Oscar Wilde once said that “there are two great tragedies in life. One is not getting what you want, the other is getting it.”
From 2012, after the Affordable Care Act was signed into law, Congress voted to repeal it over sixty times. It engages in this repeated fool’s errand, knowing that it lacked the votes to override President Obama’s veto.
Now, the Republican Party is in control of both houses of Congress and the White House.
As we used to say, when I was younger, it’s time to put up or shut up.
This past week, the Speaker of the House of Representatives, Paul Ryan, rolled out the Republican replacement for what they have commonly referred to as “Obamacare.”
It’s called the American Health Care Act and it provides anything but adequate health care.
While the proposal retains some of the more popular features of Obamacare, such as the continuation of coverage for children until they reach the age of 26 and the prohibition against denying coverage for people with pre-existing conditions, overall it will make health insurance more costly and less available for those who most need it and can least afford it.
“Ryancare” or “Trumpcare” as this dubious piece of legislation might come to be known guts two of the most important mechanisms that were used to implement Obamacare.
Under Obamacare the neediest individuals and families were provided subsidies to buy insurance. These subsidies are eliminated under the current proposal and what will replace them is still in dispute.
Ryan would like to replace them with “refundable tax credits” but the Tea Party members of his caucus object to them as constituting another entitlement program.
The other and more crippling change is the end of the expansion of Medicaid.
Thirty-one states took advantage of the expansion of Medicaid to make health care available to their residents. Some, like Ohio were led by Republican Governors, who’s Governor, John Kasich opposed the Affordable Care Act but believed that affording his residents health care trumped his philosophical opposition the Obamacare.
This expansion would end in 2020 when Medicaid would be converted to more limited block grants.
Under the Affordable Care Act insurers were allowed to charge senior citizens no more than three times the premium cost being offered to younger insureds.
The law would allow insurers to charge seniors five times more for premiums than younger members of the plan, drawing opposition from the AARP.
Does anyone think that it is purely coincidental that the maximum pain that will be inflicted on those who will lose coverage is being deferred until after the 2018 mid-term congressional election?
The present legislative schedule calls for a vote on the legislation almost immediately.
As a result of this timetable, the legislation will not be scored by the Congressional Budget Office. That means that members of Congress will be voting on the legislation without having any clue to how many people will lose coverage or how much it will cost taxpayers in the future.
Presently, almost twenty million people have coverage under Obamacare. Some Wall Street analysts estimate that at least ten million will lose coverage under the current proposal.
The proposal is also opposed by the American Medical Association, American Hospital Association and the insurance industry trade association, America’s Health Insurance Plans, but what would they know about providing health care?
There are two other features of the legislation that are worth mentioning.
Insurance companies will now be able to deduct the cost of their executives’ salaries without the $ 500,000-cap that existed under Obamacare.
We wouldn’t, after all, want to inflict pain on these neediest of individuals subject to the new law.
The legislation also includes a provision defunding Planned Parenthood. So, in addition to making coverage less attainable for the poor, the law will also eliminate all health care services that have been available to women before Obamacare even existed.
Another separate proposal being considered by the House Republicans is one which would allow employers to impose a thirty percent penalty on the cost of insurance premiums on those employees that refuse to participate in genetic testing as part of a “voluntary” workplace wellness program.
These are the people that thought Obamacare was a governmental “overreach.”
Paul Ryan celebrates these reductions and changes in health care as providing “Freedom.”
During the 2009 debate on Obamacare, Sarah Palin, Rush Limbaugh, Michelle Malkin and Glenn Beck all falsely claimed that the Affordable Health Care Act would spawn the existence of “death panels” that would decide who would live and who would die.
Well, this time there is a real death panel in existence.
It’s called Congress.