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The reality of repealing the Affordable Care Act

Medical staffers prepare for surgery at University of Colorado Hospital

Even with uncertainty looming about ACA, the enrollment deadline for 2017 coverage is January 31 and, ahead of that, Schultz said signups are up, "busier than previous year", as far as she's seen. The accident resulted in a traumatic brain injury that damaged the parts of her brain that are responsible for reading, writing and communication.

But finding an approach that is superior to both Obamacare and the cruel old days of broad indifference to millions of families without health insurance isn't easy. And she's not eligible for Medicaid or Medicare, which can help cover disabled individuals. But it hasn't happened yet, and coverage is still available - but enrollment deadlines are coming up fast.

More than 11 million Americans are insured under the current system, according to the latest enrollment data released by Health and Human Services.

House Speaker Paul Ryan (R-Wis.) and others will swear up and down that the "American people" stand with the congressional GOP in their crusade against the Affordable Care Act.

You want ACA to be repealed?

As a hospital administrator with 37 years of experience in the healthcare industry, I am responsible for running the operations at Commonwealth Health, which includes Wilkes-Barre General Hospital, Regional Hospital of Scranton, Moses Taylor Hospital, Berwick Hospital Center, Tyler Memorial Hospital and First Hospital. A majority of them receive financial help to afford the coverage. When more than 80 percent of ACA enrollees get subsidies, the relatively few enrollees who don't are going to get hammered. The national rate of uninsured citizens has never been lower.

The reality of the Affordable Care Act is that 20 million people have gained coverage. Women can not be charged more than men. It also requires insurance companies to spend a certain amount of premium dollars on medical care - not administrative costs such as salaries and profits. You can not be refused insurance based on pre-existing conditions.

Just as many ACA critics predicted long ago, it is well on its way to creating a health insurance "death spiral" in many states. But for others it was a signal that competition was working - weeding out those who struggled to compete.

Since Montana began enrolling folks under the HELP Act on January 1, 2016, Montana hospitals are seeing fewer people who have no money to pay for needed care. Many who are getting the health care they need from ACA helped elect the Republicans now in power as well as Donald Trump, who takes office January 20. If we are to repeal/replace or, as Mr. Trump has started saying, "or amend" the health care law, cost is a great place to start.

Just as it seemed Democratic lawmakers, in the minority of both chambers of Congress, were almost powerless in stopping the repeal of Obamacare Republicans have promised, they may get a shot at one last Hail Mary.