To repeal the Affordable Care Act right now, with nothing better agreed upon to replace it, would be the height of cruelty and conservative extremism — yet that is exactly what President-elect Donald Trump’s chosen secretary of health and human services and House Speaker Paul Ryan are pushing.
Set a date to dump Obamacare, they say, and don’t worry about a replacement plan. That’ll come soon enough once the clock starts ticking and a sense of urgency builds.
But a ticking clock can also signal a bomb that’s about to explode — and that’s all we see here for the 20 million Americans who have insurance coverage thanks to Obamacare.
Get ready for an insurance industry in disarray; it is impossible to write insurance policies, which are premised on long-term calculations of user pools and health status, when you have no idea what’s next.
Over eight years, the Republicans have never once offered an alternative to Obamacare that didn’t dump more cost on consumers, cheapen the quality of coverage and fail to contain skyrocketing health care costs. We’ll believe there is a better alternative to Obamacare — which we believe needs fixing, not scuttling — when we see it.
Until then, to start the clock ticking to end Obamacare is reckless.
A repeal of the Affordable Care Act doesn’t just upend the lives of tens of millions who use the Obamacare health insurance exchanges. It affects the entire U.S. health care system.
“I think once it’s repealed, you will have hopefully fewer people playing politics and [instead] coming together to try to find the best policy,” House Majority Leader Kevin McCarthy, R-Calif., told Politico last week. When there is “a date certain that something’s going away … you know you have to have something done.”
And if McCarthy is wrong, will he volunteer to go without health insurance like the millions of other Americans he will have consigned to that fate? Enough with such pie-in-the-sky rationalizations.
Relatively moderate Republicans want to set an expiration date to appease conservatives calling for the immediate demise of Obamacare. But only a small fraction of America wants that to happen. A poll by the nonpartisan Kaiser Family Foundation shows only 26 percent want Trump and Congress to repeal the law. What’s more, 80 percent of Americans, including 67 percent of Republicans, have a favorable view of giving states the option to expand their Medicaid programs to cover more low-income and uninsured adults.
Trump’s pick for secretary of health and human services, U.S. Rep. Tom Price, R-Ga., is — no surprise here — a longtime critic of Obamacare. He is a hardliner who opposes a woman’s right to choose and wants to cut funding to Planned Parenthood. He also has proposed legislation to slash Medicaid and repeal Obamacare.
Giving Americans tax credits to buy insurance is the way to go, according to Price, but he wants to increase credits as people age rather than base them on income. He and other Republicans have touted tax breaks associated with health savings accounts. Such accounts usually accompany high-deductible plans to protect against catastrophic events.
The savings accounts would be an impossibility to middle- and working-class Americans who live paycheck to paycheck. They can’t afford to sock away thousands of dollars each year. Lower-income families who pay little in federal income tax wouldn’t see much of a tax break.
Republican proposals continually dodge the issue of rapidly increasing health care costs and the burden that puts on Americans. Remember, that was a big problem even before Obamacare. They don’t have a fix for that.
Ryan’s desire to also overhaul and privatize Medicare, part of the GOP “A Better Way” plan, has met resistance from AARP, formerly known as the American Association of Retired Persons, because it would shift more costs on individuals as opposed to holding down costs, David Certner, legislative counsel for the group, tells us.
A voucher-like system to cover Medicare premiums in the private market is what Ryan prefers. The government would stop paying directly for care. Certner points out that most seniors would be unable to keep up with steep price increases they surely would face.
Trump and Republicans want to keep alive a few core Obamacare principles: Giving patients with pre-existing conditions access to health care and keeping children on their parents’ plans until they are 26. Otherwise, they want to trash the health care law.
“President Obama’s signature health care law has proven unaffordable, unworkable, and intrusive in Americans’ everyday lives,” Republicans claimed in their Better Way agenda.
That’s far from the truth. While imperfect, the Affordable Care Act has given tens of millions of Americans access to health care coverage long denied to many in the working class, Americans with pre-existing illnesses and those with the bad luck of losing their jobs.
Access to health care is a tenet of a civilized society. Don’t go back on it now.
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