Summary

As Congress continues to make legislative moves to repeal the Affordable Care Act, King County Executive Dow Constantine and Chair of the King County Council Joe McDermott stood with local health care providers to express their firm commitment to protect and improve access to affordable health care in King County.

Story

The people of King County benefitted dramatically from the expansion of health insurance and other reforms under the Affordable Care Act – and a repeal without a comparable replacement threatens widespread damage to the region’s health and economic well-being.

“More than 200,000 people access health care in King County through the Affordable Care Act. We’ve cut the uninsured rate by half. And all of those folks who are able to go to the doctor, and get preventative care, and get their kids to a physician when they’re sick – all of those people are in danger of losing their health care,” said King County Executive Dow Constantine. “I will fight to protect families and ensure access to care.  I will make sure Congress and the new president understand what’s at stake for our residents. And our public health and human services and community partners will do everything in their power to prevent people from suddenly being left without care.”

One of the biggest Affordable Care Act stories in the nation

In the past four years, thanks in part to nationally-recognized outreach efforts:

• The number of uninsured working-age adults has dropped by 54 percent since 2013, to just 7.7 percent, the lowest level ever recorded.
• The uninsured rate for children in King County has also reached an historic low of 1.6 percent.
• The uninsured rate for African Americans dropped by nearly two-thirds, from 27 percent to 10 percent.

More than 200,000 people in King County stand to lose coverage if key provisions of the Affordable Care Act – including the Medicaid expansion and subsidies to individuals who enroll through the health insurance exchange (Washington Healthplanfinder) – are repealed.

Many more in King County would be at risk if Congress does not maintain the ban on discrimination against people with pre-existing conditions and the ability to keep adult children on family health plans until age 26. Removing these and the core requirement that everyone participate in insurance could result in a “death spiral” in the insurance market, impacting not only those who have benefited from the Affordable Care Act but also the broader population.

Medical providers that serve as a “safety net” for people who lose jobs, work part-time, or for other reasons lose their employer insurance have formed a nearly seamless network under the structures of the Affordable Care Act. A repeal threatens the economic sustainability of that network.

Executive Constantine announced his health care priorities, which included:

• Striving for universal coverage, because access to health care is a human right.
• Keeping the insurance market steady by maintaining rules that everyone participate. This is critical to keeping the most popular elements of the ACA: No restrictions on pre-existing conditions, no life-time limits on coverage, maintaining coverage for adult children 26-years-old or younger on their parents’ insurance.
• Continuing to improve health outcomes and control costs.

These items will be at the top of King County’s federal legislative agenda that Executive Constantine and the Council take to Washington, DC, in April.

King County remains committed to innovative efforts that improve the efficiency of our delivery system, address stark health inequities and improve overall population health. Currently, the county is funding its own improvements aimed at children, through Best Starts for Kids; integrating systems of care for people’s physical health needs and mental health / substance use disorders; offerings veterans health programs; and identifying strategies to improve health and reduce criminal justice involvement for people who are frequent utilizers of the jail.

Relevant links

• How King County became one of the best Affordable Care Act success stories in the country

• How to get health insurance

• Should you still sign up for health insurance under the Affordable Care Act? Yes

Quotes

More than 200,000 people have health care in King County thanks to the Affordable Care Act. We’ve cut the uninsured rate by half. And all of those folks who are able to go to the doctor, and get preventative care, and get their kids to a physician when they’re sick – all of those people are in danger of losing their health care. I will fight to protect families and ensure access to care.  I will make sure Congress and the new president understand what’s at stake for our residents. And our public health and human services and community partners will do everything in their power to prevent people from suddenly being left without care.”

Under the Affordable Care Act, the number of people with health coverage has reached an historic high, meaning more children and adults can more easily access needed health care. It is a foundation on which we can build our efforts to improve health, whereas repeal would be destructive to our region, including for the 200,000 King County residents who have become insured as a result of this law.”

Repealing the Affordable Care Act without a replacement is shredding the health care safety net. People without insurance tend to wait until they are very sick and end up in emergency rooms, the most expensive form of care. For the sake of the many individuals and families who finally went to the doctor or dentist because they finally got insurance or qualified for Medicaid, any replacement has to have equal coverage and equal benefits. Community health centers like ICHS also need this funding source to continue serving the underserved and fragile populations who now have access to affordable, quality care."

It is more prudent and humane to address mental illness and substance use disorders before someone escalates symptoms to a crisis state and requires costly hospitalization and institutionalization.  Medicaid expansion has given people access to these early interventions. It would be expensive and tragic to have to go back to a time when so many went without care until they became deeply disabled and required expensive crisis care."

The Affordable Care Act is the event that has had the greatest impact on access to quality health care since the founding of community health centers. In the case of Neighborcare Health alone, we’ve grown our ability to provide medical and dental care from about 50,000 people before the Affordable Care Act to a projected 80,000 this year. It’s unconscionable to think that so many people--including homeless individuals and working adults who aren't insured through employers-- could lose insurance coverage, or that Neighborcare would have to contend with enormous funding cuts that could make it impossible to maintain our current level of service to patients and the community. "

The Affordable Care Act has allowed equal access to quality health care for people in King County who suffer from the greatest health disparities. Individuals from refugee and immigrant communities, people of color and low income communities can now access health care services without going into debt.   This allows individuals to seek treatment for chronic diseases and cancer related illnesses before they reach the critical stage.”  

Patients who have been unable to get the surgery they’ve needed can come and get the care they need now.  Fewer patients are putting off procedures, saving lives.  We’re very busy taking care of our community because they can come to us now.  We’ve had to add two more positions doing what I do because of our large caseload.”

Whatever happens at the federal level will not deter us from dogged pursuit of local innovations to improve population health. We can and will continue to promote better health for families and individuals who demonstrate amazing resilience but also face challenges from health problems that are often preventable”

We have been able to open doors to behavioral health treatment for thousands of people in King County who had been unable to access treatment before. Not only are they improving their health and wellbeing, we are beginning to see reductions in costly involuntary psychiatric hospitalizations and jail use - all of which could be lost if the ACA is repealed.”

For more information, contact:

Alex Fryer, Executive Office, 206-477-7966

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