Nel's New Day

January 13, 2017

So How’s That Obamacare Repeal Going?

Why did people hate the Affordable Care Act, a law that helped people have better health care and live longer? Conservative leadership fed lies to their constituents—like this one from House Speaker Paul Ryan (R-WI) at a town-hall event this week–because they feared a Democratic plan would be popular. Ryan’s mistake was taking a question from a man who owns a small business in a red state, worked for the Reagan and Bush campaigns, and opposed the ACA. That was before the ACA saved his life after his life-threatening cancer was treated, thanks to “Obamacare.” Jeff Jeans said, “I want to thank President Obama from the bottom of my heart because I would be dead if it weren’t for him.”

Ryan’s response? The flat-out lie that the ACA is a “death spiral” because people won’t buy insurance when it gets too expensive.  If Ryan were right, enrollment numbers would be dropping. But instead they’re skyrocketing. The proportion of young adults is steady, proving that the mix of people enrolling this year is less likely to be sicker and more expensive. And this is happening despite the uncertainty about the future of health care for the people in the United States, thanks to the unhealthy obsession in the GOP Congress about a repeal.  Lies are failing with the public, however, because 75 percent object to repealing if there isn’t even a replacement.

Today, the U.S. House began their process of destroying health care for the millions and millions of people in the United States. A vote of 227-198 with only nine GOP defectors approved the budget resolution that the Senate passed in the dark of night earlier this week. The bill doesn’t specifically address the ACA, but the passed “budget reconciliation” is needed to kill off the ACA because of the danger from a Senate filibuster.

Rep. Charlie Dent (R-PA) warned that their action could send insurance markets into a collapse. Rep. Justin Amash (R-MI) tweeted, “Most massive budget in U.S. history passed 227-198. It adds more than $9 TRILLION to the debt over the next decade.” House Majority Whip Steve Scalise (R-LA) argued that the House had to pass the bill because they had campaigned on it.

The Senate vote allowed non-binding amendments showing the chamber’s position. These are positions that the GOP Senate oppose:

Protect people with pre-existing conditions: 52 million people in the U.S.—25 percent of non-elderly people—have pre-existing conditions. Before ACA, they were frequently denied any coverage. Only two Republicans voted in support of keeping these conditions in a health care plan.

Let young adults stay on their parents’ plan: Over six million young people 26 years old and younger have gained health insurance since this plan went into effect in 2010. Surveys show 85-percent approval of this provision. Again only two Republicans support this condition.

Maintain access to contraceptive coverage: The ACA has caused spending on contraceptive health care to drop 20 percent. Only two Republicans vote in favor of this amendment.

Ensure Medicaid expansion stays in place: 11 million low-income people benefited from this provision in 2015, and thousands of jobs were created for direct care workers.  Republicans unanimously defeated this amendment.

Protect children on Medicaid or CHIP: GOP Senators blocked this amendment.

Protect veterans’ health care: Republicans blocked an amendment to make it harder to restrict veterans’ access to VA health care.

Republicans demonstrated that they oppose insurance that requires pre-existing conditions, puts children up through age 26 on the parents’ policy, provides free contraceptive care, helps low-income people and children, and protects veterans. These are the leaders who want to take people’s health care: Vice President-elect Mike Pence with Senate Majority Leader Mitch McConnell and Sen. John Barrasso (AP Photo/Cliff Owen).

health-care-killers

The public opposition to ACA repeal began when more and more people understood that the congressional goal was to take away health care without any new plan. Sen Bob Corker warned that repeal without replacement would be “not very appealing.” Even ultra-conservative Sen. Ron Johnson (R-WI) asked for a replacement “game plan.” Passing the repeal/replacement also requires 60 votes in the Senate because of the filibuster.

The derailing of the grand repeal plan began just four days after the GOP Congress took over the country. That’s when Republicans determined that the GOP project to Make America Sick Again would cost more than four times than the extremely expensive Iraq War while it kills millions of private sector jobs. Republicans had a solution: hide the cost of their repeal. Page 25 of the new rules package passed by GOP House members stated that the Congressional Budget Office (CBO) should estimate the cost over $5 trillion—except Obamacare. Unfortunately, that plan didn’t work either: the word got out that what the GOP calls an “appropriate” level of public debt is actually an unnecessary anti-job debt spike.

Add to that problem Ryan’s decision to defund Planned Parenthood through a bill to repeal Obamacare, and the bill riled more conservatives. Two moderate female GOP senators opposed this suggestion, and the program is highly popular throughout the nation.

Some of the most conservative senators—Rand Paul (R-KY), Bob Corker (R-TN), and Tom Cotton (R-AR) for example—are reluctant to vote for the repeal because of the increasing deficit. Paul wants an immediate repeal but isn’t happy about the $10 trillion dollars added to the deficit. Even ultra-conservative Sen. Lamar Alexander (R-TN), chairman of the Health Committee, declared that it’s not smart to repeal without a replacement.  Sens. Susan Collins (R-ME) and John McCain (R-AZ) don’t like Repeal without Replace. Six dubious senators will put the 48 Democrats opposing the repeal to a majority of the chamber. Lisa Murkowski (R-AK) might join them because she, like Collins, doesn’t like the idea of defunding Planned Parenthood.

The repeal is rapidly coming to a head because GOP leadership wants to force the development of legislation by January 27. Wanting to postpone the deadline until March 3 are at least five GOP senators: Bill Cassidy (LA ), Susan Collins (ME), Bob Corker (TN), Lisa Murkowski (AK), and Rob Portman (OH).

Congressional Republicans are also facing opposition from GOP governors. John Kasich (OH) and Rick Snyder (MI) have already complained about the loss of Medicaid. Kasich said the hospitals need Medicaid that “has worked very well in this state.” He said that the program covers 700,000 of his residents; Snyder agreed when talking about his 642,000 people in Michigan. Other GOP governors opposing the repeal thus far are Charlie Baker (MA),  Asa Hutchinson (AR), and Brian Sandoval (NV).

Kasich eloquently expressed his concern:

“Let’s just say they just got rid of it, didn’t replace it with anything.” What happens to the 700,000 people [in Ohio]? What happens to drug treatment? What happens to mental health counseling? What happens to these people who have very high cholesterol and are victims from a heart attack? What happens to them?”

The GOP desire to balance the federal budget occurs only with Democratic presidents. Republican legislators showed no longing for “fiscal responsibility” during the Reagan/Bush years. Under Clinton, their need for zero deficit returned, but unfortunately for them, Clinton showed a surplus by the end of his two terms. In the two following Bush/Cheney terms, Republicans asserted that “deficits don’t matter.” They ran up trillions of costs for two wars, two tax-cut packages, Medicare expansion, and the Wall Street bailout.

During the two terms of Democratic President Obama, conservatives screamed about the ballooning deficit set in place by his predecessor. The GOP even lowered the credit rating of the United States and then closed down the country because of their demand for a balanced budget. With a prospective GOP president, the majority of GOP Congressional legislators started to repeal a law vastly increasing the deficit, a law that keeps people alive. Their plans would put the public debt to at least $29.1 trillion by 2016, according to the budget resolution they passed.

People are already losing jobs because of the GOP’s declaration that they will “repeal Obamacare.” The loss of health care for millions of people is already sending shock waves throughout the $3 trillion-a-year health system. Hospitals estimate that the repeal will cost them $165 billion within five years and trigger “an unprecedented public health crisis” if sick people can’t get care. The Advisory Board Company, providing services to health care firms, has already laid off 200 people partly because hospitals vastly decreased spending after the election.

With much lower health coverage, hospitals and health providers could find themselves on the hook for up to $1.1 trillion for uncompensated care in the next decade, causing the collapse of finances in hospitals serving needy populations. Their only solution would be to curtail services and reduce workforce, impacting health care access even for the insured. Illinois alone would suffer a loss of 95,000 jobs and $13.1 billion. Forty percent of the state’s hospitals are already in the red or close to it.

The question is whether the GOP can get over its gridlock and lack of bipartisanship to pass a “repeal and replace” law. I wouldn’t bet on it.

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