The proposed changes mean a lot for consumers - particularly low-income families and seniors.
First, we would see a rollback in coverage for low-income families. What didn't get as much attention as the 22 percent average premium increase this Open Enrollment season was the fact that a large portion of shoppers wouldn't be hit quite that hard thanks to subsidies and expanded Medicaid coverage offered by the government in an attempt to make health insurance more affordable.
Approximately 15.7 million people have enrolled in Medicaid and CHIP since the October 2013 expansion. Repealing Obamacare would cause an estimated 22 million people to become uninsured – including many consumers who are covered through the Medicaid expansion. Eight million children are covered by CHIP, so if that program expires (which it is currently set to do at the end of September 2017) as part of Medicaid's rollback, that leaves even more people uninsured.
If Medicare requires premium payments and for senior consumers to buy private insurance, that, along with other potential changes like changing age banding requirements from a 3-to-1 ratio to a 5-to-1 ratio (which serves as a rate cap for what insurers can charge older consumers) means that some seniors will end up with wildly different, and potentially more expensive, healthcare options. It's not far-fetched to predict a scenario where many seniors - facing a more expensive and confusing array of private health insurance options - just throw up their hands and forego coverage.
Changes to both programs go outside of just consumers. Medicaid cuts would affect insurers in the Medicaid managed care market, not to mention "hospitals, drug companies, medical equipment manufacturers, doctors and other health-care providers." If Medicare becomes another insurance marketplace, that could be a boon for insurers offering Medicare Advantage plans who would stand to gain many more customers.
The purpose of Obamacare was to offer healthcare protection. Though it's been mired in compromise and controversy, it's achieved this goal, or is at least well on its way. Changes to Medicaid and Medicare, and the subsequent results those changes will have on the health insurance system, threaten to roll back those protections for the people who need them most. Higher cost for coverage and a more convoluted system may not be what Republican lawmakers are trying to impose, but it's what their proposed changes may result in if they go forward.