ECLECTIC RANT:Senators: don't repeal ObamaCare, fix it

Ralph E. Stone
Friday May 26, 2017 - 11:35:00 AM

The Patient Protection and Affordable Care Act (ACA) was repealed in the U.S. House of Representatives and replaced with the American Health Care Act (AHCA). The AHCA is now pending in the U.S. Senate.  

After the AHCA reached the Senate, all 48 Senate Democrats signed a letter asking the Republican majority for a fresh start on health care reform. In a letter released on May 9, the entire Senate Democratic Caucus asked Senate Majority Leader Mitch McConnell and key Republican committee leaders for a "bipartisan, open and transparent" effort to improve the health care system. The letter proposes a number of issues to work on including reducing the cost of prescription drugs, decreasing the cost of premiums without cutting the quality of benefits, making the cost of care more affordable by reducing out-of-pocket costs, stabilizing and strengthening the insurance market, helping more struggling families get covered, and making it easier and less expensive for small businesses to provide health care. To my knowledge, the Senate Republican leadership has not responded. 

The letter points out that the Congressional Budget Office (CBO) had not analyzed the new AHCA before passage in the House. According to the CBO, a similar, earlier version of the AHCA would have reduced the number of insured by 24 million people by 2026. The AHCA would also cut "$880 billion from state Medicaid programs and important patient and consumer protections – especially for women and all those with pre-existing conditions."  

On May 24, 2017, the GBO released its analysis of the revised AHCA, finding that the number of people without insurance would be 23 million within a decade with 14 million losing their insurance within a year. In addition, the federal budget would shrink by cutting Medicaid by $834 billion and reducing subsidies for people who buy insurance on individual exchanges for a savings of $276 billion. The AHCA would reduce premiums for younger healthier people, and raise them for older and sicker people, including those with pre-existing conditions. House Minority Leader Nancy Pelosi called the AHCA, "Trumpcare is a billionaire's tax cut disguised as a health care bill: one of the largest transfers of wealth from working families to the rich in our history." 

If the House had waited for this CBO analysis, would some House members have voted "no," considering the vote was close, 217 to 213? No wonder House Speaker Paul Ryan rushed passage of the AHCA with little time for House members to review it, with no amendments allowed, and only three hours for debate. 

The ACHA is diametrically at odds with Trump's pledge on the campaign trail to cover everyone and avoid Medicaid cuts. 

While Trump's general poll numbers are at an all time low, he still polls high among republican voters. Republicans in the House and Senate are aware that repeal of the ACA may have political consequences at the midterm elections and payback from the White House.  

However, now that a special prosecutor has been appointed to look into whether or not Russia interfered in the 2016 presidential election and whether there was any coordination with Trump campaign officials. The Special Prosecutor is also permitted to investigate any attempts to impede the inquiry, which would include the circumstances surrounding the firing of FBI Director James B. Comey. Hopefully now that Trump is operating under a black cloud, Republican Senators may be less susceptible to White House intimidation.  

Many of us would rather have a single-payer national health insurance or "Medicaid for all,” where a single public or quasi-public agency organizes healthcare financing, but the delivery of care remains largely in private hands.  

Until the U.S. is ready for a Medicaid-for-all healthcare system, I join the Senate Democrats in proposing that the U.S. Senate take the ACA and establish what is working and what is not, and what is learned should guide their tweaking of, rather than a repeal of, the ACA. There are certainly plenty of healthcare experts with plenty of ideas to help the Senate in this bipartisan task.