The Affordable Care Act’s ban on preexisting condition exclusions was a big benefit to those with disabilities: they were allowed to purchase insurance despite having preexisting medical issues, without having to pay higher rates or suffer through waiting periods. But the Affordable Care Act (“Obamacare”) has also had a positive effect on Social Security disability, Medicare, and Medicaid. Repealing it, or reversing course on preexisting conditions, could be a big setback for these programs.
The Affordable Care Act undeniably helped lower the number of people on Social Security disability and disability-related Medicare. Since it went into effect, annual applications for Social Security disability have decreased by over 12% (from 2013 to 2016). In 2014 alone, the first year Obamacare plans were available, there was an 8% drop in disability applications. While there were economic factors at play, affordable health care undoubtedly played a role. Historically, many folks with preexisting conditions who lost their work-based health coverage applied for disability benefits so they could get health care benefits. They knew that an approval for Social Security disability meant they could either qualify early for Medicare, or, if they had very low income (or somewhat low income and very high medical expenses), for Medicaid. After Obamacare was passed, some of these folks undoubtedly were able to buy insurance on the health care exchanges—or get coverage through their state’s Medicaid expansion—and didn’t have to file for benefits.
Not only that, but since the Affordable Care Act gave persons with disabilities or chronic medical conditions access to good health care and reasonably priced medications, more of them were no doubt able to work despite having physical or mental impairments; fewer of them may have needed to apply for disability benefits.
And because of better health care and access to medications, those who couldn’t work due to a temporary illness or injury might have been less likely to need to be off work indefinitely. They might have recovered sooner, thanks to regular doctors’ visits and proper medication, and not have had to apply for disability benefits.
A repeal of the Affordable Care Act and/or the preexisting condition exclusion could reverse these improvements. In addition, taking health care away from people with severe disabilities makes it harder for them to get approved for the benefits they need. Disability applicants who aren’t able to see a doctor for treatment regularly, and who don’t have lab results or MRIs to prove their disability, are often denied. When applicants have poor medical records, Social Security spends more money to send applicants to consultative medical exams—and then often denies them anyway. In short, a repeal of the Affordable Care Act or the ban on preexisting condition exclusions is likely to affect the disabled more than others.
Update: The first three quarters of 2017 show an additional 7% drop in disability applications from the first three quarters of 2016. The trend continues.