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Report: Obamacare Repeal Could Cost Maryland Billions

BALTIMORE (WJZ/AP) -- With Republicans promising to repeal the Affordable Care Act as President Barack Obama prepares to leave office, Maryland's Department of Legislative Services has released a report showing how that could cost the state billions of dollars.

President-elect Donald Trump has vowed to overturn and replace the Affordable Care Act, and majority Republicans in Congress this week began the process of repealing it using a budget maneuver that requires a bare majority in the Senate.

The law has delivered health coverage to about 20 million people, providing subsidies and Medicaid coverage for millions who don't get insurance at work. It has required insurers to cover certain services such as family planning and people who are already ill, and has placed limits on the amount that the sick and elderly can be billed for health care. However, it is also saddled with problems such as rapidly rising premiums and large co-payments.

"Implementation of the ACA in Maryland to date has largely been funded with federal dollars, including expansion of Medicaid and establishment of MHBE (Maryland Health Benefit Exchange)," the report says.

"While details are uncertain, repeal or substantial amendment of the ACA and adoption of alternative reforms could have a tremendous impact on Maryland and will require the General Assembly to consider significant financial and policy decisions. If enhanced federal funding is repealed, Maryland must decide whether to maintain and how to fund the Medicaid expansion."

Without enhanced federal funding, the net cost to Maryland will be $1.27 billion in fiscal 2018, the report says, rising to $1.5 billion in fiscal 2022.

The loss of an enhanced matching rate for the Maryland Children's Health Program would increase general fund spending by an estimated $68 million in fiscal 2018, $72.8 million in fiscal 2019, and $19.5 million in fiscal 2020.

And, an ACA repeal could "have a profound impact on the Maryland all-payer model contract that governs hospital rate setting."

If Maryland loses that contract, $2.3 billion in Medicare and Medicaid payments to Maryland hospitals per year could eventually be lost.

The report shows that Maryland's uninsured rate has dropped from 10.1 percent to 6.7 percent between 2012 and 2015.

The percentage of Marylanders who needed, but did not get medical care due to cost fell from 7 percent in 2011 to 2.8 percent in 2014.

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(TM and Copyright 2017 CBS and its relevant subsidiaries. CBS and EYE Logo TM and Copyright 2017 CBS Broadcasting Inc. Used under license. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.)

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