Goodbye, Obamacare. Hello, American Healthcare Act.
Unless you were living under a rock all week you heard that the House unveiled their answer to the Affordable Care Act (aka ACA) (aka Obamacare). So far, the reaction on Capitol Hill has been less than gleeful—not just by the Democrats, but by many Republicans as well. This is going to be fun to watch.
I am not taking a position either way on the proposed new bill. Just call me Jack Webb from Dragnet: “Just the facts, ma’am. Just the facts.”
As I’ve read over the new bill and compared it to the ACA, it really seems as though the changes the drafters are proposing do nothing to improve healthcare access and affordability for all Americans, as was repeatedly promised during the campaign. Instead, it appears as though the drafters just feel they need to repeal Obamacare as promised to allow the GOP to save face by doing what they said they’d do.
Obamacare has many flaws but its shortcomings could have been fixed as time went on, similar to how Social Security and Medicare were tweaked in the years following their introduction. But the opposition from the GOP has been so strong for so long, the drafters instead chose to repeal and replace it with the heavily gutted AHA, with most of the gutting coming from Medicaid rollbacks. For now, the future of anyone relying on Medicaid is anybody’s guess. The AHA does cut a whole bunch of taxes—mainly on the higher income folks—that are now in effect to support Obamacare.
Since they haven’t gotten any cost estimates from the Congressional Budget Office, nobody has any idea how we will fund the new program and whether it will blow a bigger hole in the deficit. It seems strange for the House to release the bill before knowing what it would cost… but what do I know?
For the past seven-plus years, we’ve heard about repeal and replace. But there’s never been a solid answer on how to “replace.” Like President Trump said on February 26th to the GOP Governors Conference, the healthcare challenges are “unbelievably complex”, which he reiterated in a meeting with health care CEOs on February 27th by saying, “Nobody knew that health care could be so complicated.”
One of the big ideas pushed for the past eight years is that folks should be able to buy healthcare across state lines. Supposedly, allowing that would increase competition and lower health care costs. I read through all 124 pages of the proposed bill. Guess what? Not one mention of buying health care across state lines. Want to know why? Read this column (click here) and you’ll better understand. Who knew that healthcare could be so complicated?
Finally, President Trump has made some huge promises about healthcare in this nation. Talking to journalist David Muir after his inauguration, Trump said “It’s going to be — what my plan is is that I want to take care of everybody. I’m not going to leave the lower 20% that can’t afford insurance.” (Only about 10% of the US population currently does not have coverage.) (Read more here)
How will all this play out? Your guess is as good as mine. As proposed, I see it cutting coverage for many poor folks, lowering subsidies for many middle class folks and cutting taxes for high income folks while increasing the deficit. This is going to be fun to watch.
Enjoy the weekend…