health insurance more like "catastrophic coverage" and less like a maintenance plan. Deductibles increased for many. So even though people were much better covered if they got really sick, they were less likely to have "first dollar coverage" which led to dissatisfaction among many.
4. The individual mandate could be looked at as both a pro and a con. It encourages more people to carry coverage, but this has also been labeled as "government overreach".
5. pro or con: Insurance costs have risen since the passage of the ACA. But they were rising at a fast rate before as well. It's unclear how much the ACA really accelerated that increase, or if repealing it would really lead to lower premiums.
6. pro or con: The employer mandate - the plus is more people are likely to be offered health insurance, but the minus is the burden it places on employers, particularly in lower-wage industries, where health insurance was less commonly offered. This would be one benefit to a "single payer" system - is that it would remove the burden from business and the subsequent drag on employment entirely, but that would be a drastic shift in policy.
Basically, a full repeal would reverse the situation.
One thing that the GOP is struggling with, is that virtually any kind of repeal is likely to lead to fewer people being covered. This may be consistent with the viewpoint that it should be a free market, and a more limited role for government in healthcare, but the optics of having someone lose their healthcare are not good.
A repeal would likely benefit younger, healthier people by removing the mandate and making their insurance more affordable, but it would likely cost older people big time. Depending on how the replacement bill is written, it could also roll back some the essential benefits.
Hope that helps.