Repeal And Rhetoric?


President-elect Donald Trump shocked America this weekend when in an interview he seemed to come out in favor of a Bernie Sanders like plan for national health care. Meanwhile the Congressional Republicans are already making the preliminary legislative moves to repeal Obamacare without any viable replacement in sight. What are we in for? Let’s explore.

Taking its lead from the Tea Party, Republicans have been running on the slogan of repeal and replace for six years. They passed somewhere in the neighborhood of 60 pieces of repeal legislation in the House before the current Congress was even seated. All those attempts were little more than symbolic because Obamacare was never going to be repealed without a presidential veto as long as Barack Obama was in the White House and the Republicans lacked the votes to override a veto.

With Republicans in control of both chambers of Congress and a path to do an end run around a Democratic filibuster in the Senate in place, the Republicans only have to wait for Friday’s inauguration of Trump to have all the pieces in place to finalize the repeal part of their slogan; replacement is another matter.

A very predictable thing happened during Obamacare’s short (and admittedly flawed lifetime); many aspects of it became widely popular with the American people. Some of those features include parents being able to keep their children on their health care plan until age 26, insurers not being able to deny coverage based on a pre-existing condition or setting a lifetime cap on what they will pay for a particular ailment. The Republicans saw they were faced with having to include those features in any replacement plan.

Let’s take this discussion aside for a moment and discuss the two main reasons people dislike Obamacare (or at least think they do). The money people who have financed the Tea Party hate Obamacare because it did raise the taxes of the wealthy. The greed of people like the Tea Party’s primary financiers, the Koch brothers, has neither bounds nor reason. Any amount they are taxed is too much and any wealth they accumulate is insufficient to satisfy their greed.

For many of the rank and file of the Tea Party racism is the main motivation. In polling the Affordable Care Act (ACA) is nine percent more popular than Obamacare. Reality check: they are the same thing referred to by two different names. Interestingly as it appears Obamacare’s repeal may be imminent many Americas are convinced that they personally won’t be affected because they get their health insurance through the ACA. They are in for an unpleasant surprise!

Most Americans still receive their health insurance through their employers. What few of them realize is that they also have the benefits described above because of Obamacare. If it is repealed without an immediate replacement containing those same provisions they also lose those valuable benefits.

To talk economic impacts for a moment it is estimated that as many as 30 million Americans would lose their health insurance if Obamacare is repealed. They didn’t all vote for Hillary Clinton. In the aftermath of Obamacare’s repeal as many as 2.5 million Americans could lose their jobs and of course the health insurance coverage that goes with those jobs. They would be eligible for COBRA for a short period of time on the assumption that they could afford it sans their income.

Suddenly Trump seems to be talking about a Medicare for all type plan, although in typical Trump fashion he is big on talk and tiny on plans. My comment is: good luck getting that through a Republican congress! I’ve been on record favoring a single payer, conception to grave plan for years now. Such a plan would run contrary to everything the Republicans have ever advocated and would turn the insurance and pharmaceutical industries on their heads. To me, importantly it would be great for America’s health and lower health care costs in the process.

Massachusetts Democratic Senator Elizabeth Warren came up with the best line to date when she recently called the Republican health care “plan”, “Repeal and run away.” What exactly will happen is something we will have to wait and see. My guess is a rather swift repeal – hopefully with a somewhat distant effective date – and a lot of rhetoric as to how great their basically non-existent replacement plan will be. This allows the Republicans to placate Bubba with “repeal”, not alienate him by taking his coverage and benefits away, all the time kicking the can down the road while not hurting their financiers.

Repeal and rhetoric; or at least that’s the polite word for it.

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