After years of promises and eleventy-billion votes in the House to fully repeal Obamacare the Republicans finally have the chance to do it FOR REAL this time, and what are they doing? They are putting forward a plan that is actually worse than Obamacare.
The new health care plan written by the establishment and supported by the President will destroy the health insurance industry and make the Republican party own an even worse disaster than Obamacare. It keeps the worst parts of Obamacare and substitutes one new entitlement with a different new entitlement (except this time they call it a “refundable tax credit”).
Republican lawmakers have lost their spines. They have been showing up to Town Hall meetings and getting inundated with astro-turfed protesters demanding that they keep Obamacare. They seem more concerned with trying to make people happy than doing their jobs, and as a result they are proposing really bad policy. If this bill passes it will be a disaster for our party.
We need to do everything we can to remind our elected leaders of the promise they made to us over, and over, and over again. Call your Representative and Senators. For that matter contact EVERY REPUBLICAN IN CONGRESS. Tell them that you want a full repeal of Obamacare. Tell them to vote against anything but a full repeal, nothing more, nothing less.
Here are three major points you can make about how bad this bill is:
1 It accelerates the death spiral by keeping the pre-existing condition mandate.
While we all hate the mandate from the government to buy health insurance, it was put into Obamacare for a reason. Health insurance companies are a business. They are able to stay in business because they use the premiums paid by healthy people who don’t use their insurance in order to offset the costs of the sick people who need it. The incentive healthy people have to buy insurance is to make sure they are covered in case they get sick.
By mandating health insurance companies cover pre-existing conditions, you take away the incentive for healthy people to buy insurance. Why would you waste thousands of dollars a year for a product you don’t use, especially when you can just run out and buy a policy as soon as you are sick, and drop it once you are well again? It’s like waiting to buy homeowners insurance until after your house burns down. That’s where the mandate to buy insurance came from. Trumpcare, however, makes things worse. It does away with the mandate to buy health insurance, but it keeps the requirement to cover pre-existing conditions.
With no incentive or mandate to be insured, healthy people won’t buy insurance. This leads to the “death spiral” where insurance companies have to pay out more money in claims than they receive in premiums. The CEO of AETNA believes the death spiral has already begun under Obamacare because people are choosing to pay the penalty instead of buying insurance. If Trumpcare passes, this death spiral will be accelerated. If that happens we won’t have to worry about health insurance costs, because in about 10 years there won’t be any health insurance companies left in business.
2 It keeps all the existing Obamacare regulations and does NOTHING to cut health care costs.
As I mentioned in my last post on this subject, we need to STOP trying to micro-manage the health insurance industry and START working to bring down health care COSTS. Trumpcare does not do any of that. It keeps all of the regulations created by Obamacare and does nothing to start controlling costs. This is the same thing as managing the symptoms without ever trying to cure the disease.
Instead of moving people off government health care systems (Medicare and Medicaid), it protects and extends the Medicaid expansion brought on by Obamacare. The added federal money keeps flowing for years, and then anyone who is receiving Medicaid services will be grandfathered in. Putting more and more people on the federal dole does nothing to cut costs. It simply makes health care coverage more expensive because the government is now having to cover more and more people. This means the per capita amount they are able to reimburse health care providers will shrink and shrink. Those costs are passed on by the health care providers to the people that pay for their own insurance. Namely you and me.
3 Don’t try to sell us the “three phases of healthcare” line. We all know there will only be one phase.
The current line coming from the establishment and the White House is to just be patient. They are doing things in “phases” and the really good things are coming in phases 2 and 3. Well, that just won’t happen. The limitation we are facing right now is what can be done under a reconciliation process. A budget reconciliation bill cannot be filibustered which means we only need 50 votes in the Senate to pass it. The catch is that anything that happens in a reconciliation bill must be “budget related.” There are a lot of reforms we all would like to see happen that just can’t happen under a reconciliation process, because we are limited to rules and regulations that have a budgetary impact. Anything else that we want done will have to come through the regular process, which means it can be filibustered.
What that means is that there will be no phases 2 and 3. Any bills designed to replace the remaining parts of Obamacare will be filibustered by Democrats in the Senate and will go nowhere. Mitch McConnell will make a half-hearted effort to pass a so-called “phase 2” through the Senate, but will throw up his hands when the Democrats filibuster it, and nothing else will be passed.
This will be the only chance we have to repeal Obamacare, and the Senate Parliamentarian has already ruled that a straight out, nearly full repeal of Obamacare CAN BE DONE via reconciliation. Here is from an op-ed by Senator Ted Cruz (R-TX) on how we can do things right:
In 2015, Congress passed language on reconciliation repealing most of Obamacare. Virtually every Republican in Congress voted for that language, and the parliamentarian has already ruled it as permissible. We should begin with that previously approved repeal language as the baseline.
Second, repeal the insurance regulations as well. In 2015, these coverage mandates of Obamacare were excluded from the repeal language. The parliamentarian never ruled on whether including them would be permissible on reconciliation. But we’ve got to repeal those mandates. Why? The single biggest factor driving popular dissatisfaction with Obamacare is skyrocketing premiums. And the insurance mandates are the biggest factor driving those premiums. If we “repeal” Obamacare, and leave the insurance mandates in place, the premiums paid by families will remain sky-high. And that’s unacceptable—voters would rightly deem repeal a farce if we don’t actually drive premiums down to where they’re affordable again.
Can we get the mandates repealed on reconciliation? The answer is yes: The mandates are driving up federal expenditures by billions, and so should properly be deemed budgetary in nature. But if the parliamentarian disagrees, the vice president has the statutory and constitutional authority (as does the Senate majority) to rule to the contrary. And that’s exactly what should happen, if necessary.
We need to cut Obamacare out root and branch. It is bad policy, period. We can’t keep any of it just because a Republican is now proposing it. A bad idea is a bad idea, no matter where it comes from.
Once that is done we can work on small, stand-alone reform issues that make a lot of sense and will be very hard for Democrats up for re-election in red states to vote against. Let President Trump use his power and his rallies in states like West Virginia, Missouri, and Montana, daring Democrat Senators like Joe Manchin (D-WV), Claire McCaskill (D-MO), and John Tester (D-MT) to vote against Tort reform, or reforming the FDA approval process, or any number of popular reform ideas that will cut health care costs and start solving the problem.
We’re going to get just one chance at this. We have to do it right. Act now, before your Congressman caves to the pressure to just “do something,” and gives us something worse than what we have.
UPDATE – President Trump has threatened to support primary opponents against Republicans that don’t vote for Trumpcare. That means Trump will seek to replace Conservative Republicans who are trying to repeal Obamacare with establishment friendly Republicans who will leave it in place. This makes it more important than ever that you contact your Representative and Senators and tell them to only support a full repeal of Obamacare.