More than just health insurance: repealing the ACA will impact health, jobs and community

Philadelphia — A repeal of the Affordable Care Act (ACA) and changes to the Medicaid program would have a profoundly negative impact on the people, organizations and clients supported by the Health Federation of Philadelphia (HFP). Speaking at two high profile events, HFP senior director of population health Suzanne Cohen testified about the effect that changes to these programs would have on Federal Qualified Community Health Centers (FQHCs).

Speaking with Senator Casey at a roundtable discussion of healthcare providers organized by the Pennsylvania Health Action Network (PHAN) on Monday, March 3, Cohen stressed the quality of care FQHCs provide patients, with and without insurance, in Philadelphia and throughout the state. The ACA and the Medicaid expansion have opened the door for thousands of health center patients to obtain insurance. Access to affordable insurance has provided patients access to a full range of care including specialty and hospital care and allowed health centers to expand their services.

“I think this event was helpful for Senator Casey and his staff,” said Cohen. “Physicians, nurses and other provider-organizations gave specific details about the economic and healthcare-related impact a repeal of the ACA and changes to Medicaid will have in Pennsylvania.”

HFP was founded in 1983 as a membership organization of Federally Qualified Community Health Centers. Today the organization has 13 member organizations in Philadelphia and the surrounding counties and supports many more through various programs. Members include the City of Philadelphia District Health Centers and 12 other nonprofit health centers, which provide primary health care services to over 300,000 individuals in Greater Philadelphia each year.

“Health centers do more than provide primary medical care. They employ comprehensive strategies to improve the well-being of individuals and communities,” said HFP’s chief executive officer Natalie Levkovich. “Poor health of individuals creates a burden for families, communities and systems. Healthy people work, contribute to economic activity,  to the stability of their families and neighborhood, and to lower healthcare costs.  Weakening health centers and repealing the Medicaid expansion would adversely affect millions of low-income people across the country and have profound, and expensive, ripple effects beyond the individual level.”

HFP had the opportunity to elaborate more on the role of FQHCs in Philadelphia during a hearing held by the Philadelphia City Council’s Committee on Public Health and Human Services on Monday, March 6. Cohen again testified to the quality of care and services FQHCs provide. She stressed that they are also major employers within Philadelphia, with a combined employment of approximately 1,500 individuals in a variety of positions.

“Health centers are at a vulnerable juncture. They are facing the potential repeal of Medicaid expansion, the ACA and could also see dramatic cuts in federal grants,” Cohen said during her testimony to City Council.  “The Health Federation’s member health centers could have their federal funding cut by 70%. This will result in the loss of jobs and the loss of access to health care in underserved communities.”

A repeal of the ACA and the Medicaid expansion would have a direct impact on other HFP programs as well. Certain programs, such as the Chronic Disease Collaborative, might lose all of its funding. Many of HFP’s public health training services, such as work supporting efforts of the City of Philadelphia to reduce the spread of infectious and chronic diseases would be affected. Many of the families in programs such as Early Head Start and the Enhanced Home Visiting Program are enrolled in Medicaid, and they may no longer have access to health insurance. This is concerning as a public health agency and as an organization with a mission to serve underserved and vulnerable populations.

The future of the ACA Outreach and Enrollment program is also uncertain. Since the beginning of ACA, HFP health insurance navigators have helped over 3,600 individuals enroll in an affordable insurance program. “We’ve seen firsthand the success of the ACA. We’ve helped children, families, recent immigrants and others obtain the coverage that they need for quality care,” said Christina Kappiuzhathil, HFP’s outreach and enrollment coordinator.

For example, during this year’s enrollment period, insurance navigators helped a young 22 year-old freelance writer just beginning her career as a journalist. “She was self-employed and needed to be able to access mental health services; mental health services that she depended on,” explained Kappiuzhathil. “Without the ACA, there are few resources available for low cost mental health care. With the ACA, our client was able to receive the treatment that she needed and have peace of mind that she would have access to care. This is just one example about why ACA and the Medicaid expansion are critical to so many people.”

The Congressional Budget Office (CBO) released its analysis of the current proposal in the House of Representatives to repeal the ACA and reduce Medicaid Funding. A fact sheet developed by PHAN states “According to CBO analysis, 14 million people would lose their health care coverage in 2018, increasing to 24 million in 2026.”

“It is important to make sure that our voices are heard,” said Cohen. “The current proposal is incredibly regressive in terms of its impact on low income people. We’re very concerned that people are going to lose their health insurance at the same time as many other programs and services are threatened. This is a real problem.”

To talk with a HFP insurance navigator for information about ACA and Medicaid enrollment call 215-977-7255 or email

Click here for information about PHAN and how to get involved.