How the G.O.P. Sabotaged Obamacare

[markee]

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How the G.O.P. Sabotaged Obamacare

Obamacare is not “collapsing under its own weight,” as Republicans are so fond of saying. It was sabotaged from the day it was enacted. And now the Republican Party should be held accountable not only for any potential replacement of the law, but also for having tried to starve it to death.

The Congressional Budget Office on Wednesday released its accounting of the House Republicans’ replacement bill for the Affordable Care Act, and the numbers are not pretty: It is projected to leave 23 million more Americans uninsured over 10 years, through deep cuts to insurance subsidies and Medicaid. The report underscores how the bill would cut taxes for the rich to take health care away from the less well-off.

The A.C.A. is not perfect, and improvements to it would be welcome. But it worked in many respects and would have worked much better had Congress been a faithful guardian of the law.

It is worth making a record of those Republican saboteurs’ efforts. The A.C.A.’s opponents brought a lawsuit against its requirement that people buy insurance — a Republican idea — the very day the statute was signed into law. The Supreme Court rejected that claim. But the court gave opponents a major victory on another front, ruling that Obamacare’s expansion of Medicaid was optional for states. Yet another lawsuit seized on some sloppy language in the law to make the implausible argument that Congress did not provide for the insurance subsidies on which the law depends. The Supreme Court also rejected that challenge.

But if the Republicans lost those cases, they succeeded in sowing the insurance markets with doubt and forcing states to slow down implementation while awaiting the court’s decisions. That in turn may have reduced sign-ups, further destabilizing the insurance market. The second case challenging the subsidies was not decided until 2015, more than a year after the statute’s critical 2014 deadline for implementation.

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Even worse,these lawsuits helped make the A.C.A. the salient partisan issue of the Obama administration, turning the law into the ultimate Republican litmus test: Implementing a state insurance exchange or expanding Medicaid, even when it seemed in a state’s interest, became treasonous for the party. Nevertheless, about a dozen principled Republican governors bucked their party and expanded their programs.

Health insurance executives summoned by House Republicans to a hearing on the Affordable Care Act in 2014.

In 2014, the House brought a lawsuit, arguing that a critical piece of A.C.A. funding — the cost-sharing subsidies that pay insurers to lower premiums — had not been properly appropriated. For insurers, not knowing whether that money could be cut off — President Trump is still threatening not to pay them — has caused anxiety about whether to remain in the A.C.A. markets. More than 100 other suits have been filed, including challenges to contraception provisions and the requirement that employers provide insurance.

On the political front, the Republicans targeted provisions of the law that provided crucial transitional financing to steady the insurance markets early in the program. Senator Marco Rubio of Florida, calling the money an insurance “bailout,” sponsored a measure that prevented appropriation of some of those funds. The courts have issued mixed rulings on whether the federal government must pay, adding yet more instability to the insurance markets.

The Affordable Care Act, like any major statute, surely could use adjustments. For example, the insurance subsidies were probably set too low initially. The Obama administration’s decision to allow more people to stay on their old plans than originally expected may also have narrowed the new pool of insurance customers in ways that contributed to premium hikes. The Republican-controlled House never provided any additional implementation money after the initial appropriation set forth in the Affordable Care Act itself, forcing the Department of Health and Human Services to scrounge for needed funds.

A caretaking Congress would have fixed what wasn’t working. Instead, opponents did everything possible to shut off all the A.C.A.’s financing — starvation intended to wreak havoc in the insurance markets and to make it falsely appear that the A.C.A.was collapsing because it was just bad policy.

The irony is that the A.C.A. was vulnerable to this strategy because the Democrats had tried to compromise with the Republicans in an ultimately unsuccessful effort to build bipartisan support for the law. If the Democrats had instead enacted a single-payer policy — such as Medicare for all — the entire health care system would have been in the hands of the federal government, instead of dependent on the states and private insurers.

Now the Republicans find themselves in a mess. The Affordable Care Act has brought health care to an estimated 20 million more Americans and has expanded services — including access to drugs and preventive screening — for many more. A good number of Americans, including Republicans and the president himself, say they like elements of the law. It’s not a coincidence that the Trump administration’s first proposed health care regulation was aimed at stabilizing the insurance markets.

Still, Republicans are using the Affordable Care Act’s so-called collapse as an argument for a much stingier law, one that would leave states responsible for paying many health care costs. Some conservatives are using the assault on the A.C.A. not to assail its novel insurance provisions — which many people like — but rather to grind an old ax against the entire Medicaid program, which was enacted in 1965 to help the poor.

As the Senate turns to its own bill, it still has time to preserve the parts of the Affordable Care Act that are working and, more importantly, strengthen those that could succeed with proper support. That would be responsible — and, indeed, is what should have happened all along.

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[Reefa]

Thread Edited to suit forum Dark theme users....

[dMog]

PARTISAN  politics hurts everyone....both parties in the USA are very good at it and it is to the point, and even well past  point that STATE AND  federal governments are well past the state od paralysis

[steven36]

LOL , maybe some those people on welfare have too go to work now boohoo , before Hillary Clinton's welfare reform act  in the 1990s it was never left up too they state if did they want too take advantage of  extra welfare are not  it was up the to federal govt. every since welfare existed  . It don't effect my state much because were not a welfare state . They proposed too cut welfare a little bit for the next 10 years ..If they not got a job in 10 years they are never going too get a job .  It's another case of the liberal press who have a agenda too make it sound worse than it is in reality  . If the money is coming from the federal reserve it should not be left up too the state on how they spend it.

 

it's ether they cut programs  or ether they raise taxes to the point you  lose a lot more of you're paycheck . Someone is going lose ether way but there are many people on welfare just miking the system and can work if they wanted too. Because only some states even precipitate in all them extra programs  and some states it's like before that bill was passed still.

[myidisbb]

I getting the feeling MARKEE account has been hijacked by anti GOP spam.

[markee]