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These include: 1) Young adults up to the age of 26 will be able to stay on their parents’ healthcare plan; 2) There will be no return to lifetime caps on healthcare; 3) There will be no return to “pre-existing” conditions. These are critical healthcare reforms that protect those who have health insurance, especially those who access health insurance through their employers. The proposed changes to the healthcare system mainly come in the area of funding: who can access health insurance and how it will be paid for. In this regard, the changes are less positive, particularly for the poor and the aging. One aspect of the ACA under attack by Republicans is Medicaid expansion. Under Obama, many states were able to expand Medicaid coverage. Some of those states, like Ohio, are among those that have been hardest hit by the opioid abuse epidemic. Medicaid is currently funded on a flexible basis. States are paid based on the number of poor who are covered through the program. When the economy lags or a state has an increase in the number of people qualifying for Medicaid for other reasons, the federal government increases funding to pick up the slack. Adderall Rehabs covered bay Aetna Policy Medicaid is a true safety net under this system. The current administration wants to change Medicaid funding to a block grant system. With block grants, the federal government pledges a specific amount of money to each state. This amount does not change based on need and is re-evaluated at three year intervals. In times when the economy lags, it is likely that the federal government will decrease funding to states, rather than increase it as the current system does. Most block grant funded programs atrophy . As federal Medicaid funding becomes increasingly unavailable, states that are unable to make up the losses will have larger and larger numbers of people without Medicaid coverage. Older Americans will also suffer under this proposed ACA revision. Caps on how much insurance companies are able to charge older adults will significantly increase and although tax credits will switch from assisting the poorest Americans to assisting older Americans, it is unclear that these tax credits will cover the skyrocketing premiums older Americans will face. These changes to the ACA are not a foregone conclusion.

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