I've read bits and pieces that Congress wants to repeal the ACA and give themselves 3-4 years for that repeal to kick in, making it just a toothless symbolic achievement.
Unfortunately, there are 20-30 million of the aforementioned cohorts above that will be impacted by the repeal whenever it goes into effect. But what if the repeal is immediate? What happens to the cohorts of people listed above?
I'm one of these people. I got really sick in 2003, going to Urgent Care and the Emergency Room four times before the ER doctor was able to get me medication that cured it. But, it took two weeks and losing 18lbs in the process. I also had a fluky preexisting condition from over a decade ago that insurers (pre-ACA medical and Disability insurers) have used against me in order to raise my monthly premiums. Or, to "properly rate my risk level" in insurance industry language.
But under the ACA, the insurance company didn't bring up the two instances from over a decade ago. They just approved me as a male in my age group, pooling my money as a now 39-year old man who ran six half marathons and a Duathlon in 2016, with the other healthy and unhealthy people. Pooling means that healthy people who never use insurance should cover the costs of the unhealthy or those who get a fluke illness.
Granted, my premiums on January 1st jumped by 50%. This really wasn't a surprise to me since 20 million new people had come into the pool and many had pre-existing uninsurable conditions so the policies probably were not priced correctly. I understand that. Fortunately, I can afford the premium increase and I'm grateful to have coverage even though I'm out of pocket the first $5,000 of my medical care because I chose a high deductible plan to keep my monthly premiums down.
But if I lose my automatic coverage if Congress and Trump repeal immediately, then I have to be re-underwritten and they'll bring up two flukes where I actually used the coverage twice in 16 years against me to raise my monthly premiums even higher. Every insurer does this so I'm used to it.
But what about those with more severe pre-existing conditions? Or those who are undergoing treatment right now? How about the poor or those on the fringe of being able to afford insurance who may just go without since the premiums are too high? Will they go back to the way it was prior to the ACA when they'd show up at the ER for treatment rather than having a number they can call for nurse triage or a regular doctor they can see.
I get the feeling the repeal of "Obamacare" is a political stunt based upon symbolism. I'm sure that the bill will have some kind of language about de-funding Planned Parenthood, which they'll use to win over the religious right who show up to vote every time even if many of those will be losing coverage. (Too bad most don't know the history of the Republican party and came to embrace the anti-abortion movement - it was a books for votes deal).
Hopefully, the symbolic overturning of the ACA will be delayed for several years, to be dealt with down the road. Within two years, the Democrats will probably have majority control of the House and maybe of the Senate as voters wise up to just how far and in your face the GOP has redirected funds for the welfare state used for actual people and given those funds to the corporate people, in terms of massive corporate welfare to appease campaign donors.