New District by District and Metro Area Analysis of the Impact of Repealing Health Reform

Jan 18, 2011

Today Rep. Henry A. Waxman, Ranking Member of the Committee on Energy and Commerce, and Rep. Frank Pallone released, for each congressional district and the 30 largest metropolitan areas, an analysis of the impact of the repeal of patients’ rights, protections, and benefits contained in the historic health care reform law.

Click here for the full text of the letter sent by Reps. Waxman and Pallone to their colleagues to assist them in understanding the ramifications of repeal.

Impact of Repealing the Health Care Reform Law, by Congressional District and Metro Area

Click on the map for information by Congressional District or Metro Area, or choose from the list below.


List of Fact Sheets by Congressional District









District of Columbia






















New Hampshire

New Jersey

New Mexico

New York


North Carolina

North Dakota





Rhode Island

South Carolina

South Dakota







West Virginia



List of Fact Sheets by Metro area

**Information on Data Sources, January 2011


Below is the full text of the letter sent by Reps. Waxman and Pallone to their colleagues to assist them in understanding the ramifications of repeal.

January 18, 2011

Dear Colleague:

           This week, we will be considering legislation to repeal the patients’ rights, protections, and benefits contained in the historic health care law.  To assist members in understanding the ramifications of repeal, we asked the minority staff of the Committee on Energy and Commerce to analyze the impacts of repeal in every congressional district in the country. 

            Today, we are releasing these analyses.  We have also prepared analyses on the impact of repeal in the 30 largest metropolitan areas in the country.  The district-specific and metropolitan-area reports are online at

            We believe many members, especially newly elected ones, may be surprised by the results.  Health care reform is already delivering important health benefits to your constituents.  As a result of the law, insurers have stopped discriminating against sick children in your district, seniors in your district are saving money on prescription drugs, small businesses in your district are receiving tax credits to provide health insurance, and insured individuals with individual or employer coverage are enjoying new rights and protections against insurance industry abuses.  Repeal will roll back these benefits.

            We regret that there have been no hearings on the implications of repeal.  The failure to hold hearings denies members and the public an opportunity to understand fully what is at stake.  This is especially a problem for freshmen members because they did not participate in any of the many hearings held last Congress prior to passage of the health reform law.  Our Committee alone held over ten days of hearings and heard from over 100 witnesses before the House voted to enact health reform.

            To give you an idea of what is at stake, here are some examples of the benefits the law provides in the districts of ten new members: 

            Protection for Individuals with Pre-Existing Conditions.  Under the health reform law, insurance companies can no longer deny coverage to children with pre-existing conditions and will be banned from discriminating against adults with pre-existing conditions in 2014.  Freshman Rep. Joe Walsh, from Illinois, represents a district that has 10,000 to 47,000 children with pre-existing conditions.  Freshman Rep. Nan Hayworth from New York represents a district with 128,000 to 324,000 non-elderly residents with pre-existing conditions.  If repeal passes, these children and adults lose the protection afforded by the law and could be denied individual policies by insurance companies. 

            Protection Against Coverage Rescissions.  The health reform law prohibits insurers from rescinding coverage for individuals who become ill.  Freshman Rep. Patrick Meehan from Pennsylvania represents a district in which 40,000 residents purchase individual health insurance.  Repeal would allow insurance companies to resume the practice of rescinding their coverage after they get sick and need care. 

            Benefits for Young Adults.  The health reform law allows young adults to remain on their parents’ insurance policies up to age 26.  Freshman Rep. Daniel Webster from Florida represents 4,000 young adults who have or are expected to take advantage of this benefit.  If repeal passes, these young adults would lose their coverage.

            Closing the Donut Hole.  Beginning in 2011, the health reform law provides a 50% discount for prescription drugs for Medicare beneficiaries who enter the Medicare Part D “donut hole” and lose coverage for their drug expenses.  The law then increases the discount to Medicare beneficiaries each year until 2020, when the donut hole is finally eliminated.  Freshman Rep. Allen B. West from Florida represents 15,000 Medicare beneficiaries who are expected to benefit from these provisions.  Repeal would increase the average cost of prescription drugs for these seniors by over $500 in 2011 and over $3,000 in 2020.

            Preventive Care and Other Benefits for Seniors.  The health reform law improves Medicare by providing free preventive and wellness care, improving primary and coordinated care, and enhancing nursing home care.  The law also strengthens the Medicare trust fund, extending its solvency from 2017 to 2029.  Freshman Rep. Bill Johnson from Ohio represents 116,000 Medicare beneficiaries.  Repeal would eliminate these benefits for the seniors in the district. 

            Tax Credits for Families.  Starting in 2014, the health reform law gives tax credits to middle class families with incomes up to $88,000 for a family of four.  Freshman Rep. Reid Ribble from Wisconsin represents 186,000 families who could use these tax credits to lower the costs of their health insurance.   

            Tax Credits for Small Businesses.  The health reform law provides tax credits to small businesses worth up to 35% of the cost of providing health insurance.  Freshman Rep. Michael G. Fitzpatrick from Pennsylvania represents up to 18,100 small businesses that are eligible for this tax credit.  Repeal would force these small businesses to drop coverage or bear the full costs of coverage themselves. 

            Funding for Retiree Coverage.  The health reform law provides funding to encourage employers to continue to provide health insurance for their retirees.  Freshman Rep. Jaime Herrera Beutler from Washington represents 11,900 early retirees who could benefit from this assistance.  Repeal would increase costs for the employers in the district and jeopardize the coverage their retirees are receiving. 

            Coverage of the Uninsured.  When fully implemented, the health reform law will extend coverage to 32 million uninsured Americans.  Freshmen Rep. Daniel Webster from Florida represents a district in which over 100,000 uninsured individuals would gain coverage under the health reform law.       

            Hospital Savings.  The health reform law benefits hospitals by covering more Americans and thereby reducing the cost of providing care to the uninsured.  Repeal would undo this benefit.  In the district of Freshman Rep. Charles Bass from New Hampshire, this would increase the cost of uncompensated care by $48 million annually for hospitals in the district. 

            The examples above illustrate the kind of benefits the health reform law provides in districts represented by freshmen members.  But similar benefits occur in all of our districts.  In Rep. Waxman’s district, 53,000 residents purchase insurance through the individual market and would lose protection against rescissions if the health care law was repealed; almost 12,000 seniors would be forced to pay more for prescription drugs under Medicare.  In Rep. Pallone’s district, repeal would mean eliminating health care tax credits for up to 18,200 small businesses and 117,000 families. 

            The report for your district will explain the specific benefits the new law provides for your constituents.  We hope this information is useful to you as you consider how to vote on repeal of health reform. 



Henry A. Waxman
Ranking Member
Committee on Energy and Commerce


Frank Pallone, Jr.
Committee on Energy and Commerce