GOP Muddles Health Care Repeal

Let’s be crystal clear: the Republicans in Congress hate Obamacare, a.k.a. the Affordable Care Act. Well, most of them hate most of it. Well, maybe there are a few good parts, but overall, they truly hate Obamacare; after all, they voted to repeal it 60 times. Then along comes the unpredictable Donald Trump and talks about a program that would have to be single-payer to be as good as he describes. Of course, he is not going to give details about his program until Tom Price, his Health and Human Services nominee, is confirmed. One thing we know about Representative Tom Price: he really, truly, honestly hates Obamacare, root and branch, down to the dots on the pages of the statute. In fact, this orthopedic surgeon has been the GOP point person on its repeal. It’s hard to see how he is going to be the architect of a health program that, we have been promised, is going to be cheaper, more comprehensive, in short, all-around better than the Affordable Care Act.

Just to show that no one hates Obamacare more than he does, Trump made sure that his first
executive order, signed just hours after he took the oath of office, expressed his opposition to the ACA. Analysts are still discussing the meaning of the order. One thing seems to be clear: the order grants the power to Federal agencies to waive, exempt or delay provisions of the law that would impose costs on states or individuals. But does this mean
that the individual mandate, requiring people to get health insurance or be fined, can be effectively ended? It’s not clear. The individual mandate has brought millions of uninsured healthy people into the insurance pools. This influx has made possible the insurance mechanism that allows coverage of persons with pre-existing conditions and that requires charging the same premiums for men and women. Without the mandate and without raising premiums, the mechanism collapses: insurance companies would have to absorb unacceptable losses or withdraw from the health insurance markets. Probably the coverage of insured people is safe in 2017 because the insurance companies have already determined the policy terms for this year, but there could be a wholesale collapse of the markets in 2018. Insurance companies like to get as close to certainty as mathematics makes possible; policy muddles make this impossible.

In the midst of this confusion, the nonpartisan Congressional Budget Office last week released a study of the effect of the repeal of the ACA. Had the law been repealed effective January 1, 2016, the CBO estimates that 19 million people would have been added
to the 29 million still uninsured under the ACA, for a total 48 million uninsured. In a population of 271 million nonelderly people, the current uninsured rate of about 11% would rise to an uninsured rate of about 18%. Bad as they are, these are only statistics. Translate 18% into the millions of human lives, and you will see the heath care catastrophe
that looms before us.

1 Response to "GOP Muddles Health Care Repeal"

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