It seems very easy to ridicule the American Health Care Act and Republican efforts to promote their plan which would replace the Affordable Care Act.
Mick Mulvaney, the director of the Office of Management and Budget told Mark Halperin on MSNBC’s “Morning Joe” that insurance coverage isn’t “the end goal” of healthcare reform. It needs be. Vice President Mike Pence told an audience in Louisville, Kentucky that healthcare in their state was made worse by Obamacare. It wasn’t.
In perhaps the epitome of Obamacare criticism, Speaker of the House Paul Ryan declared that Obamacare was in a “death spiral” because it forced healthy people to pay for sick people. A statement for which there are almost too many things wrong to properly elucidate.
Critiques of these statements, as well as others, have been swift, and harsh. And many would say such disapproving judgments are deserved. Except here’s the thing…the Republican effort to “repeal and replace” the Affordable Care Act has nothing to do with healthcare.
From the very beginning the American public liked Obamacare. They just didn’t know it due to the massive, years-long public relations campaign the GOP waged against the healthcare plan. Once talks of a Republican repeal of the Affordable Care Act became concrete, it became more popular than ever. People began to understand what the Act was and did for them. They didn’t want their healthcare taken away.
It was quickly apparent the second statement wasn’t true. The American Health Care Act will provide tax credits, only those credits most benefit those who can already afford healthcare.
As to the President’s first statement, there was initial skepticism. Skepticism which was justified and seemingly solidified when the Congressional Budget Office’s official report on the American Health Care Act said it would increase the number of uninsured people by 24 million by 2026. In other words, according to the CBO the Republican healthcare plan will increase the number of uninsured Americans by 86 percent. It would also increase premiums in the short-term.
But remember, it isn’t about coverage. Additionally, we were already told that the CBO analysis would be wrong and meaningless.
Under Obamacare insurance premiums were skyrocketing. Quality of healthcare was plummeting. It caused the national debt to go through the roof. It destroyed jobs. It was immoral. And the CBO projections were completely wrong.
At least so argued conservatives and the Republican Party. Never mind that none of those things are true.
It isn’t about healthcare.
In fact, the Affordable Care Act took the form it did because of numerous comprises during the legislative process, compromises which incorporated many Republican ideas. The Affordable Care Act was designed a lot like a Republican comprehensive healthcare plan.
The Democrats’ original vision of comprehensive health insurance was tied to Social Security and Medicare, largely funded via payroll taxes. It would most likely have been cheaper, simpler, and more popular.
This is to say that many of the problems of Obamacare against which Republicans rail were created, or at least exacerbated, by political comprises made to incorporate Republican ideas.
There were issues with the Affordable Care Act. Even President Obama admits problems with the legislation. But the idea of revising or replacing is improvement.
To recap, many of the criticisms leveled against the Affordable Care Act by conservatives and the Republican Party are either largely the result of Republican ideas about comprehensive healthcare, fabricated by the Republican Party, or the result of creative truth-telling.
The Affordable Care Act was healthcare. “Obamacare” was politics.
Following the release of the Congressional Budget Office’s report Paul Ryan issued a statement in response:
This report confirms that the American Health Care Act will lower premiums and improve access to quality, affordable care. CBO also finds that this legislation will provide massive tax relief, dramatically reduce the deficit and make the most fundamental entitlement reform in more than a generation.
Under Obamacare, we have seen how government-mandated coverage does not equal access to care, and now the law is collapsing. Our plan is not about forcing people to buy expensive, one-size-fits-all coverage. It is about giving people more choices and better access to a plan they want and can afford. When people have more choices, costs go down. That’s what this report shows.
This is all true, except for the “all” part. And the “true” part.
The CBO does project the Republican bill would reduce the federal debt by $337 billion over the next decade. Part of the bill is eliminating tax increases made under Obamacare. And insurance premiums are projected to decrease after 2020.
Here’s the problem: the American Health Care Act is projected to cost the federal government as much as $600 billion in revenue over the same period. Those tax breaks mainly benefit the wealthy. For the poor and the elderly the cost of healthcare will increase. Especially as the initial increase in premiums and Medicaid cuts will cause many Americans to lose their insurance so when/if they attempt to pick up insurance in the future the continuous coverage premium will kick in, making it even more costly.
Even if the American Health Care Act does theoretically improve healthcare access and choices, if people can’t pay for those choices and that access, there is no healthcare.
But the American Health Care Act isn’t healthcare. The American Health Care Act is politics.
Follow @armchairmidrash on Twitter to get notifications of the latest posts and to continue the conversation.