true costs of repeal: republican plans to repeal the ... · repealed, and could be subject to a new...

455
U.S. House of Representatives Committee on Energy and Commerce Committee on Oversight and Government Reform Democratic Staff Memo True Costs of Repeal: Republican Plans to Repeal the Affordable Care Act Will Harm Every Congressional District March 2017

Upload: others

Post on 05-Jun-2020

4 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

U.S. House of Representatives Committee on Energy and Commerce Committee on Oversight and Government Reform Democratic Staff Memo

True Costs of Repeal: Republican Plans to Repeal the Affordable Care Act Will Harm Every Congressional District

March 2017

Page 2: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

2

I. EXECUTIVE SUMMARY

As a direct result of the Patient Protection and Affordable Care Act (ACA), more than 20 million Americans have gained access to affordable and high quality health insurance, and the country’s uninsured rate has reached an historic low. The ACA’s historic coverage gains were achieved by expanding Medicaid and creating online Marketplaces for consumers to purchase insurance with financial assistance in the form of premium tax credits and cost-sharing reductions.1

Since 2010, congressional Republicans have taken endless actions to sabotage the ACA

through funding cuts, legislative changes, and legal challenges. Republicans in Congress are now threatening to repeal the ACA through a process known as budget reconciliation. Repealing the ACA and reversing the Medicaid expansion would harm lower and middle class Americans in every congressional district. Repeal of the ACA’s market reforms and Republican proposals to tax employer-based coverage would harm Americans in every congressional district who receive health insurance through their employer.

To examine the impact of potential ACA repeal on each of the 435 congressional districts

and the District of Columbia, the Democratic staff of the Committees analyzed health insurance data collected from sources including the Census Bureau’s American Community Survey (ACS) and Small Area Health Insurance Estimates (SAHIE).

The analysis found: (1) all congressional districts and the District of Columbia have seen

reductions in their uninsured rates since the ACA was implemented, with an average reduction of 5.4 percentage points; (2) on average, 396,200 individuals with employer-sponsored insurance in each congressional district are at risk of losing important consumer protections if the ACA is repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class tax hike in the last 50 years; and (3) on average, 360,200 individuals in each congressional district stand to lose access to free preventive care if the ACA is repealed.

Staff conducted additional analyses to examine the potential impact of repeal on

Republican congressional districts, whose representatives have been advocating strongly for ACA repeal. The analysis found: (1) 79 Republican congressional districts have seen greater than average reductions their uninsured rates; (2) 99 Republican congressional districts have seen greater than average Marketplace enrollment; and (3) 85 Republican congressional districts have seen greater than average gains in Medicaid enrollment.

Nearly 80 Republican congressional districts have seen greater than average declines in

their uninsured rates. In Rep. David Valado’s (R-CA) district, the uninsured rate declined by 13.1 percentage points—more than twice the average. Below are the ten Republican congressional districts with the largest reductions in the uninsured rate since the ACA was

1 Approximately 2.3 million young adults under 26 gained coverage as a result of an ACA reform that requires insurers to allow young adults to stay on their parents’ insurance policies, but this analysis does not examine the impact of this provision at the congressional district level.

Page 3: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

3

implemented. Table 1: Top Ten Republican Districts, By Decline in Uninsured Rate

District Representative Uninsured rate, 2012

Uninsured rate, 2015

Change in Uninsured Rate

CA-21 David Valadao 25.4 12.2 13.1 FL-27* Ileana Ros-Lehtinen 29.1 16.4 12.7 KY-5 Hal Rogers 17.4 5.7 11.8 CA-8 Paul Cook 18.9 7.7 11.2 NV-2 Mark Amodei 20.2 9.8 10.4 FL-26* Carlos Curbelo 28.8 18.5 10.3 CA-10 Jeff Denham 16.2 6.3 9.9 CA-23 Kevin McCarthy 15.7 5.9 9.8 WV-1 David McKinley 14.7 4.9 9.8 CA-39 Ed Royce 17.1 7.4 9.7 *Denotes state that did not expand Medicaid

Republican congressional districts have also seen significant Marketplace enrollment,

which contributed to declines in the uninsured rates even in states that chose not to expand Medicaid. Rep. Ileana Ros-Lehtinen’s (R-FL) district had nearly 100,000 people enrolled in Marketplace coverage. In total, 99 Republican congressional districts saw greater than average Marketplace enrollment. Below are the ten Republican congressional districts with the highest Marketplace enrollment levels. Table 2: Top Ten Republican Districts, By Marketplace Enrollment

District Representative Marketplace Enrollment

FL-27 Ileana Ros-Lehtinen 96,300 FL-26 Carlos Curbelo 92,500 FL-25 Mario Diaz-Balart 83,100 FL-18 Brian Mast 60,000 GA-7 Rob Woodall 53,600 MT Ryan Zinke* 51,800 FL-19 Francis Rooney 50,300 FL-6 Ron DeSantis 48,800 ID-1 Raul Labrador 47,200 ID-2 Mike Simpson 47,100 *Seat became vacant as of March 1, 2017

Republican congressional districts have also seen dramatic gains in Medicaid coverage as

a result of the ACA’s Medicaid expansion. More than 80 Republican congressional districts saw greater than average enrollment through the Medicaid expansion. Rep. Greg Walden (R-OR) had the largest Medicaid expansion enrollment of any Republican congressional district, with nearly 130,000 of his constituents enrolling in Medicaid through the expansion. Below are the ten Republican districts with the highest Medicaid expansion enrollment levels.

Page 4: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

4

Table 3: Top Ten Republican Districts, By Medicaid Expansion Enrollment

District Representative Medicaid Expansion Enrollment OR-2 Greg Walden 129,200 CA-21 David Valadao 115,600 KY-5 Hal Rogers 104,600 WA-4 Dan Newhouse 87,400 NY-23 Tom Reed 86,100 NM-2 Steve Pearce 85,900 CA-8 Paul Cook 85,600 CA-22 Devin Nunes 82,800 NY-22 Claudia Tenney 82,300 NY-11 Dan Donovan 78,800

These Republican congressional districts will be the most negatively impacted by their

representatives’ plans to repeal the ACA. The analysis reveals that repeal of the ACA would endanger coverage for newly insured

Americans, millions of whom live in Republican congressional districts. Despite the fact that significant numbers of their own constituents are currently enjoying the law’s many benefits, House Republicans continue to pursue their extreme, ideological agenda of repealing the ACA at any cost.

Page 5: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

5

II. BACKGROUND A. The ACA has Expanded Access to Coverage, Improved the Quality of

Coverage, and Reduced Health Care Spending The ACA has expanded affordable, quality health insurance to approximately 20 million

Americans—many for the first time in their lives.2 As a direct result of the ACA, 3.4 million children have now gained coverage, as have 3.6 million Americans whose pre-existing health conditions previously prevented them from accessing affordable insurance.3 An additional 2.3 million young adults have been able to stay on a parent’s insurance plan, and 14 million people are now covered through the ACA’s Medicaid expansion.4 The ACA has also made health insurance more affordable for approximately 9.4 million Americans who receive financial assistance to purchase insurance through the ACA Marketplaces in the form of advance premium tax credits and the 6.4 million Americans who receive financial assistance in the form of cost-sharing reductions.5 The country’s uninsured rate is at an historic low—8.6 percent in 2016, as compared with approximately 16 percent in 2010, before the ACA was implemented.6

The ACA put an end to the discriminatory and abusive insurance practices that were

rampant before the law was enacted. Prior to the ACA, 105 million Americans—including 70 million Americans with employer-sponsored insurance—faced annual or lifetime dollar limits on

2 National Center for Health Statistics, Centers for Disease Control and Prevention,

Department of Health and Human Services, Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, January-March 2016 (Sept. 2016) (online at www.cdc.gov/nchs/data/nhis/earlyrelease/insur201609.pdf).

3 House Committees on Oversight and Government Reform and Energy and Commerce, Democratic Staff, Oversight and Energy & Commerce Dems Release State Fact Sheets on Impact of GOP Assault on ACA (Jan. 5, 2017) (online at democrats-oversight.house.gov/news/press-releases/oversight-and-energy-commerce-dems-release-state-fact-sheets-on-impact-of-gop); Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, Health Insurance Coverage for Americans with Pre Existing Conditions: The Impact of the Affordable Care Act (Jan. 5, 2017) (online at aspe.hhs.gov/system/files/pdf/255396/Pre-ExistingConditions.pdf).

4 House Committees on Oversight and Government Reform and Energy and Commerce, Democratic Staff, Oversight and Energy & Commerce Dems Release State Fact Sheets on Impact of GOP Assault on ACA (Jan. 5, 2017).

5 Centers for Medicare and Medicaid Services, Department of Health and Human Services, March 31, 2016 Effectuated Enrollment Snapshot (June 30, 2016) (online at www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-06-30.html) (accessed Jan. 3, 2017).

6 National Center for Health Statistics, Centers for Disease Control and Prevention, Department of Health and Human Services, Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, January-March 2016 (Sept. 2016) (online at www.cdc.gov/nchs/data/nhis/earlyrelease/insur201609.pdf).

Page 6: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

6

their coverage.7 As a result of the ACA, insurance plans can no longer place annual or lifetime limits on care. Prior to the ACA, women who lived in states that allowed gender rating paid from 10 percent to 57 percent more than men for their health insurance, simply for being a woman.8 The ACA put an end to this practice. Prior to the ACA, 52.2 million Americans had pre-existing medical conditions that meant they could be charged more for coverage, face exclusions or limitations on their care, have their coverage rescinded, or be denied health insurance altogether.9 Insurance companies can no longer discriminate on the basis of health status, as a direct result of the ACA.

The ACA has improved the quality of health insurance for all Americans, including

those who receive insurance through their employer. Approximately 137.7 million Americans with private insurance—including employer-sponsored insurance—receive free preventive services, such as cholesterol screenings, mammograms, and flu shots.10 Seniors have also benefited from this reform. As a result of the ACA, approximately 26.5 million seniors enrolled in Medicare Part B received free wellness visits and preventive services in 2015.11 The ACA also improved the quality of coverage in the individual and small group markets. All insurance plans sold in these markets must now cover ten categories of Essential Health Benefits, including prescription drugs, mental health services, emergency services, and pediatric care.12

In addition to expanding access and improving the quality of coverage, the ACA has helped millions of Americans save money by slowing premium growth. Employer-sponsored

7 Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, ASPE Issue Brief: Under the Affordable Care Act, 105 Million Americans No Longer Face Lifetime Limits on Health Benefits (Mar. 2012) (online at aspe.hhs.gov/basic-report/under-affordable-care-act-105-million-americans-no-longer-face-lifetime-limits-health-benefits).

8 National Women’s Law Center, Turning to Fairness (Mar. 2012) (online at www.nwlc.org/sites/default/files/pdfs/nwlc_2012_turningtofairness_report.pdf).

9 Kaiser Family Foundation, Pre-Existing Conditions and Medical Underwriting in the Individual Insurance Market Prior to the ACA (Dec. 12, 2016) (online at kff.org/health-reform/issue-brief/pre-existing-conditions-and-medical-underwriting-in-the-individual-insurance-market-prior-to-the-aca).

10 Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Compilation of State Data on the Affordable Care Act (Dec. 2016) (online at aspe.hhs.gov/compilation-state-data-affordable-care-act ).

11 Department of Health and Human Services, Centers for Medicare and Medicaid Services, Beneficiaries Utilizing Free Preventive Services by State, 2015 (online at https://downloads.cms.gov/files/Beneficiaries%20Utilizing%20Free%20Preventive%20Services%20by%20State%20YTD%202015.pdf) (accessed Jan. 3, 2017).

12 Center for Consumer Information and Insurance Oversight, Centers for Medicare and Medicaid Services, Department of Health and Human Services, Information on Essential Health Benefits (EHB) Benchmark Plans (online at www.cms.gov/cciio/resources/data-resources/ehb.html) (accessed Feb. 22, 2017).

Page 7: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

7

insurance premiums have increased at an annual rate of approximately 5 percent since the ACA was implemented, as compared to 7.9 percent before the ACA. As a result, the average family paid about $3,600 less for employer-sponsored insurance in 2016 than it would have paid had the ACA not been enacted.13 Premiums in the individual insurance market have also grown 12 percent to 20 percent more slowly than projected before the ACA was passed.14

B. Repealing the ACA Would Harm All Americans

President Trump and congressional Republicans’ plan to repeal the ACA will have

devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for many of the millions of Americans who received financial assistance to purchase insurance through the ACA Marketplaces in 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who have coverage through the ACA’s historic Medicaid expansion. Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

A recent analysis issued by the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) estimates that 18 million Americans would lose their health insurance in just the first year following repeal, even if the law’s market reforms are kept in place. CBO and JCT predict that 27 million people would lose coverage if Medicaid expansion is reversed, and 32 million fewer people would have health insurance by 2026.15

The Urban Institute has reached similar conclusions: if the ACA is even partially

repealed, the number of uninsured Americans would increase by approximately 30 million in 2019, a 103 percent increase.16 If congressional Republicans move forward with repeal, more people would be uninsured in 2019 than were uninsured in 2009, before the ACA was passed.

13 Council of Economic Advisors, Executive Office of the President, The Economic Record of the Obama Administration: Reforming the Health Care System (Dec. 2016) (online at obamawhitehouse.archives.gov/blog/2016/12/13/economic-record-obama-administration-reforming-health-care-system).

14 Kaiser Family Foundation, How ACA Marketplace Premiums Measure up to Expectations (Aug. 1, 2016) (online at kff.org/health-reform/perspective/how-aca-Marketplace-premiums-measure-up-to-expectations); Brookings Institution Center for Health Policy, ACA Premiums Are Lower Than You Think (July 21, 2016) (online at www.brookings.edu/research/affordable-care-act-premiums-are-lower-than-you-think/).

15 Congressional Budget Office, How Repealing Portions of the Affordable Care Act Would Affect Health Insurance Coverage and Premiums (Jan. 17, 2017) (online at www.cbo.gov/sites/default/files/115th-congress-2017-2018/reports/52371-coverageandpremiums.pdf).

16 Urban Institute, Implications of Partial Repeal of the ACA through Reconciliation (Dec. 2016) (online at www.urban.org/sites/default/files/publication/86236/2001013-the-implications-of-partial-repeal-of-the-aca-through-reconciliation_1.pdf).

Page 8: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

8

According to the study, approximately 82 percent of those becoming uninsured because of ACA repeal would be from working families, 56 percent would be Caucasian, and 80 percent would not have college degrees.17

Reversing the ACA’s Medicaid expansion would be exceptionally harmful to the

residents of states that expanded Medicaid. In these states, such as California, Illinois, and New York, the uninsured rate would more than double.18 An additional 4 million Americans who live in states that have not yet expanded Medicaid will lose the opportunity to gain coverage if the ACA is repealed or the Medicaid expansion is reversed.19 To date, the Medicaid expansion has been entirely federally funded, generating significant savings for state and local governments. If the Medicaid expansion is reversed, states are at risk of losing $78.8 billion in federal Medicaid dollars.20

In addition repealing the ACA and reversing the Medicaid expansion, Republicans in Congress have proposed taxing workers on their employer-sponsored health insurance. This change would shift costs onto employees in the form of higher taxes. According to CBO, the employer tax exclusion subsidizes approximately 30 percent of the average premiums for employees.21 In 2016, the tax exclusion was valued at about $250 billion.22 This new tax on employer-sponsored insurance would amount to the largest middle-class tax hike in the last 50 years.

Finally, Republicans have proposed changing current law to allow insurers to charge up

to five times what they charge younger adults. This increase in “rate-banding” would increase the federal deficit by $11 billion while raising prices by as much as $3,000 per year for older Americans.23

17 Id. 18 Id. 19 Center on Budget and Policy Priorities, Repealing Health Reform’s Medicaid

Expansion Would Cause Millions to Lose Coverage, Harm State Budgets (Dec. 22, 2016) (online at www.cbpp.org/research/health/repealing-health-reforms-medicaid-expansion-would-cause-millions-to-lo se-coverage).

20 House Committees on Oversight and Government Reform and Energy and Commerce, Democratic Staff, Oversight and Energy & Commerce Dems Release State Fact Sheets on Impact of GOP Assault on ACA (Jan. 5, 2017).

21 Congressional Budget Office, Private Health Insurance Premiums and Federal Policy (Feb. 2016) (online at www.cbo.gov/sites/default/files/114th-congress-2015-2016/reports/51130-Health_Insurance_Premiums.pdf).

22 Id. 23 The Commonwealth Fund, Insuring Young Adults through the ACA’s Marketplaces:

Options to Expand Enrollment (Dec. 16, 2016) (online at www.commonwealthfund.org/publications/blog/2016/dec/insuring-younger-adults).

Page 9: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

9

III. IMPACT OF REPEAL AT THE CONGRESSIONAL DISTRICT LEVEL

The staff analysis examined uninsured rates, private insurance coverage—including employer-sponsored insurance—Marketplace enrollment and related financial assistance, and Medicaid coverage, in each of the 435 congressional districts and the District of Columbia. The analysis found that repealing the ACA would endanger coverage for millions of Americans in Democratic and Republican congressional districts alike.

A. Constituents in Every Congressional District Saw Substantial Reductions in

the Uninsured Rate That Would be Threatened by Repeal Based on 2012 and 2015 data from the Census Bureau’s American Community Survey

(ACS), every single congressional district in the country has experienced reductions in the uninsured rate under the ACA. The average reduction in the uninsured rate from 2012 to 2015 across all congressional districts was 5.4 percentage points. The uninsured rate likely declined even further in many, if not all, congressional districts in 2016.

Congressional districts in states such as Massachusetts, which had near-universal

coverage prior to the enactment of the ACA, saw the smallest declines in the uninsured rate, while congressional districts in states such as California and Nevada, which had high uninsured rates prior to the ACA and took advantage of the ACA’s Medicaid expansion, saw the greatest reductions in the uninsured rate. Unsurprisingly, congressional districts in states that expanded Medicaid saw greater declines in the uninsured rate than states that did not—5.8 percentage points versus 4.9 percentage points on average.

Coverage gains have been achieved through a combination of both Medicaid expansion

and Marketplace enrollment. This analysis examined Marketplace enrollment as of March 2016 in all 435 congressional districts and the District of Columbia, using data from the Kaiser Family Foundation.24 All congressional districts experienced significant Marketplace enrollment, ranging from a low of 5,200 enrollees in the 1st Congressional district of Hawaii, represented by Rep. Colleen Hanabusa (D), to a high of 96,300 enrollees in the 27th Congressional District of Florida, represented by Rep. Ileana Ros-Lehtinen (R). Across all congressional districts, the average number of Marketplace enrollees was 26,400.

A large majority of these enrollees are receiving financial assistance to purchase

insurance. The average number of Marketplace enrollees receiving advanced premium tax credits was 21,500, or approximately 81 percent of all Marketplace enrollees. The average number of Marketplace enrollees receiving cost-sharing reductions was 14,600, or 55 percent of all Marketplace enrollees.

This analysis also examined Medicaid expansion enrollment using 2015 Medicaid

enrollment data from the Medicaid Budget and Expenditure System (MBES) analyzed by the

24 Kaiser Family Foundation, Interactive Maps: Estimates of Enrollment in ACA

Marketplaces and Medicaid Expansion (Jan. 10, 2017) (online at kff.org/interactive/interactive-maps-estimates-of-enrollment-in-aca-Marketplaces-and-medicaid-expansion).

Page 10: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

10

Kaiser Family Foundation.25 The 19 states that have not adopted the Medicaid expansion contain 166 congressional districts, while the 32 states and the District of Columbia, which have expanded Medicaid, contain 270 congressional districts. The average number of Medicaid expansion enrollees across all congressional districts was 32,800.

These coverage gains are very much at risk as congressional Republicans move to repeal

the ACA through reconciliation. Congressional Republicans intend to eliminate the Medicaid expansion, make additional harmful cuts to the Medicaid program, and eliminate the premium assistance tax credits and cost-sharing reductions—replacing them with less generous tax credits that are unlikely to be sufficient for lower and middle class Americans to afford coverage.26

B. Americans in Private and Employer-Based Insurance Will Also be Impacted by Efforts to Repeal the ACA

Based on ACS data for 2015, the repeal of the ACA would also deeply impact individuals

in each congressional district with employer-based coverage, who now enjoy important consumer protections because of the ACA, and individuals with private insurance coverage, who now have access to preventive health services at no cost.

If the ACA is repealed, more than 150 million Americans with employer-sponsored plans

stand to lose critical consumer protections and benefits that many have gained thanks to the ACA. These benefits include protection against pre-existing coverage exclusions, prohibition against annual and lifetime limits on coverage, protection against arbitrary and unfair rescissions of health insurance policies, and a requirement that insurers allow children to stay on their parent’s insurance up to age 26.27 On average, 396,200 individuals in each congressional district stand to lose these consumer protections if the ACA is repealed.

As a result of the ACA, most individuals in private insurance policies now have access to

preventive services such as immunizations, screenings, and annual checkups, without any co-pays, coinsurance, or deductibles.28 These individuals stand to lose this access if Republicans in

25 Kaiser Family Foundation, What Coverage and Financing is at Risk Under a Repeal of the ACA Medicaid Expansion? (Dec. 6, 2016) (online at kff.org/medicaid/issue-brief/what-coverage-and-financing-at-risk-under-repeal-of-aca-medicaid-expansion).

26 Center for Budget and Policy Priorities, House Republicans Would Reverse ACA Coverage Gains and Radically Overhaul Medicaid, New Talking Points Confirm (Feb. 17, 2017) (online at www.cbpp.org/research/health/house-republicans-would-reverse-aca-coverage-gains-and-radically-overhaul-medicaid).

27 Congressional Research Service, Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act (Feb.10, 2016) (online at fas.org/sgp/crs/misc/R42069.pdf).

28 Grandfathered health plans are exempt from this requirement. See Kaiser Family Foundation, Preventive Services Covered by Private Health Plans under the Affordable Care Act (Aug. 4, 2015) (online at kff.org/health-reform/fact-sheet/preventive-services-covered-by-private-health-plans/).

Page 11: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

11

Congress repeal the ACA. On average, 360,200 individuals in each congressional district stand to lose access to free preventive care if the ACA is repealed.

C. Republicans Voting For ACA Repeal Will Harm Their Own Constituents Congressional Republicans’ plans to repeal the ACA will undermine insurance coverage

and access to care for millions of their own constituents. This analysis demonstrates the extent to which constituents in Republican congressional districts are benefitting from the ACA and how many individuals may be directly harmed by efforts to repeal the ACA.

Americans in all 435 congressional districts and the District of Columbia are currently benefitting from the ACA. Below are the Republican congressional districts that experienced the largest coverage gains, as represented by reductions in the uninsured rates. These are the same districts that will likely experience the most dramatic coverage losses if repeal is successful. All of these congressional districts experienced significantly greater reductions in the uninsured rate than the average reduction across all congressional districts (5.4 percentage points). Table 4- Top 40 Republican Congressional Districts, By Decline in Uninsured Rate District Representative Uninsured

rate, 2012 Uninsured rate, 2015

Change in Uninsured

Rate

Marketplace Enrollment

CA-21 David Valadao 25.4 12.2 13.1 18,000 FL-27* Ileana Ros-Lehtinen 29.1 16.4 12.7 96,300 KY-5 Hal Rogers 17.4 5.7 11.8 12,000 CA-8 Paul Cook 18.9 7.7 11.2 23,700 NV-2 Mark Amodei 20.2 9.8 10.4 22,500 FL-26* Carlos Curbelo 28.8 18.5 10.3 92,500 CA-10 Jeff Denham 16.2 6.3 9.9 23,600 CA-23 Kevin McCarthy 15.7 5.9 9.8 19,300 WV-1 David McKinley 14.7 4.9 9.8 11,200 CA-39 Ed Royce 17.1 7.4 9.7 29,100 CA-22 Devin Nunes 17.1 7.4 9.7 19,700 FL-25*^ Mario Diaz-Balart 32.2 22.7 9.5 83,100 AR-1 Rick Crawford 18.0 8.6 9.4 15,000 OR-2 Greg Walden 17.3 8.0 9.3 29,500 NC-2*^ George Holding 17.6 8.8 8.8 40,400 CO-4 Ken Buck 14.2 5.4 8.8 14,500 CA-1 Doug LaMalfa 15.9 7.2 8.7 24,900 WV-3 Evan Jenkins 15.4 6.9 8.4 10,200 NM-2 Steve Pearce 18.8 10.4 8.3 15,100 KY-1 James Corner 15.1 6.8 8.3 12,200 FL-17*^ Tom Rooney 25.1 16.8 8.3 39,300 FL-18* Brian Mast 19.5 11.3 8.2 60,000 FL-3* Ted Yoho 21.0 12.9 8.1 35,100 CA-42 Ken Calvert 15.9 7.9 8.1 25,200

Page 12: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

12

KY-2 Brett Guthrie 13.2 5.3 7.9 12,600 CO-6 Mike Coffman 15.8 7.9 7.8 14,000 WA-8 Dave Reichert 13.3 5.5 7.8 17,100 NC-9*^ Robert Pittenger 19.1 11.4 7.7 43,500 WA-3 Jamie Herrera Beutler 13.9 6.4 7.6 16,400 CA-50 Duncan Hunter 16.2 8.7 7.5 29,500 CA-25 Steve Knight 14.9 7.4 7.5 28,900 CA-48 Dana Rohrabacher 14.0 6.6 7.5 30,200 WA-5 Cathy McMorris

Rodgers 12.9 5.4 7.4 14,500 TX-24* Kenny Marchant 20.7 13.3 7.4 32,900 FL-15* Dennis Ross 18.4 11.1 7.4 39,700 WA-4 Dan Newhouse 19.2 11.9 7.3 11,300 WV-2 Alex Mooney 13.3 6.1 7.2 11,800 CA-4 Tom McClintock 12.2 5.1 7.1 26,900 AR-3 Steve Womack 16.9 9.9 7.0 17,900 CA-49 Darrell Issa 15.0 8.0 7.0 30,100 *Denotes state that did not expand Medicaid ^ Denotes state for which Small Area Health Insurance Estimates were used (uninsured rate for adults under 65)

Districts in states that had high uninsured rates prior to the ACA and decided to expand Medicaid, such as California, Kentucky, West Virginia, and Arkansas, have seen the greatest coverage gains under the ACA, as well as corresponding declines in uninsured rates.

Although most of the congressional districts with the largest reductions in uninsured rates are located in Medicaid expansion states, some of the most significant declines in the uninsured rate occurred in non-expansion states such as Florida, where Marketplace enrollment was particularly high. Moreover, a vast majority of Marketplace enrollees in these districts—93 percent—qualified for and received premium assistance, and a significant majority—72 percent—are receiving cost-sharing reductions. Republican efforts to repeal the ACA will directly harm these constituents, who make less than 400 percent of the federal poverty level (FPL) and are unlikely to be able to afford health insurance without this financial assistance—particularly given the significantly less generous tax credits congressional Republicans have proposed.29 Congressional Republicans have also proposed completely eliminating cost-sharing reductions, which are crucial for individuals and families below 200 percent of the FPL to be able to afford to use their health insurance. Below are the Republican congressional districts that experienced the highest Marketplace enrollment:

29 Center on Budget and Policy Priorities, House Republicans Would Reverse ACA

Coverage Gains and Radically Overhaul Medicaid, Talking Points Confirm (Feb. 17, 2017) (online at www.cbpp.org/research/health/house-republicans-would-reverse-aca-coverage-gains-and-radically-overhaul-medicaid).

Page 13: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

13

Table 5- Top 25 Republican Congressional Districts, By Marketplace Enrollment

District Representative Marketplace Enrollment

Premium Tax

Credits

Cost-Sharing Reductions

FL-27 Ileana Ros-Lehtinen 96,300 93,200 74,100 FL-26 Carlos Curbelo 92,500 89,400 70,200 FL-25 Mario Diaz-Balart 83,100 79,800 63,800 FL-18 Brian Mast 60,000 55,700 44,100 GA-7 Rob Woodall 53,600 48,800 38,000 MT Ryan Zinke* 51,800 44,100 23,500 FL-19 Francis Rooney 50,300 47,100 37,000 FL-6 Ron DeSantis 48,800 45,100 33,800 ID-1 Raul Labrador 47,200 41,445 29,422 ID-2 Mike Simpson 47,100 41,357 29,359 UT-3 Jason Chaffetz 44,800 39,900 29,200 NC-11 Mark Meadows 44,500 41,700 29,200 NC-13 Ted Budd 43,900 40,900 29,100 FL-8 Bill Posey 43,700 40,300 30,600 NC-9 Robert Pittenger 43,500 39,600 29,400 FL-12 Gus Bilirakis 43,400 39,700 30,900 FL-16 Vern Buchanan 42,400 38,200 28,100 UT-2 Chris Stewart 42,000 37,500 27,500 NC-7 David Rouzer 41,800 38,800 28,500 UT-4 Mia Love 41,600 35,900 27,000 NC-10 Patrick McHenry 41,500 38,200 26,500 FL-11 Daniel Webster 41,200 38,300 30,900 GA-6 Tom Price** 40,600 34,200 25,100 TX-22 Pete Olson 40,500 33,300 23,600 NC-2 George Holding 40,400 35,500 25,100 *Seat vacant as of March 1, 2017 **Seat vacant as of February 10, 2017

Finally, the ACA’s historic Medicaid expansion has significantly expanded health care coverage across the country, and in many Republican districts. Yet congressional Republicans persist in their efforts to take health insurance coverage away from their own constituents by reversing the Medicaid expansion and cutting Medicaid funding, which will result in rationing of health care for low-income individuals. Below are the Republican congressional districts that experienced the highest Medicaid expansion enrollment:

Page 14: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

14

Table 6- Top 40 Republican Congressional Districts by Medicaid Expansion Enrollment

District Representative Medicaid Expansion Enrollment OR-2 Greg Walden 129,200 CA-21 David Valadao 115,600 KY-5 Hal Rogers 104,600 WA-4 Dan Newhouse 87,400 NY-23 Tom Reed 86,100 NM-2 Steve Pearce 85,900 CA-8 Paul Cook 85,600 CA-22 Devin Nunes 82,800 NY-22 Claudia Tenney 82,300 NY-11 Dan Donovan 78,800 AR-1 Rick Crawford 77,200 WA-5 Cathy McMorris Rodgers 76,300 KY-1 James Corner 76,000 AR-4 Bruce Westerman 75,600 KY-6 Andy Barr 75,100 CA-10 Jeff Denham 74,100 NY-21 Elise Stefanik 73,700 CA-1 Doug LaMalfa 73,600 CA-23 Kevin McCarthy 73,500 NY-24 John Katko 72,000 AR-3 Steve Womack 69,800 AR-2 French Hill 69,100 NY-19 John Faso 68,600 KY-2 Brett Guthrie 68,200 WV-3 Evan Jenkins 67,300 CO-3 Scott Tipton 61,900 WA-3 Jamie Herrera Beutler 60,200 WV-1 David McKinley 56,300 CA-50 Duncan Hunter 54,700 CA-42 Ken Calvert 54,100 NY-27 Chris Collins 53,800 KY-4 Thomas Massie 53,000 CA-25 Steve Knight 52,700 WV-2 Alex Mooney 51,500 CO-5 Doug Lamborn 50,100 NJ-2 Frank LoBiondo 48,700 MI-3 Justin Amash 45,100 OH-6 Bill Johnson 44,800 CA-48 Dana Rohrabacher 44,600 OH-10 Michael Turner 44,600

Page 15: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

15

IV. CONCLUSION

Republicans are poised to repeal the ACA and send the nation back to a time when insurance companies could discriminate against people based on their gender or pre-existing conditions, when 50 million Americans were uninsured, and when health insurance in the individual market often failed to cover important services such as maternity care and prescription drugs. New Republican proposals to tax individuals on employer provided benefits and cut Medicaid funding would impose additional harms on our health care system by raising health care taxes on middle class Americans and rationing care for low-income Americans.

Republican proposals to repeal the Medicaid expansion and eliminate the premium tax

credits and cost-sharing reductions would harm lower and middle class Americans in every congressional district. Repeal of the ACA’s market reforms and Republican proposals to tax employer-based coverage would harm Americans in every congressional district who receive health insurance through their employers.

Overall, Republican proposals to repeal the ACA will leave Americans sicker, poorer, and less financially secure.

Page 16: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

16

APPENDIX: METHODOLOGY

For purposes of these fact sheets, the number of individuals in each congressional district who have gained health insurance coverage since the ACA was implemented was drawn from the Census Bureau’s American Community Survey (ACS) 1-year estimates of individuals in the district who reported having insurance coverage in 2012 and 2015.30 The 2012 and 2015 uninsured rates, as well as the change in the district’s uninsured rate from 2012 and 2015, were calculated using this data. Changes in uninsured rates may not sum due to rounding.

The number of individuals in each congressional district who now have health insurance that covers free preventive services was drawn from ACS data on the number of individuals who reported having private health insurance in 2015.31 This number excludes individuals with TRICARE coverage.32 This number has also been reduced by 25 percent to account for grandfathered health insurance plans that were excluded from the ACA’s preventive services coverage requirement.33

The number of individuals in each congressional district with employer-sponsored health insurance with was drawn from ACS 1-year estimate data for 2015.34

The number of individuals who have purchased Marketplace coverage was drawn from a

Kaiser Family Foundation estimate of the number of individuals in each congressional district who selected a Marketplace plan as of March 2016.35

30 Census Bureau, 2012 and 2015 American Community Survey 1-Year Estimates by Congressional District, Selected Characteristics of Health Insurance Coverage in the United States (online at factfinder.census.gov/faces/nav/jsf/pages/download_center.xhtml).

31 Census Bureau, 2015 American Community Survey 1-Year Estimates by Congressional District, Private Health Insurance Status by Sex by Age (online at factfinder.census.gov/faces/nav/jsf/pages/download_center.xhtml).

32 Census Bureau, 2015 American Community Survey 1-Year Estimates by Congressional District, TRICARE/Military Health Coverage Status by Sex by Age (online at factfinder.census.gov/faces/nav/jsf/pages/download_center.xhtml) (TRICARE coverage is considered to be private insurance for purposes of the ACS).

33 Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, ASPE Data Point (May 14, 2015) (online at aspe.hhs.gov/system/files/pdf/139221/The%20Affordable%20Care%20Act%20is%20Improving%20Access%20to%20Preventive%20Services%20for%20Millions%20of%20Americans.pdf); Kaiser Family Foundation, 2016 Employer Health Benefits Survey (Sept. 14, 2016) (online at kff.org/health-costs/report/2016-employer-health-benefits-survey0).

34 Census Bureau, 2015 American Community Survey 1-Year Estimates by Congressional District, Employer-Based Health Insurance by Sex by Age (online at factfinder.census.gov/faces/nav/jsf/pages/download_center.xhtml).

35 Kaiser Family Foundation, Interactive Maps: Estimates of Enrollment in ACA Marketplaces and Medicaid Expansion (online at kff.org/interactive/interactive-maps-estimates-

Page 17: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

17

The number of individuals who have received financial assistance to purchase Marketplace coverage in the form of APTC and CSR was drawn from the Kaiser Family Foundation and the Centers for Medicare and Medicaid Services (CMS). For states that use the Federally-Facilitated Marketplace, the number of individuals in each congressional district who received APTCs was drawn from an analysis conducted by the Kaiser Family Foundation.36 For states that established State-Based Marketplaces, statewide APTC data was drawn from the March 31, 2016, Effectuated Enrollment Snapshot prepared by CMS.37 The number of individuals in each congressional district receiving APTCs and CSRs was estimated by applying the distribution of Marketplace enrollment in each district to statewide APTC and CSR data.

The number of individuals in each congressional district who are covered by the ACA’s Medicaid expansion was calculated using statewide Medicaid expansion data from the Kaiser Family Foundation.38 These figures represent the number of individuals who were part of Expansion Group Enrollment in each state in 2015; this number includes individuals who may have been covered by state-initiated Medicaid expansions prior to the ACA, such as in New York and in Massachusetts. All individuals in the Expansion Group are deemed to have coverage at risk given the uncertainty of state-funded Medicaid coverage if the ACA is repealed and the likelihood of additional Medicaid financing cuts in the form of block grants and per-capita caps. The number of Expansion Group individuals in each congressional district was estimated by applying the distribution of individuals living below 138 percent of the federal poverty line (FPL) in each congressional district, drawn from the 2015 ACS 1-year estimates, to statewide Medicaid figures.

For states that have not expanded Medicaid, the number of individuals in each

congressional district who would have been covered by the ACA’s Medicaid expansion had the state adopted the Medicaid expansion was drawn from the Department of Health and Human

of-enrollment-in-aca-marketplaces-and-medicaid-expansion) (accessed Feb. 28, 2017).

36 Department of Health and Human Services, Centers for Medicare and Medicaid Services, March 31, 2016 Effectuated Enrollment Snapshot (June 30, 2016) (online at www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-06-30.html); Kaiser Family Foundation, Interactive Maps: Estimates of Enrollment in ACA Marketplaces and Medicaid Expansion (online at kff.org/interactive/interactive-maps-estimates-of-enrollment-in-aca-marketplaces-and-medicaid-expansion) (accessed Feb. 28, 2017).

37 Department of Health and Human Services, Centers for Medicare and Medicaid Services, March 31, 2016 Effectuated Enrollment Snapshot (June 30, 2016).

38 Kaiser Family Foundation, What Coverage and Financing is at Risk Under a Repeal of the ACA Medicaid Expansion? (Dec. 6, 2016) (kff.org/report-section/what-coverage-and-financing-is-at-risk-under-a-repeal-of-the-aca-medicaid-expansion-appendix/). In the cases of Louisiana, Montana, and North Dakota’s Medicaid expansions, for which Kaiser did not have data, numbers were drawn from the Compilation of State Data on the ACA prepared by ASPE. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Compilation of State Data on the Affordable Care Act (online at aspe.hhs.gov/compilation-state-data-affordable-care-act) (accessed Feb. 28, 2017).

Page 18: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

18

Services’ statewide estimates of the number of individuals who could have gained coverage if all states had expanded Medicaid.39

Congressional district lines in three states—Florida, North Carolina, and Virginia—were redrawn prior to the 115th Congress. Additional analyses were conducted to reflect the current composition of the congressional districts in these states.

For these three states, ACS data was collected at the county level and converted to the congressional district level using a county-to-district crosswalk provided by the Kaiser Family Foundation, derived from the Missouri Census Data Center.40 This crosswalk produces the percentage of each county that falls into each congressional district and allows for the conversion of county-level data to congressional district-level data for the 115th Congress.

The number of individuals in each district in the redistricted states who have gained

health insurance coverage since the ACA was implemented was drawn from both ACS and the Census Bureau’s Small Area Health Insurance Estimates (SAHIE) data. Coverage data for 2012 was drawn from ACS 1-year estimates for counties with populations of 60,000 individuals or more, while 2012 coverage data for counties with fewer than 60,000 individuals was drawn from SAHIE.41 Data for districts that are comprised entirely of large counties was drawn from ACS and represents the coverage numbers for all individuals, including those 65 and older. Districts comprised of both large and small counties required the combination of ACS and SAHIE data. As SAHIE data is restricted to individuals aged 0 to 64, the ACS data for the large counties within these combined districts were also limited to individuals aged 0 to 64, for both the total population and the uninsured population. County coverage data was then converted to district-level data using the Missouri Census Data Center crosswalk.

The 2015 coverage data in the redistricted states was drawn from updated district-level

data for 115th Congress, released by the Census Bureau on February 16, 2017.42 The data from these updated 1-year estimates was used to calculate the 2015 uninsured rate. For those districts comprised of large and small counties, the updated 2015 ACS data were limited to individuals

39 Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Compilation of State Data on the Affordable Care Act (online at aspe.hhs.gov/compilation-state-data-affordable-care-act) (accessed Feb. 28, 2017).

40 Missouri Census Data Center, Home Page (online at mcdc.missouri.edu) (accessed Feb. 28, 2017). 41 Census Bureau, 2012 American Community Survey 1-Year Estimates by Congressional District, Selected Characteristics of Health Insurance Coverage in the United States (online at factfinder.census.gov/faces/nav/jsf/pages/download_center.xhtml); Census Bureau, 2012 Small Area Health Insurance Estimates Using the American Community Survey (ACS) Data (online at www.census.gov/did/www/sahie/data/20082014/index.html).

42 Census Bureau, American Community Survey 1-Year Estimates by Congressional District, 115th Congress Data Profiles (online at /t.congressweb.com/l/?YUHMMALRFRIIONQ).

Page 19: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

19

aged 0 to 64, both for the total population and uninsured population, , to ensure appropriate comparisons to 2012 data.

The number of individuals in each congressional district with private insurance and

employer-sponsored insurance was calculated generally as described above for non-redistricted states. All data was collected on a county level and converted into district-level data using the Missouri Census Data Center crosswalk.

Private health insurance and employer-sponsored insurance data was not available within

the SAHIE data file. As a result, these figures were omitted from the fact sheets for districts comprised of one or more SAHIE counties (those with populations under 60,000). The number of individuals in each congressional district who enrolled in Marketplace coverage, as well as the number of individuals who received APTCs and CSRs, was calculated generally as described above for non-redistricted states.

The number of individuals who could have become eligible for Medicaid under the ACA’s Medicaid expansion had Florida, North Carolina, or Virginia adopted the Medicaid expansion was calculated using 2014 SAHIE county-level data, which was converted to congressional district-level using the Missouri Census Data Center county-to-district crosswalk.43 The number of individuals in each congressional district who could have been covered by the Medicaid expansion was calculated generally as described above.44

43 Missouri Census Data Center, Home Page (online at mcdc.missouri.edu) (accessed Feb. 28, 2017).

44 Census Bureau, 2042 Small Area Health Insurance Estimates Using the American Community Survey (ACS) Data (online at www.census.gov/did/www/sahie/data/20082014/index.html) (accessed Feb. 28, 2017).

Page 20: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Alabama Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Byrne’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.6% to 10.9% since the ACA was implemented. This 4.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 328,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 348,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 29,200 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 22,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 25,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 21: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Alabama Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Roby’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.3% to 10.5% since the ACA was implemented. This 2.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 307,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 327,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 19,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 25,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 22: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Alabama Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Rogers’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.2% to 9.3% since the ACA was implemented. This 2.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 335,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 359,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 21,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 19,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 23: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Alabama Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Aderholt’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.7% to 10.4% since the ACA was implemented. This 3.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 326,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 349,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 18,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 27,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 24: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Alabama Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Brooks’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.1% to 10.1% since the ACA was implemented. This 3.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 370,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 408,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,400 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 23,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 19,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 21,500 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 25: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Alabama Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Palmer’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.8% to 7.9% since the ACA was implemented. This 1.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 397,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 447,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 17,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 16,300 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 26: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Alabama Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Sewell’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.7% to 11.9% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 282,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 304,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 34,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 27: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on Alaska’s Congressional District Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Young’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.5% to 14.9% since the ACA was implemented. This 5.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 332,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 389,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 18,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 8,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 28: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Arizona Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. O'Halleran’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.3% to 11.5% since the ACA was implemented. This 6.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 314,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 340,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 8,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 52,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 29: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Arizona Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. McSally’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.4% to 7.7% since the ACA was implemented. This 5.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 328,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 337,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 39,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 30: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Arizona Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Grijalva’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 23.5% to 14.1% since the ACA was implemented. This 9.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 288,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 324,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 62,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 31: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Arizona Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Gosar’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.3% to 9.4% since the ACA was implemented. This 6.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 320,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 298,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 39,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 32: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Arizona Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Biggs’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.5% to 7.4% since the ACA was implemented. This 4.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 456,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 488,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 33: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Arizona Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Schweikert’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.0% to 9.0% since the ACA was implemented. This 5.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 387,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 383,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 34,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 34: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Arizona Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Gallego’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 31.4% to 19.2% since the ACA was implemented. This 12.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 227,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 259,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 82,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 35: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Arizona Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Franks’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.5% to 7.0% since the ACA was implemented. This 4.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 405,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 430,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 28,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 36: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of Arizona Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Sinema’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.0% to 11.9% since the ACA was implemented. This 6.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 385,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 425,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 48,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 37: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Arkansas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Crawford’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.0% to 8.6% since the ACA was implemented. This 9.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 289,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 286,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 15,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 8,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 77,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 38: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Arkansas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Hill’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.2% to 9.2% since the ACA was implemented. This 5.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 359,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 374,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 14,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 8,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 69,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 39: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Arkansas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Womack’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.9% to 9.9% since the ACA was implemented. This 7.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 381,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 415,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 69,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 40: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Arkansas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Westerman’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.8% to 10.2% since the ACA was implemented. This 6.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 292,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 288,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 8,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 75,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 41: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. LaMalfa’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.9% to 7.2% since the ACA was implemented. This 8.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 311,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 311,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 73,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 42: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Huffman’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.8% to 6.5% since the ACA was implemented. This 7.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 358,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 353,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 23,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 53,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 43: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Garamendi’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.8% to 7.5% since the ACA was implemented. This 6.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 328,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 357,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 21,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 18,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 70,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 44: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. McClintock’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.2% to 5.1% since the ACA was implemented. This 7.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 394,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 429,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 23,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 39,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 45: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Thompson’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.9% to 5.9% since the ACA was implemented. This 10.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 375,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 411,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 53,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 46: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Matsui’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.2% to 7.5% since the ACA was implemented. This 10.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 315,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 356,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 87,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 47: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Bera’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.6% to 4.7% since the ACA was implemented. This 8.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 395,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 454,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 52,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 48: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Cook’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.9% to 7.7% since the ACA was implemented. This 11.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 266,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 294,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 85,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 49: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. McNerney’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.6% to 6.7% since the ACA was implemented. This 10.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 324,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 366,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 71,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 50: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 10th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Denham’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.2% to 6.3% since the ACA was implemented. This 9.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 314,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 349,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 74,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 51: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 11th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. DeSaulnier’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.5% to 6.2% since the ACA was implemented. This 6.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 401,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 444,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 49,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 52: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 12th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Pelosi’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.6% to 4.4% since the ACA was implemented. This 6.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 411,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 452,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 48,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 53: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 13th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lee’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.1% to 6.4% since the ACA was implemented. This 7.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 385,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 415,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 68,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 54: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 14th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Speier’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.3% to 4.8% since the ACA was implemented. This 6.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 425,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 470,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 40,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 55: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 15th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Swalwell’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.7% to 3.6% since the ACA was implemented. This 7.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 453,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 520,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 24,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 56: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 16th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Costa’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 22.5% to 11.1% since the ACA was implemented. This 11.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 221,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 246,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 21,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 19,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 121,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 57: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 17th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Khanna’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.2% to 3.5% since the ACA was implemented. This 6.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 452,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 527,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 29,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 58: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 18th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Eshoo’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.5% to 4.0% since the ACA was implemented. This 5.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 455,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 511,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 28,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 59: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 19th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lofgren’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.9% to 6.1% since the ACA was implemented. This 8.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 385,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 435,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 49,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 60: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 20th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Panetta’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.7% to 9.2% since the ACA was implemented. This 9.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 318,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 335,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 23,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 67,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 61: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 21st Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Valadao’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 25.4% to 12.2% since the ACA was implemented. This 13.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 193,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 213,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 18,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 115,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 62: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 22nd Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Nunes’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.1% to 7.4% since the ACA was implemented. This 9.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 325,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 366,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 82,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 63: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 23rd Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. McCarthy’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.7% to 5.9% since the ACA was implemented. This 9.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 330,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 379,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 73,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 64: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 24th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Carbajal’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.5% to 9.4% since the ACA was implemented. This 7.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 359,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 365,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 27,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 24,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 61,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 65: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 25th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Knight’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.9% to 7.4% since the ACA was implemented. This 7.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 359,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 410,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 52,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 66: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 26th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Brownley’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.7% to 9.6% since the ACA was implemented. This 7.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 345,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 380,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 47,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 67: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 27th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Chu’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.1% to 7.0% since the ACA was implemented. This 9.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 343,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 352,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 58,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 68: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 28th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Schiff’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.0% to 9.9% since the ACA was implemented. This 10.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 330,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 341,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 60,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 69: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 29th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Cardenas’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 29.7% to 13.6% since the ACA was implemented. This 16.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 243,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 266,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 90,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 70: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 30th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Sherman’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.6% to 8.7% since the ACA was implemented. This 7.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 397,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 410,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 48,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 71: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 31st Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Aguilar’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.5% to 8.7% since the ACA was implemented. This 11.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 300,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 347,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 80,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 72: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 32nd Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Napolitano’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 22.2% to 11.9% since the ACA was implemented. This 10.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 305,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 337,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 59,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 73: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 33rd Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lieu’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.6% to 4.4% since the ACA was implemented. This 4.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 444,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 429,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 74: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 34th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in California’s 34th congressional district.

Here is what is at risk:

• The district’s uninsured rate has gone from 35.6% to 18.6% since the ACA was implemented. This 17.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 212,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 223,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 111,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 75: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 35th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Torres’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 24.8% to 12.0% since the ACA was implemented. This 12.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 280,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 327,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 74,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 76: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 36th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Ruiz’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 21.7% to 10.3% since the ACA was implemented. This 11.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 270,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 271,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 90,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 77: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 37th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Bass’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 22.1% to 12.7% since the ACA was implemented. This 9.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 318,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 332,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 79,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 78: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 38th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Sanchez’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.1% to 10.4% since the ACA was implemented. This 9.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 333,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 384,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 29,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 51,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 79: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 39th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Royce’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.1% to 7.4% since the ACA was implemented. This 9.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 380,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 403,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 29,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 42,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 80: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 40th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Roybal-Allard’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 31.7% to 17.5% since the ACA was implemented. This 14.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 196,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 228,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 106,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 81: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 41st Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Takano’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 24.3% to 11.8% since the ACA was implemented. This 12.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 292,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 333,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 74,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 82: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 42nd Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Calvert’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.9% to 7.9% since the ACA was implemented. This 8.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 369,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 418,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 54,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 83: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 43rd Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Waters’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 23.3% to 12.8% since the ACA was implemented. This 10.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 297,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 345,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 88,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 84: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 44th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Barragan’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 25.7% to 13.2% since the ACA was implemented. This 12.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 237,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 274,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 91,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 85: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 45th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Walters’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.2% to 5.7% since the ACA was implemented. This 4.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 441,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 469,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 30,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 41,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 86: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 46th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Correa’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 28.3% to 16.6% since the ACA was implemented. This 11.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 257,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 293,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 30,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 83,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 87: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 47th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lowenthal’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.9% to 9.0% since the ACA was implemented. This 9.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 317,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 356,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 29,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 71,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 88: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 48th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Rohrabacher’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.0% to 6.6% since the ACA was implemented. This 7.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 382,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 393,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 30,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 44,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 89: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 49th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Issa’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.0% to 8.0% since the ACA was implemented. This 7.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 370,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 377,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 30,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 43,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 90: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 50th Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Hunter’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.2% to 8.7% since the ACA was implemented. This 7.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 350,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 383,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 29,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 54,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 91: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 51st Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Vargas’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 27.2% to 13.0% since the ACA was implemented. This 14.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 222,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 248,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 36,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 31,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 18,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 100,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 92: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 52nd Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Peters’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.4% to 5.4% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 424,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 442,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 30,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 39,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 93: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 53rd Congressional District of California Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Davis’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.5% to 8.6% since the ACA was implemented. This 7.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 365,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 397,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 30,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 59,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 94: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Colorado Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. DeGette’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.9% to 10.5% since the ACA was implemented. This 5.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 386,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 417,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 4,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 62,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 95: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Colorado Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Polis’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.1% to 5.7% since the ACA was implemented. This 4.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 461,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 485,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 12,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 44,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 96: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Colorado Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Tipton’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.3% to 11.3% since the ACA was implemented. This 5.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 324,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 322,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 18,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 11,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 61,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 97: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Colorado Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Buck’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.2% to 5.4% since the ACA was implemented. This 8.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 429,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 467,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 9,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 3,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 42,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 98: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Colorado Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lamborn’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.8% to 7.4% since the ACA was implemented. This 6.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 332,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 335,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 10,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 6,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 2,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 50,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 99: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Colorado Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Coffman’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.8% to 7.9% since the ACA was implemented. This 7.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 429,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 488,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 8,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 3,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 37,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 100: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Colorado Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Perlmutter’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.2% to 8.3% since the ACA was implemented. This 8.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 393,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 432,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 13,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 8,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 3,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 48,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 101: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Connecticut Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Larson’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.5% to 4.8% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 379,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 429,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 41,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 102: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Connecticut Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Courtney’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 6.9% to 3.6% since the ACA was implemented. This 3.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 382,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 434,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 103: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Connecticut Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. DeLauro’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.4% to 5.6% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 376,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 423,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 43,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 104: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Connecticut Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Himes’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.1% to 9.0% since the ACA was implemented. This 2.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 391,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 441,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 41,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 105: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Connecticut Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Esty’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.6% to 6.6% since the ACA was implemented. This 3.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 367,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 419,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 41,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 106: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the District of Columbia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Norton’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 5.9% to 3.8% since the ACA was implemented. This 2.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 345,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 388,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 1,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 62,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 107: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on Delaware’s Congressional District Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Blunt Rochester’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.8% to 5.9% since the ACA was implemented. This 3.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 490,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 563,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 61,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 108: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Gaetz’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.9% to 13.2% since the ACA was implemented. This 4.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 31,100 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 21,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 109: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Dunn’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.2% to 14.1% since the ACA was implemented. This 6.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 31,500 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 29,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 23,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 29,500 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 110: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Yoho’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 21.0% to 12.9% since the ACA was implemented. This 8.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 35,100 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 32,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 25,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 29,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 111: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Rutherford’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.5% to 8.9% since the ACA was implemented. This 6.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 342,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 391,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 39,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 35,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 25,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 25,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 112: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lawson’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.7% to 14.9% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 34,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 30,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 23,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 30,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 113: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. DeSantis’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.5% to 12.0% since the ACA was implemented. This 4.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 319,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 335,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 48,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 45,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 33,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 25,900 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 114: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Murphy’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.8% to 11.2% since the ACA was implemented. This 8.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 353,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 389,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 58,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 53,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 41,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 115: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Posey’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.3% to 11.4% since the ACA was implemented. This 5.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 311,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 340,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 43,700 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 40,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 30,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 22,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 116: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Soto’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.9% to 15.7% since the ACA was implemented. This 5.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 316,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 349,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 59,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 56,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 47,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 36,300 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 117: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 10th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Demings’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 22.2% to 15.0% since the ACA was implemented. This 7.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 343,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 392,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 64,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 60,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 50,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 118: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 11th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Webster’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.7% to 9.3% since the ACA was implemented. This 6.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 296,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 291,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 41,200 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 38,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 30,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 24,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 119: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 12th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Bilirakis’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.1% to 9.9% since the ACA was implemented. This 6.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 307,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 340,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 43,400 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 39,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 30,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 23,900 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 120: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 13th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Crist’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.2% to 11.6% since the ACA was implemented. This 5.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 306,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 331,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 44,200 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 40,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 30,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 22,400 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 121: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 14th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Castor’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.9% to 13.4% since the ACA was implemented. This 5.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 325,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 376,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 41,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 37,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 30,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 29,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 122: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 15th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Ross’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.4% to 11.1% since the ACA was implemented. This 7.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 317,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 361,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 39,700 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 36,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 28,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 29,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 123: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 16th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Buchanan’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.2% to 13.2% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 329,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 335,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 42,400 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 38,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 28,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 24,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 124: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 17th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Tom Rooney’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 25.1% to 16.8% since the ACA was implemented. This 8.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 39,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 36,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 27,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 125: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 18th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Mast’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.5% to 11.3% since the ACA was implemented. This 8.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 311,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 319,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 60,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 55,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 44,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 25,300 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 126: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 19th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Francis Rooney’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.4% to 14.0% since the ACA was implemented. This 6.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 309,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 312,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 50,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 47,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 37,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 127: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 20th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Hastings’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 21.6% to 17.5% since the ACA was implemented. This 4.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 320,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 330,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 79,500 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 73,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 58,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 25,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 128: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 21st Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Frankel’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.9% to 13.7% since the ACA was implemented. This 6.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 327,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 335,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 69,100 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 64,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 50,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 24,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 129: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 22nd Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Deutch’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 22.0% to 13.8% since the ACA was implemented. This 8.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 319,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 329,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 81,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 76,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 60,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 25,400 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 130: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 23rd Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Wasserman-Schultz’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 23.1% to 11.3% since the ACA was implemented. This 11.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 316,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 326,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 85,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 80,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 63,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 131: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 24th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Wilson’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 28.3% to 21.8% since the ACA was implemented. This 6.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 277,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 282,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 94,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 91,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 72,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 132: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 25th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Diaz-Balart’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 32.2% to 22.7% since the ACA was implemented. This 4.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 83,100 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 79,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 63,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 133: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 26th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Curbelo’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 28.8% to 18.5% since the ACA was implemented. This 10.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 269,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 272,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 92,500 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 89,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 70,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,300 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 134: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 27th Congressional District of Florida Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Ros-Lehtinen’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 29.1% to 16.4% since the ACA was implemented. This 12.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 266,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 270,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 96,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 93,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 74,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 135: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Georgia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Carter’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.6% to 14.6% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 299,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 313,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 32,100 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 28,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 21,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 31,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 136: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Georgia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Bishop’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.9% to 15.2% since the ACA was implemented. This 4.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 243,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 260,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,500 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 37,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 137: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Georgia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Ferguson’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.9% to 12.1% since the ACA was implemented. This 3.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 352,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 382,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 19,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 138: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Georgia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Johnson’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.7% to 16.2% since the ACA was implemented. This 3.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 340,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 379,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 45,700 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 40,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 31,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 31,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 139: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Georgia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lewis’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.8% to 13.7% since the ACA was implemented. This 7.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 346,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 382,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 40,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 34,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 25,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 31,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 140: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Georgia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Georgia’s 6th congressional district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.8% to 10.7% since the ACA was implemented. This 5.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 429,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 481,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 40,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 34,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 25,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 14,900 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 141: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Georgia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Woodall’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.2% to 14.8% since the ACA was implemented. This 3.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 410,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 446,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 53,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 48,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 38,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 21,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 142: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Georgia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Austin Scott’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.7% to 14% since the ACA was implemented. This 3.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 294,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 323,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 19,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 143: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of Georgia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Collins’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.1% to 15.4% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 333,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 354,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 30,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 20,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 144: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 10th Congressional District of Georgia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Hice’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.7% to 12.4% since the ACA was implemented. This 2.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 357,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 394,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 29,200 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 20,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 28,400 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 145: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 11th Congressional District of Georgia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Loudermilk’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.0% to 11.9% since the ACA was implemented. This 5.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 404,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 450,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 38,400 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 33,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 24,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 19,400 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 146: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 12th Congressional District of Georgia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Allen’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.1% to 14.7% since the ACA was implemented. This 3.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 291,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 319,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,100 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 20,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,500 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 147: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 13th Congressional District of Georgia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. David Scott’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 22.8% to 15.5% since the ACA was implemented. This 7.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 343,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 374,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 41,500 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 37,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 28,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 28,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 148: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 14th Congressional District of Georgia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Graves’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.7% to 12.8% since the ACA was implemented. This 6.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 333,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 376,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,500 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 23,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 17,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 149: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Hawaii Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Hanabusa’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 5.9% to 3.6% since the ACA was implemented. This 2.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 378,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 442,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 5,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 4,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 3,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 45,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 150: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Hawaii Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Gabbard’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 7.9% to 4.3% since the ACA was implemented. This 3.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 364,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 424,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 8,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 6,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 4,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 62,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 151: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Idaho Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Labrador’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.9% to 10.3% since the ACA was implemented. This 5.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 430,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 430,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 47,200 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 41,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 29,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 29,300 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 152: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Idaho Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Simpson’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.4% to 11.9% since the ACA was implemented. This 4.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 409,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 406,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 47,100 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 41,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 29,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 29,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 153: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Rush’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.9% to 6.8% since the ACA was implemented. This 7.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 337,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 387,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 48,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 154: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Kelly’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.4% to 8.4% since the ACA was implemented. This 7.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 305,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 351,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 18,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 8,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 53,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 155: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lipinski’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.3% to 9.0% since the ACA was implemented. This 5.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 362,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 413,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 35,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 156: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Gutiérrez’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 26.7% to 18.2% since the ACA was implemented. This 8.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 249,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 286,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 61,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 157: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Quigley’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.4% to 6.5% since the ACA was implemented. This 6.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 424,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 479,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 14,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 158: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Roskam’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 7.6% to 4.7% since the ACA was implemented. This 3.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 453,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 497,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 16,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 159: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Danny Davis’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.1% to 8.1% since the ACA was implemented. This 8.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 310,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 347,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 59,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 160: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Krishnamoorthi’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.2% to 9.1% since the ACA was implemented. This 6.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 375,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 419,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 21,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 27,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 161: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Schakowsky’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.3% to 7.0% since the ACA was implemented. This 5.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 396,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 425,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 35,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 162: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 10th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Schneider’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.8% to 8.8% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 369,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 407,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 21,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 28,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 163: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 11th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Foster’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.6% to 8.0% since the ACA was implemented. This 4.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 385,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 442,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 164: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 12th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Bost’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.8% to 5.4% since the ACA was implemented. This 6.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 334,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 371,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 12,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 42,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 165: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 13th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Rodney Davis’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.9% to 4.6% since the ACA was implemented. This 5.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 377,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 413,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 12,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 43,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 166: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 14th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Hultgren’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.0% to 4.3% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 447,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 503,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 19,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 167: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 15th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Shimkus’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.3% to 4.9% since the ACA was implemented. This 5.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 354,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 381,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 14,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 37,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 168: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 16th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Kinzinger’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.3% to 5.0% since the ACA was implemented. This 5.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 378,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 415,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 169: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 17th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Bustos’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.3% to 5.3% since the ACA was implemented. This 6.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 330,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 361,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 14,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 42,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 170: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 18th Congressional District of Illinois Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. LaHood’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 7.8% to 3.4% since the ACA was implemented. This 4.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 408,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 452,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 12,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 27,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 171: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Indiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Visclosky’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.5% to 8.7% since the ACA was implemented. This 5.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 363,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 417,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 14,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 8,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 41,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 172: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Indiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Walorski’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.5% to 11.3% since the ACA was implemented. This 4.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 359,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 392,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 18,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 8,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 42,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 173: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Indiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Banks’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.8% to 11.8% since the ACA was implemented. This 5.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 376,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 417,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 36,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 174: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Indiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Rokita’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.0% to 8.9% since the ACA was implemented. This 3.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 413,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 462,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 14,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 175: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Indiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Brooks’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.3% to 7.2% since the ACA was implemented. This 3.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 443,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 496,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 27,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 176: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Indiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Messer’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.7% to 8.6% since the ACA was implemented. This 5.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 382,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 425,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 14,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 37,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 177: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Indiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Carson’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.8% to 13.0% since the ACA was implemented. This 5.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 311,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 349,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 65,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 178: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Indiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Bucshon’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.7% to 8.3% since the ACA was implemented. This 5.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 372,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 412,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 18,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 8,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 41,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 179: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of Indiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Hollingsworth’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.2% to 8.9% since the ACA was implemented. This 4.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 401,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 451,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 18,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 36,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 180: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Iowa Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Blum’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 7.3% to 5.1% since the ACA was implemented. This 2.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 440,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 464,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 11,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 11,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 181: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Iowa Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Loebsack’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.0% to 5.3% since the ACA was implemented. This 3.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 429,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 464,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 12,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 40,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 182: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Iowa Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Young’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.4% to 4.8% since the ACA was implemented. This 3.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 455,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 503,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 13,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 11,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 35,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 183: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Iowa Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. King’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.9% to 4.9% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 423,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 429,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 11,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 9,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 37,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 184: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Kansas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Marshall’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.8% to 9.3% since the ACA was implemented. This 3.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 366,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 366,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 21,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 185: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Kansas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Jenkins’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.9% to 7.4% since the ACA was implemented. This 5.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 387,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 405,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 21,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 186: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Kansas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Yoder’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.1% to 7.7% since the ACA was implemented. This 3.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 440,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 485,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,700 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 24,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 14,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 187: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Kansas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Kansas’s 4th congressional district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.7% to 12.2% since the ACA was implemented. This 1.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 370,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 401,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,700 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 20,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 188: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Kentucky Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Corner’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.1% to 6.8% since the ACA was implemented. This 8.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 314,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 337,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 12,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 9,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 76,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 189: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Kentucky Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Guthrie’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.2% to 5.3% since the ACA was implemented. This 7.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 357,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 395,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 12,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 9,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 68,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 190: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Kentucky Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Yarmuth’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.3% to 5.3% since the ACA was implemented. This 7.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 382,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 426,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 12,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 9,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 62,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 191: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Kentucky Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Massie’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.2% to 6.0% since the ACA was implemented. This 5.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 391,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 453,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 12,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 9,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 53,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 192: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Kentucky Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Rogers’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.4% to 5.7% since the ACA was implemented. This 11.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 253,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 274,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 12,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 9,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 104,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 193: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Kentucky Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Barr’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.1% to 6.9% since the ACA was implemented. This 6.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 380,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 427,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 12,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 9,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 75,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 194: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Louisiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Scalise’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.5% to 11.4% since the ACA was implemented. This 4.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 395,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 420,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 36,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 33,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 24,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 195: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Louisiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Richmond’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.3% to 13.3% since the ACA was implemented. This 5.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 313,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 341,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 39,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 35,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 25,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 40,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 196: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Louisiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Higgins’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.0% to 12.1% since the ACA was implemented. This 4.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 363,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 392,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 24,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 17,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 31,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 197: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Louisiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Johnson’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.1% to 12.9% since the ACA was implemented. This 3.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 308,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 332,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 23,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 34,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 198: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Louisiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Abraham’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.9% to 14.0% since the ACA was implemented. This 6.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 298,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 332,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 17,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 37,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 199: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Louisiana Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Graves’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.7% to 8.3% since the ACA was implemented. This 5.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 421,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 475,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 19,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 23,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 200: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Maine Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Pingree’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.2% to 7.7% since the ACA was implemented. This 1.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 361,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 389,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 39,200 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 31,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 21,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 15,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 201: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Maine Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Poliquin’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.2% to 9.1% since the ACA was implemented. This 2.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 307,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 312,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 36,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 32,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 21,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 24,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 202: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Maryland Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Harris’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.3% to 4.1% since the ACA was implemented. This 4.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 401,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 445,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 15,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 11,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 8,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 203: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Maryland Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Ruppersberger’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.7% to 6.6% since the ACA was implemented. This 4.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 379,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 438,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 12,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 8,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 40,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 204: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Maryland Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Sarbanes’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.9% to 6.1% since the ACA was implemented. This 2.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 420,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 485,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 12,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 8,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 28,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 205: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Maryland Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Brown’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.1% to 10.4% since the ACA was implemented. This 4.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 375,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 440,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 12,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 8,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 28,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 206: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Maryland Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Hoyer’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.9% to 5.6% since the ACA was implemented. This 3.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 432,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 513,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 13,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 21,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 207: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Maryland Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Delaney’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.7% to 6.8% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 410,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 467,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 14,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 31,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 208: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Maryland Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Cummings’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.4% to 6.0% since the ACA was implemented. This 3.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 355,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 404,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 15,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 11,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 8,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 50,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 209: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Maryland Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Raskin’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.6% to 7.0% since the ACA was implemented. This 3.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 444,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 503,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 21,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 27,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 210: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Massachusetts Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Neal’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 3.6% to 3.1% since the ACA was implemented. This 0.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 355,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 409,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 59,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 211: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Massachusetts Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. McGovern’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 4.2% to 2.2% since the ACA was implemented. This 2.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 406,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 463,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 49,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 212: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Massachusetts Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Tsongas’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 4.4% to 3.1% since the ACA was implemented. This 1.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 394,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 457,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 45,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 213: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Massachusetts Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Kennedy’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 2.8% to 2.1% since the ACA was implemented. This 0.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 457,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 530,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 28,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 214: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Massachusetts Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Clark’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 3.1% to 2.8% since the ACA was implemented. This 0.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 452,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 516,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 215: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Massachusetts Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Moulton’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 3.1% to 2.3% since the ACA was implemented. This 0.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 434,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 499,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 35,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 216: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Massachusetts Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Capuano’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 5.8% to 4.6% since the ACA was implemented. This 1.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 361,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 419,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 74,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 217: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Massachusetts Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lynch’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 3.6% to 1.9% since the ACA was implemented. This 1.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 438,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 519,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 40,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 218: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of Massachusetts Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Keating’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 4.1% to 3.2% since the ACA was implemented. This 0.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 383,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 415,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 43,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 219: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Michigan Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Bergman’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.6% to 6.3% since the ACA was implemented. This 6.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 358,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 371,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 30,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 29,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 40,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 220: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Michigan Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Huizenga’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.4% to 5.5% since the ACA was implemented. This 4.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 390,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 443,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 21,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 19,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 40,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 221: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Michigan Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Amash’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.0% to 5.8% since the ACA was implemented. This 4.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 395,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 456,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 45,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 222: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Michigan Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Moolenaar’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.6% to 6.7% since the ACA was implemented. This 4.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 365,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 414,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 18,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 43,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 223: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Michigan Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Kildee’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.0% to 5.6% since the ACA was implemented. This 5.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 323,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 374,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 52,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 224: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Michigan Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Upton’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.6% to 6.3% since the ACA was implemented. This 5.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 378,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 417,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 42,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 225: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Michigan Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Walberg’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.7% to 5.1% since the ACA was implemented. This 5.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 376,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 438,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 35,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 226: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Michigan Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Bishop’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 7.9% to 5.3% since the ACA was implemented. This 2.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 434,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 499,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 227: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of Michigan Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Levin’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.1% to 5.8% since the ACA was implemented. This 7.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 390,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 432,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 24,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 39,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 228: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 10th Congressional District of Michigan Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Mitchell’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.0% to 5.9% since the ACA was implemented. This 4.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 405,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 456,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 24,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 229: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 11th Congressional District of Michigan Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Trott’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.5% to 4.6% since the ACA was implemented. This 3.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 451,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 514,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 19,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 20,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 230: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 12th Congressional District of Michigan Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Dingell’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.0% to 5.7% since the ACA was implemented. This 4.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 386,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 441,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 43,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 231: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 13th Congressional District of Michigan Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Conyers’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.4% to 8.8% since the ACA was implemented. This 8.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 243,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 282,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 81,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 232: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 14th Congressional District of Michigan Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lawrence’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.1% to 7.8% since the ACA was implemented. This 7.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 298,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 333,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 21,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 65,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 233: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Minnesota Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Walz’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 7.9% to 4.3% since the ACA was implemented. This 3.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 380,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 406,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 6,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 234: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Minnesota Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lewis’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 6.8% to 3.9% since the ACA was implemented. This 2.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 423,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 469,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 5,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 17,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 235: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Minnesota Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Paulsen’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 5.6% to 3.7% since the ACA was implemented. This 1.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 427,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 463,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 5,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 15,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 236: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Minnesota Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. McCollum’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.0% to 5.1% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 374,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 415,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 5,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 237: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Minnesota Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Ellison’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.9% to 6.6% since the ACA was implemented. This 4.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 363,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 392,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 5,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 39,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 238: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Minnesota Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Emmer’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 6.3% to 3.2% since the ACA was implemented. This 3.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 413,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 460,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 5,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 19,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 239: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Minnesota Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Peterson’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.0% to 5.1% since the ACA was implemented. This 3.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 361,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 348,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 18,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 6,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 29,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 240: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Minnesota Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Nolan’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.3% to 4.0% since the ACA was implemented. This 4.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 352,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 363,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 6,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 28,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 241: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Mississippi Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Kelly’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.5% to 11.1% since the ACA was implemented. This 4.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 350,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 368,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,100 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 30,400 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 242: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Mississippi Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Thompson’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.3% to 13% since the ACA was implemented. This 6.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 258,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 273,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,200 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 18,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 43,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 243: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Mississippi Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Harper’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.2% to 11.8% since the ACA was implemented. This 2.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 342,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 359,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 18,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 31,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 244: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Mississippi Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Palazzo’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.2% to 14.9% since the ACA was implemented. This 4.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 306,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 324,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 245: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Missouri Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Clay’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.4% to 10.5% since the ACA was implemented. This 5.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 349,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 392,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 37,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 32,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 19,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 29,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 246: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Missouri Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Wagner’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 6.3% to 4.6% since the ACA was implemented. This 1.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 479,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 543,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 34,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 29,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 18,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 9,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 247: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Missouri Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Luetkemeyer’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.4% to 8.3% since the ACA was implemented. This 3.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 428,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 488,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 17,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 18,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 248: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Missouri Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Hartzler’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.4% to 10.3% since the ACA was implemented. This 4.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 370,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 378,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 29,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 18,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,900 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 249: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Missouri Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Cleaver’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.6% to 12.3% since the ACA was implemented. This 4.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 376,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 399,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 32,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 17,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 27,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 250: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Missouri Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Graves’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.4% to 8.9% since the ACA was implemented. This 3.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 414,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 444,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 20,400 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 251: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Missouri Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Long’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.8% to 12.4% since the ACA was implemented. This 4.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 383,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 389,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 36,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 34,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 23,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 27,500 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 252: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Missouri Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Smith’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.3% to 11.2% since the ACA was implemented. This 3.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 335,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 352,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 24,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 17,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 31,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 253: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on Montana’s Congressional District Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Montana’s congressional district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.0% to 11.6% since the ACA was implemented. This 6.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 522,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 509,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 51,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 44,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 23,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 254: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Nebraska Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Fortenberry’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.5% to 8.2% since the ACA was implemented. This 2.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 358,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 374,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,500 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 14,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 255: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Nebraska Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Bacon’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.5% to 7.5% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 363,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 400,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 19,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 13,900 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 256: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Nebraska Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Smith’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.7% to 9.1% since the ACA was implemented. This 2.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 329,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 324,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 33,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 29,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 17,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 14,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 257: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Nevada Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Titus’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 30.3% to 19.8% since the ACA was implemented. This 10.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 264,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 295,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 68,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 258: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Nevada Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Amodei’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.2% to 9.8% since the ACA was implemented. This 10.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 349,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 383,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 43,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 259: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Nevada Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Rosen’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.6% to 8.0% since the ACA was implemented. This 8.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 422,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 469,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 30,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 260: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Nevada Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Kihuen’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 21.9% to 11.9% since the ACA was implemented. This 10.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 322,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 357,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 18,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 44,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 261: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of New Hampshire Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Shea-Porter’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.7% to 6.9% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 381,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 429,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 25,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 262: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of New Hampshire Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Kuster’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.5% to 5.8% since the ACA was implemented. This 4.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 374,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 424,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 8,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 23,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 263: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of New Jersey Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Norcross’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.2% to 6.7% since the ACA was implemented. This 4.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 393,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 454,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 45,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 264: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of New Jersey Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. LoBiondo’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.1% to 8.2% since the ACA was implemented. This 3.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 359,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 401,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 48,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 265: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of New Jersey Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. MacArthur’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.5% to 5.1% since the ACA was implemented. This 3.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 413,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 464,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 266: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of New Jersey Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Smith’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.6% to 6.9% since the ACA was implemented. This 1.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 404,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 463,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 40,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 267: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of New Jersey Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Gottheimer’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.0% to 5.5% since the ACA was implemented. This 3.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 451,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 511,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 23,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 268: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of New Jersey Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Pallone’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.5% to 8.9% since the ACA was implemented. This 5.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 411,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 483,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 21,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 41,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 269: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of New Jersey Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lance’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.0% to 5.1% since the ACA was implemented. This 2.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 460,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 545,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 20,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 270: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of New Jersey Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Sires’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 24.5% to 17.3% since the ACA was implemented. This 7.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 308,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 361,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 75,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 271: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of New Jersey Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Pascrell’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.9% to 12.7% since the ACA was implemented. This 6.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 328,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 378,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 19,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 66,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 272: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 10th Congressional District of New Jersey Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Payne’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.3% to 14.3% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 311,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 366,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 79,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 273: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 11th Congressional District of New Jersey Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Frelinghuysen’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 7.5% to 4.4% since the ACA was implemented. This 3.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 459,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 536,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 17,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 274: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 12th Congressional District of New Jersey Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Watson Coleman’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.1% to 8.6% since the ACA was implemented. This 2.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 408,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 482,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 40,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 275: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of New Mexico Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lujan Grisham’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.4% to 10.4% since the ACA was implemented. This 6.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 283,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 310,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 77,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 276: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of New Mexico Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Pearce’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.8% to 10.4% since the ACA was implemented. This 8.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 255,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 274,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 15,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 11,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 85,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 277: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of New Mexico Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lujan’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.1% to 12.0% since the ACA was implemented. This 8.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 276,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 299,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 72,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 278: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Zeldin’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.5% to 5.6% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 423,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 482,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 4,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 41,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 279: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. King’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.6% to 6.1% since the ACA was implemented. This 4.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 422,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 489,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 4,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 38,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 280: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Suozzi’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 7.0% to 4.2% since the ACA was implemented. This 2.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 441,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 492,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 5,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 281: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Rice’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.3% to 6.2% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 414,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 480,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 4,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 39,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 282: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Meeks’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.6% to 9.5% since the ACA was implemented. This 4.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 335,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 390,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 35,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 7,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 2,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 78,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 283: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Meng’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.7% to 11.6% since the ACA was implemented. This 5.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 331,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 373,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 36,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 7,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 2,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 85,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 284: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Velazquez’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.1% to 11.7% since the ACA was implemented. This 5.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 253,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 277,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 31,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 6,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 2,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 149,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 285: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Jeffries’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.8% to 7.9% since the ACA was implemented. This 3.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 317,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 364,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 32,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 6,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 2,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 125,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 286: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Clarke’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.5% to 8.6% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 321,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 358,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 31,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 6,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 2,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 112,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 287: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 10th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Nadler’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.8% to 5.8% since the ACA was implemented. This 3.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 363,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 394,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 5,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 93,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 288: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 11th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Donovan’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.0% to 6.6% since the ACA was implemented. This 2.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 350,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 413,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 4,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 78,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 289: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 12th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Carolyn Maloney’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.1% to 6.0% since the ACA was implemented. This 3.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 428,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 467,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 5,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 57,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 290: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 13th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Espaillat’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.7% to 10.5% since the ACA was implemented. This 5.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 261,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 303,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 4,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 156,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 291: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 14th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Crowley’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 21.8% to 14.3% since the ACA was implemented. This 7.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 269,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 284,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 33,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 6,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 2,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 97,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 292: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 15th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Serrano’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.5% to 11.4% since the ACA was implemented. This 5.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 192,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 201,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 5,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 207,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 293: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 16th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Engel’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.4% to 7.6% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 371,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 421,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 21,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 4,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 78,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 294: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 17th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lowey’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.9% to 7.4% since the ACA was implemented. This 3.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 383,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 444,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 4,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 65,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 295: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 18th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Sean Patrick Maloney’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.2% to 4.5% since the ACA was implemented. This 4.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 395,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 469,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 3,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 55,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 296: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 19th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Faso’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.5% to 5.5% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 367,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 413,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 3,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 68,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 297: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 20th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Tonko’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 6.6% to 4.3% since the ACA was implemented. This 2.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 412,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 479,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 13,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 2,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 62,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 298: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 21st Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Stefanik’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.6% to 5.5% since the ACA was implemented. This 4.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 334,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 376,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 3,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 73,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 299: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 22nd Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Tenney’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.4% to 5.1% since the ACA was implemented. This 3.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 358,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 407,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 13,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 2,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 82,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 300: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 23rd Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Reed’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.7% to 6.2% since the ACA was implemented. This 3.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 358,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 400,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 3,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 86,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 301: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 24th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Katko’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 7.6% to 4.9% since the ACA was implemented. This 2.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 376,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 442,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 13,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 2,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 72,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 302: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 25th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Slaughter’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 6.7% to 4.3% since the ACA was implemented. This 2.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 380,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 414,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 3,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 1,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 79,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 303: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 26th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Higgins’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 6.9% to 3.8% since the ACA was implemented. This 3.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 347,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 388,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 12,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 2,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 104,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 304: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 27th Congressional District of New York Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Collins’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 6.2% to 4.0% since the ACA was implemented. This 2.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 406,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 462,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 13,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 2,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 53,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 305: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of North Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Butterfield’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.2% to 15.2% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 35,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 32,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 24,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 27,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 306: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of North Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Holding’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.6% to 8.8% since the ACA was implemented. This 8.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 40,400 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 35,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 25,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 22,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 307: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of North Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Jones’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.4% to 13.3% since the ACA was implemented. This 6.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 36,400 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 35,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 26,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 24,400 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 308: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of North Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Price’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.6% to 9.6% since the ACA was implemented. This 3.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 476,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 520,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 46,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 38,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 25,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 18,500 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 309: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of North Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Foxx’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.3% to 13.4% since the ACA was implemented. This 6.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 40,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 38,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 28,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 25,300 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 310: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of North Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Walker’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.8% to 14.4% since the ACA was implemented. This 5.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 38,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 35,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 25,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 24,300 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 311: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of North Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Rouzer’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.7% to 14.7% since the ACA was implemented. This 6.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 41,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 38,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 28,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,400 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 312: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of North Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Hudson’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.4% to 11.8% since the ACA was implemented. This 6.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 35,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 33,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 24,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 24,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 313: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of North Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Pittenger’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.1% to 11.4% since the ACA was implemented. This 7.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 43,500 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 39,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 29,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 25,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 314: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 10th Congressional District of North Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. McHenry’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.9% to 13.8% since the ACA was implemented. This 6.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 41,500 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 38,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 26,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 23,900 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 315: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 11th Congressional District of North Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Meadows’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 21.1% to 15.0% since the ACA was implemented. This 6.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 44,500 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 41,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 29,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 23,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 316: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 12th Congressional District of North Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Adams’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.5% to 13.8% since the ACA was implemented. This 2.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 424,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 460,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 56,400 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 50,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 36,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 22,900 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 317: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 13th Congressional District of North Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Budd’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.0% to 13.2% since the ACA was implemented. This 5.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 43,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 40,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 29,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 23,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 318: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on North Dakota’s Congressional District Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Cramer’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.0% to 7.8% since the ACA was implemented. This 2.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 436,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 449,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 18,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 319: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Chabot’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.2% to 5.4% since the ACA was implemented. This 4.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 384,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 448,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 11,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 41,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 320: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Wenstrup’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.1% to 6.4% since the ACA was implemented. This 5.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 375,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 433,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 11,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 41,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 321: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Beatty’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.1% to 10.9% since the ACA was implemented. This 6.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 330,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 384,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 64,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 322: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Jordan’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.4% to 5.1% since the ACA was implemented. This 5.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 376,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 441,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 10,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 9,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 4,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 39,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 323: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Latta’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.8% to 5.1% since the ACA was implemented. This 3.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 414,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 477,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 11,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 324: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Johnson’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.7% to 6.5% since the ACA was implemented. This 5.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 333,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 378,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 12,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 11,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 44,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 325: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Gibbs’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.5% to 9.1% since the ACA was implemented. This 4.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 382,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 432,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 13,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 11,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 38,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 326: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Davidson’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.2% to 6.0% since the ACA was implemented. This 5.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 384,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 446,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 12,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 39,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 327: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Kaptur’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.3% to 7.0% since the ACA was implemented. This 6.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 318,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 370,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 12,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 56,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 328: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 10th Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Turner’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.5% to 6.3% since the ACA was implemented. This 5.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 342,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 383,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 12,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 44,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 329: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 11th Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Fudge’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.4% to 6.8% since the ACA was implemented. This 7.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 286,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 326,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 13,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 65,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 330: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 12th Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Tiberi’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.7% to 4.6% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 445,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 525,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 13,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 29,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 331: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 13th Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Ryan’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.9% to 6.9% since the ACA was implemented. This 5.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 340,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 388,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 12,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 47,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 332: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 14th Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Joyce’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.5% to 6.2% since the ACA was implemented. This 3.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 411,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 467,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 15,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 12,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 24,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 333: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 15th Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Stivers’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.0% to 5.5% since the ACA was implemented. This 4.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 397,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 456,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 12,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 34,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 334: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 16th Congressional District of Ohio Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Renacci’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.4% to 6.1% since the ACA was implemented. This 2.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 410,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 469,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 13,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 11,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 21,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 335: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Oklahoma Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Bridenstine’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.4% to 13.8% since the ACA was implemented. This 4.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 389,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 421,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 27,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 24,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 24,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 336: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Oklahoma Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Mullin’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 21.4% to 16.9% since the ACA was implemented. This 4.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 304,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 316,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,200 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 29,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 337: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Oklahoma Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Lucas’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.9% to 12.3% since the ACA was implemented. This 3.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 372,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 390,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 25,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 338: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Oklahoma Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Cole’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.8% to 11.4% since the ACA was implemented. This 4.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 383,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 421,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 20,400 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 339: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Oklahoma Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Russell’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.3% to 15.2% since the ACA was implemented. This 5.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 367,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 398,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 30,400 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 19,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 27,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 340: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Oregon Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Bonamici’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.9% to 6.8% since the ACA was implemented. This 6.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 448,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 491,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 81,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 341: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Oregon Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Walden’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.3% to 8.0% since the ACA was implemented. This 9.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 346,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 326,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 29,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 129,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 342: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Oregon Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Blumenauer’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.7% to 7.0% since the ACA was implemented. This 7.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 413,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 443,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 31,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 112,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 343: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Oregon Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. DeFazio’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.8% to 7.2% since the ACA was implemented. This 7.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 362,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 363,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 18,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 128,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 344: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Oregon Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Schrader’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.9% to 6.2% since the ACA was implemented. This 8.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 419,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 445,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 94,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 345: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Brady’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.6% to 10.1% since the ACA was implemented. This 4.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 298,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 327,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 56,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 346: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Evans’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.8% to 7.9% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 335,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 363,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 62,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 347: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Kelly’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.9% to 5.7% since the ACA was implemented. This 3.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 369,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 396,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 12,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 36,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 348: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Perry’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.1% to 6.0% since the ACA was implemented. This 3.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 402,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 446,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 21,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 17,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 28,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 349: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Thompson’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.6% to 5.6% since the ACA was implemented. This 3.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 373,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 399,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 13,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 34,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 350: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Costello’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 6.7% to 4.4% since the ACA was implemented. This 2.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 441,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 493,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 19,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 18,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 351: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Meehan’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.2% to 5.3% since the ACA was implemented. This 2.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 434,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 473,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 16,100 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 352: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Fitzpatrick’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 6.9% to 4.6% since the ACA was implemented. This 2.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 436,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 475,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 33,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 17,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 17,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 353: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Shuster’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.7% to 6.9% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 369,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 393,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 18,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 14,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 37,000 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 354: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 10th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Marino’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.7% to 7.7% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 376,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 399,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 18,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 355: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 11th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Barletta’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 8.9% to 5.2% since the ACA was implemented. This 3.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 388,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 428,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 19,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 30,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 356: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 12th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Rothfus’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 6.4% to 3.8% since the ACA was implemented. This 2.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 407,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 432,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,000 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 14,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 357: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 13th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Boyle’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.7% to 8.3% since the ACA was implemented. This 3.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 369,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 398,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 36,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 358: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 14th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Doyle’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.2% to 6.4% since the ACA was implemented. This 3.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 366,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 390,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 21,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 14,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 43,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 359: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 15th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Dent’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.7% to 6.3% since the ACA was implemented. This 4.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 398,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 439,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 11,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 29,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 360: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 16th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Smucker’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.2% to 10.0% since the ACA was implemented. This 3.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 362,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 400,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 16,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 38,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 361: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 17th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Cartwright’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.5% to 6.6% since the ACA was implemented. This 3.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 359,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 389,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 18,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 362: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 18th Congressional District of Pennsylvania Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Murphy’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 6.5% to 3.5% since the ACA was implemented. This 3.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 425,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 453,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 20,600 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 14,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 23,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 363: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Rhode Island Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Cicilline’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.5% to 6.3% since the ACA was implemented. This 5.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 264,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 284,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 34,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 364: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Rhode Island Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Langevin’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.7% to 5.1% since the ACA was implemented. This 5.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 281,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 312,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 24,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 365: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of South Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Sanford’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.6% to 9.5% since the ACA was implemented. This 6.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 394,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 419,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 32,700 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 28,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 22,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 16,300 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 366: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of South Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Wilson’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.7% to 8.8% since the ACA was implemented. This 4.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 353,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 383,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 18,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 19,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 367: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of South Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Duncan’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.5% to 11.3% since the ACA was implemented. This 5.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 319,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 346,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 23,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 19,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 24,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 368: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of South Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Gowdy’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.9% to 11.8% since the ACA was implemented. This 5.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 353,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 381,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 31,100 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 28,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 22,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 21,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 369: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of South Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in South Carolina’s 5th congressional district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.6% to 9.3% since the ACA was implemented. This 6.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 337,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 372,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 24,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 18,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 22,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 370: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of South Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Clyburn’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.1% to 13.1% since the ACA was implemented. This 7.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 254,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 274,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,700 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 21,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 30,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 371: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of South Carolina Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Rice’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.6% to 12.7% since the ACA was implemented. This 6.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 306,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 309,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 35,500 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 33,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 27,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 372: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the South Dakota’s Congressional District Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Noem’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.5% to 10.2% since the ACA was implemented. This 1.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 447,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 448,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 25,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 373: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Tennessee Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Roe’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.6% to 11.2% since the ACA was implemented. This 4.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 318,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 324,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,700 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 23,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 22,400 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 374: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Tennessee Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Duncan Jr.’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.7% to 9.1% since the ACA was implemented. This 2.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 368,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 394,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 17,500 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 375: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Tennessee Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Fleischman’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.5% to 9.3% since the ACA was implemented. This 4.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 339,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 355,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 22,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 376: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Tennessee Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. DesJarlais’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.1% to 9.7% since the ACA was implemented. This 3.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 381,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 416,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 19,300 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 377: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Tennessee Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Cooper’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.1% to 12.3% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 365,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 400,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 33,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 18,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 20,300 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 378: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Tennessee Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Black’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.0% to 9.6% since the ACA was implemented. This 3.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 368,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 383,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 17,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 379: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Tennessee Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Blackburn’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.0% to 8.0% since the ACA was implemented. This 4.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 359,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 372,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,700 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 16,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 380: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Tennessee Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Kustoff’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.0% to 8.0% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 359,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 394,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 15,900 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 381: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of Tennessee Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Cohen’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.9% to 15.3% since the ACA was implemented. This 2.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 283,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 326,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,100 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 27,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 382: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Gohmert’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 22.1% to 18.0% since the ACA was implemented. This 4.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 311,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 332,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,100 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 383: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Poe’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.8% to 13.9% since the ACA was implemented. This 5.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 401,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 454,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 34,200 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 28,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 21,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 20,500 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 384: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Johnson’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.9% to 9.7% since the ACA was implemented. This 5.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 490,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 565,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 37,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 29,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 18,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 15,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 385: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Ratcliffe’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.8% to 15.8% since the ACA was implemented. This 4.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 333,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 365,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 19,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 30,300 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 386: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Hensarling’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 23.7% to 20.2% since the ACA was implemented. This 3.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 293,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 315,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 27,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 24,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 34,400 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 387: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Barton’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.8% to 13.9% since the ACA was implemented. This 6.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 379,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 424,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 31,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 21,900 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 388: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Culberson’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.6% to 15.1% since the ACA was implemented. This 3.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 396,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 444,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 34,200 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 28,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 21,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 24,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 389: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Brady’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 18.3% to 13.4% since the ACA was implemented. This 4.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 401,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 457,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,700 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 390: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Al Green’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 32.7% to 23% since the ACA was implemented. This 9.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 287,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 327,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 37,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 31,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 22,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 41,300 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 391: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 10th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. McCaul’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.8% to 12.5% since the ACA was implemented. This 5.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 425,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 473,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 34,500 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 19,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 21,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 392: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 11th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Conaway’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 22.0% to 17.3% since the ACA was implemented. This 4.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 353,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 375,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 21,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 18,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 24,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 393: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 12th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Granger’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.9% to 13.9% since the ACA was implemented. This 6.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 391,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 445,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 31,700 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 23,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 394: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 13th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Thornberry’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.9% to 16.1% since the ACA was implemented. This 4.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 316,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 334,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 28,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 395: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 14th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Weber’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.3% to 17.0% since the ACA was implemented. This 3.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 338,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 382,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 24,400 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 19,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 26,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 396: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 15th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Gonzalez’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 32.5% to 27.3% since the ACA was implemented. This 5.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 232,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 244,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 27,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 23,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 19,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 52,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 397: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 16th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. O'Rourke’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 26.6% to 19.2% since the ACA was implemented. This 7.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 254,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 264,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 45,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 42,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 27,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 33,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 398: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 17th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Flores’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 17.9% to 13.6% since the ACA was implemented. This 4.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 380,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 425,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 18,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 31,500 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 399: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 18th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Jackson Lee’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 28.1% to 21.9% since the ACA was implemented. This 6.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 270,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 309,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 34,200 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 28,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 21,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 44,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 400: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 19th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Arrington’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.3% to 16.2% since the ACA was implemented. This 4.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 318,900 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 345,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 18,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 15,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 10,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 31,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 401: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 20th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Castro’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 21.3% to 16.0% since the ACA was implemented. This 5.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 327,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 362,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 31,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 21,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 36,400 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 402: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 21st Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Smith’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.2% to 11.0% since the ACA was implemented. This 4.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 424,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 447,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 34,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 20,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 19,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 403: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 22nd Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Olson’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.8% to 10.3% since the ACA was implemented. This 6.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 502,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 581,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 40,500 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 33,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 23,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 14,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 404: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 23rd Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Hurd’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 23.2% to 16.5% since the ACA was implemented. This 6.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 302,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 332,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 31,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 20,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,900 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 405: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 24th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Marchant’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.7% to 13.3% since the ACA was implemented. This 7.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 427,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 482,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 32,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 18,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 20,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 406: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 25th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Williams’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.3% to 11.7% since the ACA was implemented. This 4.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 396,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 425,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 30,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 23,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 21,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 407: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 26th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Burgess’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.4% to 11.0% since the ACA was implemented. This 4.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 477,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 550,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 33,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 28,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 17,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 16,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 408: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 27th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Farenthold’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 20.5% to 16.7% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 320,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 345,500 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 18,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 32,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 409: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 28th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Cuellar’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 28.8% to 24.5% since the ACA was implemented. This 4.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 239,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 242,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 32,400 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 28,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 22,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 44,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 410: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 29th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Gene Green’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 35.8% to 30.4% since the ACA was implemented. This 5.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 219,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 255,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 34,200 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 28,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 21,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 48,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 411: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 30th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Johnson’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 27.3% to 20.8% since the ACA was implemented. This 6.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 265,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 301,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 32,700 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 19,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 43,500 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 412: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 31st Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Carter’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.9% to 9.5% since the ACA was implemented. This 5.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 427,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 480,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 27,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 21,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 413: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 32nd Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Sessions’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 21.6% to 16.0% since the ACA was implemented. This 5.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 377,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 407,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 33,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 19,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 25,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 414: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 33rd Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Veasey’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 37.9% to 31.4% since the ACA was implemented. This 6.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 203,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 227,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 32,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 18,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 49,500 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 415: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 34th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Vela’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 32.6% to 24.9% since the ACA was implemented. This 7.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 217,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 226,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 27,300 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 24,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 18,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 50,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 416: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 35th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Doggett’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 25.3% to 21.0% since the ACA was implemented. This 4.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 322,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 357,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 34,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 20,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 42,500 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 417: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 36th Congressional District of Texas Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Babin’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 21.5% to 15.8% since the ACA was implemented. This 5.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 341,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 394,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 27,100 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 23,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 22,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 418: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Utah Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Bishop’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.6% to 8.9% since the ACA was implemented. This 3.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 424,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 476,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 36,100 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 31,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 22,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 16,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 419: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Utah Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Stewart’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.5% to 12.7% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 404,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 442,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 42,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 37,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 27,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 20,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 420: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Utah Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Chaffetz’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.6% to 9.3% since the ACA was implemented. This 3.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 436,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 476,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 44,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 39,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 29,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 17,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 421: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Utah Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Love’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 16.2% to 11.0% since the ACA was implemented. This 5.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 438,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 501,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 41,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 35,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 27,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 13,900 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 422: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the At Large Congressional District of Vermont Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Welch’s district.

Here is what is at risk:

• The district’s uninsured rate has gone from 6.5% to 3.8% since the ACA was implemented. This 2.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 316,000 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 345,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 27,900 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 19,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 9,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 60,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 423: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Virginia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Wittman’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.3% to 8.9% since the ACA was implemented. This 3.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 34,500 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 29,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 20,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 12,300 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 424: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Virginia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Taylor’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.7% to 10.9% since the ACA was implemented. This 1.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 29,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 18,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 15,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 425: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Virginia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Scott’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.6% to 11.3% since the ACA was implemented. This 3.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 25,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 21,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 426: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Virginia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. McEachin’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.3% to 10.8% since the ACA was implemented. This 4.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 34,200 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 19,800 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 21,500 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 427: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Virginia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Garrett’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.3% to 11.9% since the ACA was implemented. This 3.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 34,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 29,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 20,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 19,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 428: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Virginia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Goodlatte’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.6% to 12.2% since the ACA was implemented. This 3.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 30,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 27,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 18,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 20,700 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 429: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Virginia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Brat’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.5% to 9.3% since the ACA was implemented. This 5.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 37,700 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 30,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 21,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 14,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 430: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Virginia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Beyer’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.7% to 10.6% since the ACA was implemented. This 3.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 40,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 31,800 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 22,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 10,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 431: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of Virginia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Griffith’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.9% to 11.3% since the ACA was implemented. This 4.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 26,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 24,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 17,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 23,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 432: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 10th Congressional District of Virginia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Comstock’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.7% to 8.2% since the ACA was implemented. This 4.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 39,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 32,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 22,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 9,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 433: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 11th Congressional District of Virginia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Connolly’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.7% to 10.7% since the ACA was implemented. This 1.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 44,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 37,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 26,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 9,900 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 434: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Washington Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. DelBene’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 11.1% to 5.1% since the ACA was implemented. This 6.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 421,100 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 465,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,700 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 12,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 36,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 435: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Washington Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Larsen’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.4% to 6.9% since the ACA was implemented. This 7.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 375,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 393,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 12,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 57,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 436: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Washington Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Herrera Beutler’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.9% to 6.4% since the ACA was implemented. This 7.6 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 359,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 385,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 16,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 11,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,900 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 60,200 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 437: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Washington Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Newhouse’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 19.2% to 11.9% since the ACA was implemented. This 7.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 303,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 304,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 11,300 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 7,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 4,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 87,400 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 438: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Washington Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. McMorris Rodgers’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 12.9% to 5.4% since the ACA was implemented. This 7.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 319,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 337,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 76,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 439: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Washington Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Kilmer’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.7% to 6.5% since the ACA was implemented. This 7.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 328,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 342,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 14,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,000 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 55,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 440: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Washington Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Jayapal’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.4% to 4.7% since the ACA was implemented. This 5.7 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 447,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 496,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 18,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 12,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 50,700 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 441: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Washington Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Reichert’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.3% to 5.5% since the ACA was implemented. This 7.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 419,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 467,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 17,100 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 11,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 40,900 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 442: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 9th Congressional District of Washington Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Smith’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.3% to 7.3% since the ACA was implemented. This 8.0 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 372,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 421,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 18,500 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 12,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 7,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 59,800 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 443: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 10th Congressional District of Washington Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance Marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA Marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Heck’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.9% to 6.7% since the ACA was implemented. This 8.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 340,300 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 372,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 12,400 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 8,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 66,600 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 444: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of West Virginia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. McKinley’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 14.7% to 4.9% since the ACA was implemented. This 9.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 311,500 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 353,700 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 11,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 9,600 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 56,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 445: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of West Virginia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Mooney’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.3% to 6.1% since the ACA was implemented. This 7.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 301,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 350,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 11,800 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 10,100 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 6,100 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 51,500 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 446: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of West Virginia Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 14 million Americans who enrolled in the Medicaid expansion since 2014. Additionally, Republican proposals to tax employer- based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Jenkins’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.4% to 6.9% since the ACA was implemented. This 8.4 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 242,400 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 272,300 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 10,200 individuals in the district who have purchased high quality Marketplace coverage now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 9,400 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 5,600 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 67,300 individuals in the district who are covered by the ACA’s Medicaid expansion now stand to lose coverage if the Republican Congress eliminates the Medicaid expansion.

Page 447: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 1st Congressional District of Wisconsin Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Ryan’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.3% to 5.1% since the ACA was implemented. This 4.1 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 401,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 455,900 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,800 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 21,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,700 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 2,100 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 448: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 2nd Congressional District of Wisconsin Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Pocan’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 7.4% to 5.1% since the ACA was implemented. This 2.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 449,600 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 501,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 23,400 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 18,200 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 2,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 449: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 3rd Congressional District of Wisconsin Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Kind’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 9.0% to 6.0% since the ACA was implemented. This 2.9 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 401,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 423,600 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 28,400 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 25,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 15,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 2,800 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 450: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 4th Congressional District of Wisconsin Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Moore’s (D) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 13.6% to 9.2% since the ACA was implemented. This 4.5 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 298,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 344,000 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 23,500 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 4,900 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 451: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 5th Congressional District of Wisconsin Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Sensenbrenner, Jr’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 6.3% to 4.0% since the ACA was implemented. This 2.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 436,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 495,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 25,900 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,900 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 13,400 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 1,600 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 452: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 6th Congressional District of Wisconsin Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Grothman’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 7.9% to 4.1% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 411,200 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 451,800 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 26,600 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 22,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 14,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 2,200 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 453: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 7th Congressional District of Wisconsin Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Duffy’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 10.5% to 6.4% since the ACA was implemented. This 4.2 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 385,800 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 399,100 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 36,000 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 32,700 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 19,500 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 2,500 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 454: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal on the 8th Congressional District of Wisconsin Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Gallagher’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 7.8% to 5.5% since the ACA was implemented. This 2.3 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 405,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 449,400 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 31,200 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 26,000 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 16,300 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 2,400 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.

Page 455: True Costs of Repeal: Republican Plans to Repeal the ... · repealed, and could be subject to a new tax on employer-sponsored insurance that would amount to the largest middle-class

March 2017 Impact of ACA Repeal Wyoming’s Congressional District Committee on Energy and Commerce, Democratic Staff Committee on Oversight and Government Reform, Democratic Staff

Roughly 20 million Americans have gained access to health care through the coverage provisions of the Affordable Care Act (ACA), including subsidized coverage through the insurance marketplaces and the ACA’s historic Medicaid expansion. President Trump and congressional Republicans’ plan to repeal the ACA will have devastating effects for all Americans. Eliminating premium tax credits and cost-sharing reductions will likely make coverage unaffordable for the 10.4 million Americans enrolled nationwide through the ACA marketplaces as of October 2016. Similarly, eliminating the Medicaid expansion will likely result in coverage becoming unattainable or unaffordable to the more than 11 million Americans who were newly eligible and enrolled in Medicaid since 2014. Additionally, Republican proposals to tax employer-based health coverage could destabilize employer-based coverage and raise taxes on individuals who have health insurance through their employer.

This fact sheet summarizes what is at stake as Republicans in Congress consider eliminating many of the ACA’s provisions through a process known as budget reconciliation. Repeal of the law could endanger the health and welfare of thousands of individuals and their families in Rep. Cheney’s (R) district.

Here is what is at risk:

• The district’s uninsured rate has gone from 15.4% to 11.5% since the ACA was implemented. This 3.8 percentage point drop in the uninsured rate could be reversed if the ACA is entirely or partially repealed.

• 315,700 individuals in the district who now have health insurance that covers preventive services like cancer screenings and flu shots without any co-pays, coinsurance, or deductibles stand to lose this access if the Republican Congress eliminates ACA provisions requiring health insurers to cover important preventive services without cost-sharing.

• 335,200 individuals in the district with employer-sponsored health insurance are at risk of losing important consumer protections like the prohibition on annual and lifetime limits, protection against unfair policy rescissions, and coverage of preexisting health conditions, if the ACA is entirely or partially repealed.

• 22,100 individuals in the district who have purchased high quality Marketplace coverage through now stand to lose their coverage if the Republican Congress dismantles the Marketplaces.

• 20,300 individuals in the district who received financial assistance to purchase Marketplace coverage in 2016 are now at risk of coverage becoming unaffordable if the Republican Congress eliminates the premium tax credits.

• 12,200 individuals in the district who are receiving cost-sharing reductions to lower out-of-pocket costs such as deductibles, co-pays, and coinsurance, are now at risk of health care becoming unaffordable if the Republican Congress eliminates cost-sharing reductions.

• 14,000 individuals in the district who could become eligible for Medicaid if the state expanded Medicaid will now lose the opportunity to gain coverage if the Republican Congress eliminates the Medicaid expansion.