No Repeal Without Replace: What’s At Stake


Kristen is a pre-school teacher in Davidson County with congenital heart failure. The ACA has not only made it impossible for her to be denied coverage for her pre-existing condition, but it also meant that she could buy affordable coverage on the Marketplace. But now, both of those are at risk.

Health care is at risk in Tennessee. President-Elect Trump has promised to repeal the Affordable Care Act, and to do that without having a replacement plan in place. Any changes to the healthcare system without a new plan already in place may put the health and lives of Tennesseans at risk.

If we repeal the ACA without a replacement plan in place…

  • 526,000 Tennesseans stand to lose their health care coverage, increasing our uninsured rate by 79%. Of those, 203,000 Tennesseans who receive financial assistance (which averages $299 per month) for their Marketplace insurance will no longer have affordable coverage.
  • According to the most recent Reconciliation Bill, Tennessee’s economy stands to lose $27 billion in federal funding for programs like TennCare, CHIP and financial assistance for the Marketplace over 9 years.
  • 8 million Tennesseans with pre-existing conditions like asthma, diabetes and cancer could be denied affordable, comprehensive coverage.
  • More rural hospitals will likely close because of the reductions in federal funding. Tennessee has already seen 4 rural counties lose their only hospital, and there are over 40 other hospitals at risk of closing. This means lost jobs, diminished care, and the inability to recruit and retain other industries.

There are some aspects of the ACA that everyone agrees were beneficial. But if we repeal without a replacement plan in place, those are all at risk. Since its implementation…

  • Working Tennesseans have reduced their uninsured rate by 24%.
  • Women are no longer charged up to 44% more than men for identical coverage.
  • About 2 million Tennesseans (including 523,000 children) saw lifetime limits on coverage disappear.
  • 7 million Tennesseans on private coverage (including 550,000 children) and 1.2 million Tennessee seniors on Medicare benefit from free preventive care, like blood pressure screenings, immunizations, and cancer screenings.
  • Since the implementation of the ACA, Tennesseans have received around $21.5 million in refunds from plans that overcharged for premiums.
  • Seniors and Tennesseans with disabilities have saved approximately $424 million on drug costs. In 2015, approximately 115,000 seniors saved an average of $954 on drug costs, as a result of the Medicare donut hole coming to a close (which meant that seniors used to have to pay much more for their prescriptions, even though they had insurance).

Tennesseans are at risk. Our preventative care is at risk. Our protection from pre-existing conditions is at risk. Our seniors and children are at risk.

Our state is at risk. We could lose billions of dollars in revenue. Our rural communities are struggling. Our hospitals need protection.

Don’t repeal the Affordable Care Act without a plan in place to protect Tennessee.