President-elect Donald Trump signaled a softening in his campaign mantra about repealing “Obamacare,” the signature legislative achievement of President Obama’s eight years, and a positive step for millions of Americans who had been uninsured for health care. Trump on the trail hammered Obamacare again and again as having ruined health care and a threat to break the country’s bank. But then he indicated he might want to save parts of it.
Trump’s campaign position was both misguided and unsupported by the facts: Some 20 million people have health insurance thanks to the Affordable Care Act, and others have more affordable insurance because insurance companies were no longer allowed to discriminate based on pre-existing conditions, to cite one example of the ACA’s benefits.
Parents were allowed to keep kids on their insurnace until they reached 26, a huge safety net for young people without insurance through their jobs. And, the ACA didn’t raise federal deficits. It didn’t wreak havoc with the rest of the conventional health insurance system. Costs didn’t explode. And, with more people covered, others with insurance through employers, for example, didn’t see crippling premium increases. Medicaid expansion under the ACA helped hospitals and doctors get compensated in addition to bringing millions of people under coverage.
The political truth is that the GOP’s hammering of Obamacare was really about using the health care reform act as a synonym for Obama himself — the president who drove Republicans up the wall because he succeeded, whether it was getting Osama bin Laden to restoring the auto industry to presiding over a positive explosion in financial markets to skillfully managing foreign policy.
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But it now appears Obamacare is really in the bull’s eye. Georgia congressman Tom Price has been one of the leaders in the repeal-Obamacare movement, and he’s been designated by Trump as the next secretary of the Department of Health and Human Services.
But the most worrisome statement of late has come from Kevin McCarthy, Republican of California and the House Majority Leader, who says he thinks Republicans should repeal the ACA and worry about a replacement later.
“I think,” he said, “once it’s repealed you will have, hopefully, fewer people playing politics and coming to the table to find the best policy.” For those on policies acquired through the ACA, that is a terrifying statement. It seems to mean they’ll be tossed out of their insurance coverage — and this is 20 million people. They won’t have health insurance and their kids won’t have it. But McCarthy seems to care less.
And, he raises justifiable suspicions that the GOP doesn’t really want to “repeal and replace” but just to repeal, and leave those who are not covered, as in the old days, to the mercies of emergency rooms — assuming they can even get that kind of care.
Left to the hands of the old profit-driven system of health care that works fine for those who have employer-based coverage, but not at all for millions of Americans with no such coverage, people will be sicker and their lives will be at risk — all because Republicans want to dismantle Obama’s success.
The ACA is going to change. But the president-elect can have positive influence here, if he will use it, and insist that no repeal proceeds until some form of replacement, some safety net, exists. And Republicans have misinterpreted their election victory if they think it means the public wants them to repudiate anything and everything President Obama — whose approval ratings remain good — has accomplished.