ITHACA, N.Y. — The possible repeal of the Affordable Care Act has sparked discussion nationally, locally and on Tuesday in Tompkins County Legislative Chambers.

Legislators and a member of the public Tuesday shared their opinions on the Affordable Care Act, and if it is repealed, what could replace it. Tompkins County Legislature has supported single-payer health care with a resolution in the past, and some legislators are working on a new resolution that would also make the Legislature’s health care ideals clear.

During public privilege of the floor Tuesday at Tompkins County Legislature, Deborah Dawson, of Lansing, asked people to imagine what decisions they would have to make and the hardships they would face if they did not have health insurance.

“Living without health insurance in 21st century America is truly a cruel and inhumane situation in which to find yourself in, and it’s inexcusable,” Dawson said.

Dawson is a member of the Village of Lansing planning board. On Sunday, Dawson spoke at an event discussing the Affordable Care Act hosted by Tompkins County Democrats.

Dawson closely echoed a quote from Martin Luther King Jr., in which he stated: “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

Dawson also noted cost-related reasons for keeping the Affordable Care Act. She said the first place Tompkins County would feel the impact of a repeal is in Medicaid and Medicaid reimbursement. She said about 7.5 percent — roughly 7,700 — of county residents would lose their Medicaid expansion coverage, and also that the county would lose more than $1 million in federal reimbursement for mandated Medicaid expenditures.

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According to a report by the U.S. Department of Health & Human Services, 20 million people gained health insurance because of the Affordable Care Act.

Martha Robertson, D-Dryden, said the Affordable Care Act has benefited people beyond the 20 million who gained health insurance.

“Even if you have kept your employer insurance, etc., every single one of us has benefited such as our children who can stay on our policies until age 26. You can’t get kicked off because you’ve exceeded the lifetime cap, you can’t get denied insurance because you have a pre-existing condition,” Robertson said.

Under the Affordable Care Act, health insurance companies cannot refuse to cover someone or charge more because of pre-existing conditions. Robertson said her sister has multiple sclerosis and would be “out of luck” if the pre-existing condition provision of the ACA went away.

“It matters what the replacement looks like and who pays for it,” Robertson said.

Legislator Mike Sigler, R-Lansing, said it’s clear that the Affordable Care Act is going away. He said too many political promises have been made for it to not go.

“It would seem to me that if that many people are going to lose insurance, most of those people are insured under Medicaid, maybe the argument ‘We are going to fight to keep the ACA,’ maybe the argument is ‘Hey we should fight to keep the expansion of Medicaid there because all these people are going to be out,’” Sigler said.

Over the weekend, president-elect Donald Trump said he is creating a plan to replace President Obama’s health care law with the goal of “insurance for everybody,” according to The Washington Post. He also reportedly vowed to fight pharmaceutical companies on drug prices.

Jim Dennis, D-Ulysses, said being a “nickel and dime” legislator on the budget committee, he wants to know how Trump would pay for universal health care.

Tompkins County Legislature has previously supported a single-payer approach to controlling health care costs. In 2015, legislators reaffirmed that position with a resolution. Single payer health care federalizes how health care providers are paid and leaves the choice of doctors and hospitals up to each individual and the choice of treatment up to each patient and his or her doctor.

The discussion on the Affordable Care Act will likely continue at Tompkins County Legislature. Legislator Carol Chock, D-Ithaca, said a resolution is in the works to make the legislature’s health care ideals clear.

Kelsey O'Connor

Kelsey O'Connor is the managing editor for the Ithaca Voice. Questions? Story tips? Contact her at koconnor@ithacavoice.com and follow her on Twitter @bykelseyoconnor.