GOP proposed replacement for Obamacare raises ruckus

Mr. Ryan

As predicted, the Republican blowback against Obamacare, the “repeal and replace”, that has been widely touted by President  Donald Trump and Speaker of the House, Paul Ryan, has hit more than a few speed bumps when it was rolled out on Monday, with, as predicted, higher cost premiums, especially for older Americans in their 50s and 60s.

Trump had noted, replacing the Affordable Care Act, was easier said, than done, especially in the face of coverage for over 21 million people, many in rural, as well as urban areas who received preventive care in the form of pap smears, mammograms, as well as simple medications, and vaccinations.

With the issue of health care in America, long a step child of its European cousins, the seemingly impenetrable wall of the insurance lobby, as well as any view that tried to provide even less than universal coverage, which the ACA did, had some people condemning it, even hissing that it was it was “socialism.”

If there was one mistake that President Obama made, with the ACA, it was failing to sell it himself, rather than rely on others in his administration. The subsequent widespread confusion, came to stay, and had many thinking that the the legislation was an insurance program like Aetna, or Unitedhealthcare; but that aside, the GOP has simply now run amuck with Ryan leading the charge.

His answer to use age based tax credits, instead of income, will increase, for those that are older, an increase as much as five times, while those that are younger, would see a savings, according to The S&P Global Market Intelligence report released Tuesday.

An estimated 6 to 10 million people could lose coverage they say, and others less conservative sat those figures could be 2 to 4 million; with at least 4 to 6 million enrolled in Medicaid. Extending the loss, by 2020 there could be a freeze in future enrollment for Medicaid.

As The Hill reported “A 21-year-old, according to an S&P example, might see an average decline of 20 percent in their premium costs. Instead of paying an annual premium of $3,281, they would pay $2,625.”

The American Medical Association, added their voice to the chorus of opposition, when they noted, “By replacing income-based premium subsidies with age-based tax credits, the AHCA will also make coverage more expensive — if not out of reach — for poor and sick Americans. For these reasons, the AMA cannot support the AHCA as it is currently written.”

Also, on board in opposition was the American Hospital Association, for the same reasons. And, taking the  lead, the AMA  plead: “We encourage you to ensure that low and moderate income Americans will be able to secure affordable and adequate coverage and that Medicaid, [Children's Health Insurance Program], and other safety net programs are maintained and adequately funded,” the AMA said in its letter to Congress. “And critically, we urge you to do all that is possible to ensure that those who are currently covered do not become uninsured.”

Ryan has been on record as wanting to dismember Medicaid, and now he has his chance with the AHCA proposal.

Adding to the morass is “the Office of Management and Budget director Rick Mulvaney [who] opines that “insurance is not the end goal here, is it?” Unfortunately, for tens of millions it is. He asserts actual care will be more accessible, but for virtually everyone access is only possible with insurance,” said Jennifer Rubin in an op-ed piece for The Washington Post.

Ryan, incredibly, “declared that coverage didn’t matter. “What matters is that we’re the lowering costs of health care and giving people access to affordable health care plans. The government will always win the war on government-run plans, saying, if we mandate everybody buys what we say they have to buy, then the government will always estimate that they’ll buy it. I just think that’s bogus, that entire premise of that comparison doesn’t work.”

Giving some support to the opposition, but also causing internal dissention within the GOP, are the following senators: Rob Portman of Ohio, Lisa Murkowski of Alaska, Cory Gardner of Colorado, and Shelley Moore of West Virginia.

In a joint statement, they wrote: “We are concerned that any poorly implemented or poorly timed change in the current funding structure in Medicaid could result in a reduction in access to life-saving health care services,” and, “We will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states.”

Battling on the senior side is the powerful AARP, whose executive vice president, Nancy LeaMond who said, in her statement, “Older Americans need affordable health care services and prescriptions. This plan goes in the opposite direction, increasing insurance premiums for older Americans and not doing anything to lower drug costs.”

Also on the horizon with the current language are plans that, if offered, would offer less coverage than those under Obamacare, and most, especially seniors would see out of pocket costs, in some instances; but in the absence of hard numerics from the House, it is difficult to predict with any accuracy. Suffice it to say, it’s back to the drawing board for the House before the strains of the Marseilles began to be heard on Capitol Hill.