During the Presidents Week recess, when Congressmembers are supposed to meet with constituents, I attended two jam-packed rallies focused on saving Obamacare (this followed the rallies held coast-to-coast in the days before the inauguration).
In each of these, desperately anxious people (dismissed by Republicans as “paid professional agitators”) stood up to preserve the Affordable Care Act.
While not perfect (“Mend it, don’t end it,” Congressman Tom Suozzi said) — after all, it was designed to retain a for-profit health insurance paradigm, as devised by The Heritage Foundation, to pass muster with Republicans — it was working.
In the first place because if people can get diagnostic tests and catch illnesses earlier, they are less expensive to treat, let alone reduce the amount of suffering while increasing a person’s productivity during their prime years.
Obamacare has been a significant reason in the reduction of the budget deficit at the federal and state levels.
The secret sauce?
Mandating coverage or else pay a penalty, but if you didn’t earn enough to pay, you would be able to get subsidies from the government
Why? Because the whole thing revolved around the idea that young and healthy people would pay into the system, bringing down the insurance premium for everyone.
And every policy would cover certain basics, like child birth and prostate cancer, mammogram and colonoscopy (and ending the higher premiums imposed for being a woman).
The key problems with Obamacare, people complained, are high deductibles (for the cheapest plans), that premiums rose significantly (after rising at the slowest rate of increase in 50 years and mainly because of the Republican sabotage that prevented the full implementation), and that doctors, and even insurers would change (which happened before, as well).
What Republicans are proposing now, though, doesn’t “fix” any of these problems.
In essence, the Republican plan increases the cost for fewer benefits; favors the healthy and the wealthy, shifting the burden onto working people, low-income people and the elderly, and are ramming it through without proper analysis on its impact on people, without scrutiny or debate, or even “scoring” by the Congressional Budget Office.
And here’s the added subterfuge: they are repealing Obamacare elements in stages: by 2018 for the first parts (to minimize voter ire in the midterm elections) and by 2020 for the complete repeal (so not to impede Trump’s reelection).
The Republican plan begins with ending that “freedom killing” mandate, enforced with a modest tax penalty.
Instead of a mandate, the GOP plan provides for an “incentive” to retain coverage in the form of 30 percent “surcharge” if you have let insurance lapse.
So if you have lost your job, and therefore your health insurance, and can’t pay, you will only get further and further behind.
Republicans will claim that their plan will continue to cover pre-existing conditions.
But their idea is to stick people with pre-existing conditions into high-risk pools, which could put the cost out of reach, or in any case, does not limit companies’ ability to impose stunningly high premiums.
Instead of subsidies for people who don’t earn enough to purchase health insurance, Republicans want tax credits, which only are beneficial if you earn enough to pay taxes.
What is more, they want tax credits to be based on age (reduced based on income), so a 60 year old would get $4,000 in tax credits while a 30-year old minimum-wage worker would get $2,000, up to $14,000 in credits for a family — still only a fraction of the cost of a minimally basic health plan, which could be $25,000.
The other big idea to “afford” health care is the Health Savings Account, which mainly benefits the wealthy.
The flaw is that you need to have enough money to stash away in HSA to begin with.
But suppose you get a cancer diagnosis or are hit by a car before you have accumulated sufficient funds?
Or you contract some illness that blows through your HSA?
That’s “individual accountability” for you.
The GOP plan would end the Medicaid expansion — which will result in 10 million people in 31 states losing health insurance.
The Republicans want to end the 90 percent reimbursement to states and go back to 50 percent.
An added zinger, just for good measure, is that the plan ends federal funding for Planned Parenthood. Gotcha!
Trump proposes to cure the cost problem making it possible to buy insurance across state lines, without saying how that would actually reduce the cost of the premium, under the pretext that “competition” will lower the cost.
Republicans are shoving this through with the fiction that Obamacare is failing and unsustainable, without actual evidence or taking into account how Republicans have sabotaged the implementation, and without any analysis whatsoever of the impacts on the public — the costs, how many millions would lose insurance or be underinsured (which is the biggest problem now) of their plan.
Obamacare is not socialized medicine but the epic failure of the Republican plan, which more than restores ultimate control over people’s lives and quality of life to for-profit companies, employers and abusive spouses, will ultimately result in a true universal, Medicare-for-all, single-payer system.
Trouble is, that won’t happen for decades more, and not until after hundreds of thousands of people have died needlessly, prematurely after suffering miserably, for lack of access to timely, affordable, quality health care.