Thursday, January 5, 2017

Repealing Obamacare

Man.  There is a lot to talk about today.

Can't neglect the latest news on the GOP's efforts to repeal Obamacare.  The linked-to article is short and well worth reading, but I'll just point out a few things that bear comment.  Emphases added mine throughout.

First of all, it looks like Obamacare as a whole won't be repealed, simply defunded, which will have much the same effect as repeal:

The repeal legislation will be in the form of a reconciliation bill, authorized by the Congressional Budget Act of 1974. Such bills can be adopted under special fast-track procedures. But Senate rules generally bar the use of those procedures for measures that have no effect on spending or revenue. So the legislation, as now conceived, would probably leave the most popular provisions of the health law intact, such as the prohibition on insurers’ denying coverage to people with pre-existing conditions.
Instead, the legislation would:

■ Eliminate the tax penalties imposed on people who go without insurance and on larger employers who do not offer coverage to employees.

Well, that's likely to be popular with many people.  No one likes to be fined for something they didn't want to buy.  People hate taxes, fees, period.

■ Eliminate tens of billions of dollars provided each year to states that have expanded eligibility for Medicaid.

This is likely to be far less popular.  People who can't obtain coverage other than through Medicaid are understandably pretty protective of their Medicaid.  Eliminating tens of millions of dollars per years of Medicaid funding will, quite simply, pull the rug out from under these people.

■ Repeal subsidies for private health insurance coverage obtained through the public marketplaces known as exchanges.

Again, because Obama and his Democratic colleagues felt the need to jump through hoops to placate the insurance industry (largely successful) and the Republican party (totally unsuccessful), they couldn't simply have expanded Medicaid to all and ended up with a nice single-payer program.  Instead, we got this hybrid beast known as Obamacare which subsidizes individuals to purchase health insurance through the private sector.

As such, those subsidies are 100% crucial to these people's continued healthcare coverage.  20 million people who didn't have health care have gained health care as a result of Obamacare.  With Medicaid coverage evaporating and subsidies being withdrawn, what now happens to those people?  No health insurance for them?

It could also repeal some of the taxes and fees that help pay for the expansion of coverage under the Affordable Care Act. But some Republicans have indicated that they may want to use some of that revenue for their as-yet-undetermined plan to replace the health care law.

Oh.  That sounds slimy.  They're repealing Obamacare, but not repealing the taxes and fees that make Obamacare possible?  Is this like being told a concert you bought a ticket to is being canceled, but your ticket price isn't being refunded?

Anyways, sounds like repeal won't happen overnight.  It'll take a while.  How long exactly?

Republicans say they will delay the effective date of their repeal bill to avoid disrupting coverage and to provide time for them to develop alternatives to Mr. Obama’s law. They disagree over how long the delay should last, with two to four years being mentioned as possibilities.

Saaaaaaay... that sounds a lot like right after midterm elections, or right after Donald Trump's potential re-election.  I'm sure it's just coincidence that taking away 20 million people's healthcare won't occur before either of those benchmarks, but rather, shortly afterwards.

The federal government could continue providing financial assistance to insurance companies to protect them against financial losses and to prevent consumers’ premiums from soaring more than they have in the last few years.

That sounds prudent.  Healthcare inflation, which still outpaces core inflation, has been coming down in recent years, thank God.  Some of that may be due to Obamacare, but it isn't clear that Obamacare is responsible.  The bottom line is that medical costs are rising for most American families.  But this was true before Obamacare as well.  If the Trump administration can tackle this problem somehow, it will rightly achieve much acclaim.  However, here's what the Trump plan is looking like so far:

Even as they move full speed toward gutting the existing health law, Republicans are scrambling to find a replacement. At the moment, they have no consensus.


Many experts have said that repealing the health law without a clear plan to replace it could create havoc in insurance markets. Doctors, hospitals and insurance companies do not know what to expect.

This exchange in the Senate was somewhat telling, of the whole repeal scenario:

Senator John Cornyn of Texas, the No. 2 Senate Republican, noted that it had taken six years to get into “the ditch we find ourselves in now.”

“When your truck or car is in a ditch, the first thing you need to do is get out of the ditch,” Mr. Cornyn said. “And sometimes that takes a lot of hard work.”

To that, Senator Debbie Stabenow, Democrat of Michigan, parried that when a car goes into a ditch, “the first thing I don’t do is dismantle the car.”

“That doesn’t help me get anywhere in terms of transportation,” she said.

I mean... yep.

So people are finally going to get rid of the despised Obamacare.  But then what?  The American people will not be better off.  There's no plan.  What's the plan?  What is the thought process of the GOP here?  Is there a thought process?  Who does this really placate other than dyed-in-the-wool mainline fiscal conservatives, who are very much not at the core of Donald Trump's alleged new ideology?
Meanwhile, I really, really wanted to talk about this fantastic article about the Mexican POV on NAFTA today, but my blog has already run a bit long. So I'll have to shelve for tomorrow.  In a nutshell: NAFTA isn't good for working people anywhere.  It's not just bad for American workers, it's bad for Mexican workers too!  Imagine that.  If you have the time, definitely read the article; otherwise, come back tomorrow.  Adios for now!

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