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Medicare
Dismantling Obamacare would likely mean higher premiums, deductibles and cost-sharing for the 57 million senior citizens and disabled Americans enrolled in the program. It would also bring back the infamous "donut hole" in Medicare's prescription drug coverage.
The health reform law made many changes to Medicare. It slowed the growth of payment rates to hospitals and other providers, reduced payments to Medicare Advantage plans and improved benefits for enrollees. Repealing Obamacare would increase Medicare spending by $802 billion over 10 years, according to estimates by the non-partisan Congressional Budget Office.
As a result, Medicare beneficiaries would pay more because premiums and deductibles are tied to the growth of federal outlays. So seniors would face higher deductibles and co-payments for their Part A, which covers hospital stays, and higher premiums and deductibles for Part B, which pays for doctor visits and other services. The White House estimated that the typical Medicare beneficiary is paying about $700 less in premium and cost sharing this year because of slower growth in costs.
Employer-sponsored insurance
Say goodbye to the employer mandate if Obamacare is repealed. Companies with at least 50 employees would no longer be required to provide affordable insurance to their staffers who work more than 30 hours a week.
This likely wouldn't have a major impact on the 150 million workers who are insured through their jobs since most larger employers already offer coverage for full-time workers, Levitt said.
However, setting the bar at 30 hours a week prompted some employers to extend coverage to more of their staff, since many companies had considered that threshold to be part-time. If repealed, companies could opt to cover only those working at least 35 or 40 hours a week, leaving some people uninsured.
Also, companies would no longer have to keep children on their parents' plans until they turn 26. This has proved to be one of the more popular Obamacare provisions, with 2.3 million Americans ages 19 to 25 signing up between 2010 and the start of open enrollment in 2013, according to the White House's most recent figure. (Trump has said he may keep this policy.)
Workers, however, may have to start paying again for contraceptives and preventative screenings, such as colonoscopies and mammograms. Obamacare requires these to be provided free-of-charge.
Individual market
Obamacare has had the largest impact on the individual market, which was largely unregulated prior to the health reform law.
It sought to make health insurance more accessible and affordable in a number of ways. It required insurers to cover people with pre-existing conditions and banned them from charging the sick more. The law ended the practice of insurers imposing annual or lifetime caps on benefits, and it also placed limits on annual out-of-pocket spending. It mandated that individual insurance cover an array of benefits, including medication, maternity and mental health. It prevented insurers from charging women more and restricted premiums for older folks at no more than three times those of young adults.
Obamacare set up health insurance exchanges to allow Americans to shop for individual policies and created federal subsidies so low- and moderate-income enrollees could buy policies for less than 10% of their income. Another set of subsidies limit the deductibles and co-payments for lower-income policyholders. Some 10.4 million people were covered through the Obamacare exchanges, as of June.
Another 6.9 million Americans purchase individual policies outside of the Obamacare exchanges. They cannot apply for subsidies, but receive all of the other benefits.
(Trump has said he would continue to require insurers to cover those with pre-existing conditions, but only if they were continuously insured. Those who did not have coverage could be subject to higher premiums or forced to apply for policies in state-based high-risk pools.)
Medicaid
Before Obamacare, most Medicaid enrollees were low-income children, pregnant women, parents, the disabled and the elderly.
The health reform law opened up the program to low-income adults with incomes of up to 138% of the poverty line -- $16,400 for a single person -- in states that opted to expand their Medicaid programs. So far, 31 states, plus the District of Columbia, have done so, adding nearly 17 million more people to the rolls since late 2013, just before the provision took effect. (This figure includes both those newly eligible under expansion and those who always met the criteria.)
Under the program, the federal government paid 100% of the costs of the expansion population for the first three years and slowly lowered the reimbursement rate to 90%.
Repealing Obamacare would leave millions of the poorest Americans without insurance.
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