As Donald Trump and the Republicans get ready to take control of power in Washington and follow through on their promise to repeal Obamacare, a lot of attention has been paid to how the 20 million people who get their health insurance through Obamacare will be impacted.

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An Obamacare repeal would impact 156 million who get insurance through their employer

However, a full repeal of Obamacare won’t just affect those on Obamacare plans. In fact, there are 156 million people who get their insurance through their employers in this country that would be at risk of having their benefits curtailed. The reason for that is because in addition to expanding Medicaid for poor Americans, creating healthcare exchanges and providing subsidies for middle-class Americans – Obamacare also put in place a number of major health insurance protections that apply to all Americans receiving health insurance.

Obamacare did away with lifetime spending caps

A repeal of Obamacare would do away with the ban on lifetime spending caps that the Affordable Care Act made illegal. Meaning that not only would the 20 million people who have gained health insurance through Obamacare lose their insurance, but the 156 million who get their health care through employer policies would then potentially be subject to lifetime spending caps. Prior to the passage of Obamacare, many people would find out once they became ill with a serious illness, like cancer, that their policy had a lifetime spending cap, meaning they would not get health care once that cap was reached even if they were still sick.

Obamacare banned pre-existing condition discrimination by insurance companies

Because insurance companies could refuse coverage to people with pre-existing conditions – before Obamacare outlawed that practice – those sick people who hit their spending caps had no alternative options for health insurance before Obamacare. Now that insurance companies can’t deny coverage to people with pre-existing medical conditions, Americans have far more freedom and security in their lives. Americans no longer need to worry they won’t get health insurance because they have a pre-existing condition if they want to switch jobs or shift to part-time work. And Americans who get laid off can take their health insurance with them through Cobra without fearing that there will have a gap in coverage or not be able to buy insurance again later on.

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Other important Obamacare safeguards that would impact people on employer-based plans if Obamacare is repealed

In addition to banning lifetime coverage caps and preventing insurance companies from discriminating against Americans with pre-existing conditions, Obamacare lets parents keep children on their health plans until age 26, it requires companies with at least 50 employees to offer coverage and Obamacare also makes preventive care like  health screenings, flu shots, breast-feeding supplies and contraception, free to those with insurance.

Republican’s lack of Obamacare replacement plan will cost all Americans more

It’s well documented that Republicans have no plan for what they want to replace Obamacare with – despite having 7 years to have figured it out. But Republicans do want to keep the parts of Obamacare that are popular with Americans like the bans on spending caps and pre-existing condition discrimination. And Republicans are now thinking about voting on an Obamacare repeal and delay so that they can figure out just what their plan is to cover the 20 million Americans who would lose their insurance in an Obamacare repeal.

However, this silly approach to governing won’t just put the 20 million Americans who have gained insurance through Medicaid expansion and HealthCare.gov exchange subsidies at risk. The Republicans will also be making health insurance more expensive for the 156 million with employer-based plans because they are looking keep the popular stuff but do away with the cost savings portions that make Obamacare economically viable – most notably getting more people into the insurance market by mandating everyone buy insurance. That will have one very simple consequence – insurance for everyone will get more expensive because insurance companies have to cover pre-existing conditions with no lifetime caps meaning sicker people will be buying insurance but there is nothing requiring healthy young people from buying insurance.
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