Speaker Paul Ryan may have to settle for much less than repeal-and-replace.Tom Williams/CQ Roll Call via Getty Images

Speaker Paul Ryan may have to settle for much less than repeal-and-replace.Tom Williams/CQ Roll Call via Getty Images

by Jennifer R. Farmer, Contributor

During the presidential campaign, President-elect Trump promised to simultaneously repeal and replace the Affordable Care Act (ACA). His promise was welcome news to congressional Republicans who have repeatedly tried to overturn the health care law, voting at least 62 times to repeal parts or all of the ACA. While there is a lot of talk about repealing the measure, little has been offered in the way of what a replacement might entail. We also don’t know how long it would take to roll out and implement an alternative to the ACA.

With far-reaching implications, the debate over repealing the Affordable Care Act will be one of the most significant moral and political showdowns of Trump’s administration. I call it a moral battle because the decision will impact millions of Americans and could mean the difference between life and death. Without health insurance, many Americans will die unnecessarily. See this site for more information on mortality rates for the uninsured.

In addition to rising mortality rates for the uninsured, here’s what you can expect if the health care law is repealed without a replacement. And don’t be fooled into thinking that just because you have employer-sponsored health insurance you’ll be immune if the signature domestic policy is repealed. Many people with employer-provided coverage will be adversely impacted.

What Happens if the Affordable Care Act is Repealed without an Immediate Replacement?

· If you have health insurance now, especially if your coverage is provided by your employer, you are in danger of losing it if the Affordable Care Act is repealed. The ACA includes a mandate that everyone have health insurance, and that employers of a certain size offer health care coverage. Prior to this mandate, employers were dropping health coverage left and right. Without the ACA’s mandate for employers, many may eliminate this critical lifeline.

· Without the individual mandate, which the ACA requires, health insurance companies will once again have the latitude to deny coverage to persons with pre-existing conditions. People needing medical care for cancer, diabetes, pregnancy or mental health challenges may be denied coverage.

· If the Affordable Care Act is repealed, up to 59 million Americans would lose, or be unable to obtain, health insurance. This includes people who currently have insurance as well as the 29 million Americans who do not have health insurance at this time. In other words, if the ACA is repealed, the uninsured rate would be higher than before the measure was implemented.

· Without the ACA, we’ll go back to the days when health insurance companies could discriminate against certain groups of people. We may return to the days of women paying more for health insurance than men. Seniors will be forced to ration their medication – perhaps by cutting pills in half or taking medication every couple of days rather than every day – because it will be too expensive to refill prescriptions. Many will be forced to choose between putting food on the table and paying for their prescription medication.

· Without the ACA, health care providers such as rural hospitals will lose millions of dollars, forcing many to close their doors. Shuttering rural hospitals will leave few options for sick Americans who live in these communities.

Best Practices for Discussing the Affordable Care Act

The repeal of the ACA is high stakes, and we must be careful how we discuss it.

· Be mindful of language: When discussing the Affordable Care Act, be mindful of language. Using the term “Obamacare” minimizes the significance of the policy and may fail to garner the sympathy needed to ensure its protection. Suffice it to say, when referring to the Affordable Care Act, consider using the policy’s full name; the “Affordable Care Act,” which, incidentally, describes what the measure does.

· Simultaneous repeal and replace is infeasible: Three days after his election, President-elect Trump said the Affordable Care Act would be repealed and replaced “simultaneously.” The problem is congressional Republicans have yet to detail what replacement might entail.

· Put a face on the pain: When discussing the significance of the Affordable Care Act, be sure to lead with testimonials. While numbers are important, highlighting the stories of real people is equally compelling. Here’s an example on how to use testimonials and stories in your writing on the ACA.

What You Can Do Right Now to Protect the ACA

· Contact your members of Congress to express the need to retain the Affordable Care Act. Elected officials should improve the measure, not gut it.

Jennifer R. Farmer is a strategic communicator and author of Extraordinary PR, Ordinary Budget. She is managing director for communications for PICO National Network.