The Louisiana Public Health Institute opposes efforts to repeal or weaken the Affordable Care Act (ACA). We believe health is a human right. As our nation struggles with inequity, we need to address injustices to pave the way to equal health for all. There are many benefits to this important legislation that would be lost without a viable, comprehensive plan for replacement.

Nearly every public health goal is based on the premise that everyone will have equal access to care. It’s well known that the uninsured are less likely to receive preventive services and less likely to seek care as quickly when they are sick. This results in higher costs when they do seek treatment.

In Louisiana, plans to dismantle the ACA could present serious challenges for the financial stability of providers across the state, the solvency of the state Medicaid program, and access to health care services for low-income populations.

Louisiana has benefitted from the ACA in multiple ways. The ACA established the Prevention and Public Health Fund to provide expanded and sustained national investments in prevention and public health, to improve health outcomes, and to enhance health care quality. Louisiana has received more than $29 million through the Prevention Fund since 2010[1]. Investments have been made in evidence-based activities to reduce tobacco use; prevent and control diabetes, heart disease, and obesity; engage in racial and ethnic approaches to address chronic disease risk factors; promote better detection and response to disease threats; and to strengthen the public health system. This important part of the ACA must remain intact.

Medicaid expansion, a critical benefit of the ACA in Louisiana, also provides safety-net clinics with the resources to serve a greater number of those in need; it increases the sustainability of primary care services and improves the overall effectiveness of the Louisiana health care system. Given the historically high rate of uninsured individuals in Louisiana, Medicaid expansion is critical to meeting the health needs of many who have been excluded from the health system. Some of the most vulnerable Louisianans will lose coverage if Medicaid expansion is phased out.

More than 400,000 people in Louisiana have access to health care thanks to the expansion of Medicaid. “We’re seeing a generational shift in health care for Louisiana residents,” said Dr. Rebekah Gee, secretary of the Louisiana Department of Health. “As more and more residents receive health care coverage and have access to regular and cost-effective primary care, fewer residents have to rely on expensive emergency rooms for their health needs. Medicaid expansion is creating better access to health care and saving taxpayer dollars at the same time.” Medicaid expansion is bringing more tax dollars into Louisiana and has already saved taxpayers $184 million since July 1, 2016.

The ACA is helping to reduce health disparities, especially for those in rural populations. However, we recognize there is still work to do. According to the American Public Health Association, although the ACA has helped 20 million people get coverage nationally, about 29 million people still lack health insurance.

Health care coverage, including preventative care, should be universal and affordable. Repealing the ACA without an adequate replacement will make Americans sicker and dramatically increase health care costs for everyone. The bill proposed on March 6, 2017 in the U.S. House of Representatives is not an adequate replacement.

[1] Includes funds to date but does not include total awards for fiscal year 2016.