Republican lawmakers in Washington are rolling up their sleeves and getting to work on repealing the Affordable Care Act, while possibly — as the president-elect has suggested — salvaging popular parts of the law, like protecting those who have pre-existing conditions.
But repealing the law and replacing it with something else is not so simple, said Elisabeth Benjamin, Vice President of Health Initiatives at the Community Service Society of New York, an advocacy group, and co-founder of Healthcare For All New York.
"What people don’t understand is that our healthcare system is so complicated, and it’s an integrated whole," said Benjamin. "It’s not like that game Jenga where you can take out a piece and hope it all stays standing. It doesn’t work that way."
A repeal of the health law without knowing what will replace it injects even more uncertainty in the process, she said. This is a sentiment echoed by Joel Cantor, who leads the Center for State Health Policy at Rutgers University.
"There’s a good deal of risk in dismantling the existing law in a piecemeal way and replacing it in a piecemeal way," he said.
Cantor previously wrote that in New Jersey, more than 670,000 people now have insurance on a federal exchange and are at risk of losing coverage if the law is repealed. A recent report from New Jersey Policy Perspective said a repeal could cost the state $3 billion a year.
The numbers sound grim in New York, too: state officials said more than 2.7 million people would lose coverage and that a repeal could impact the state budget by $3.7 billion.
Yevgeniy Feyman, an adjunct fellow at the conservative-leaning Manhattan Institute, is a critic of the Affordable Care Act — though he thinks it should be improved, not repealed. Feyman said it remained to be seen if that many New Yorkers would lose their insurance.
But could there be as much chaos as others are predicting?
"One hundred percent," said Feyman. "I think that a repeal of the A.C.A. would decimate New York's individual market."
Without knowing what the new rules will be, he said, there is uncertainty for insurance companies and, subsequently, the people now covered by them.