From the Desk of Bob McNett…..
REPEAL AND REPLACE—–Republicans Face Hard Realities.
Since the Affordable Care Act was enacted in 2010, Republican legislators have voted to repeal the law dozens of times.
But, these votes were made with the full knowledge that once it reached President Obama’s desk, they were sure to be vetoed.
Most people expected that this trend would continue once Hillary Clinton was elected. She promised to continue the ACA and attempt to improve and expand the law. All the polls, and virtually all the media pundits, along with supporters of both candidates, expected (either privately or publically) that Mrs. Clinton would stake her claim to the White House.
Then, on election night, when the votes began to be counted, the reality of Donald J. Trump’s victory began to sink in as the hours passed.
Now, one of the big promises of Republicans to “repeal and replace” the ACA became more than a promise, more than just an exercise in futility. It became a reality.
Because few people on both sides actually expected that the Republicans would have the opportunity to fulfill this promise, no hard plan had been formulated to follow through. It’s easy to repeal…..but once this happens, what would be the replacement plan?
In a Fox News interview with Bill O’Reilly, President Trump, when asked about his strategy for the ACA, replied “Maybe it will take sometime into next year. Very complicated. Obamacare is a disaster.” Trump continued, “But we should have something within the year and the following year.”
Trump is acknowledging the difficulty of replacing a plan that really left the station around six years ago. The ACA has had time to become ingrained in our health care system. Millions of people have their individual health coverage through the ACA “Marketplace” on healthcare.gov, and most of these folks are receiving taxpayer-provided subsidies to help them pay the premium. To suddenly pull the plug on this would likely cause massive havoc, not only amongst insureds, but with health insurance companies that have changed their business models to comply with the law.
One can argue persuasively that Obamacare has been a failure—-huge premium increases on individual health policies in 2015 and 2016 (around 85% in Oklahoma last year) testify to this opinion. Others argue that, because of the ACA, the number of uninsureds in this country has been reduced considerably. Hospitals and doctors have seen fewer “no pay” patients in recent years. Plus, people with pre-existing health conditions with no access to employer-sponsored coverage can now purchase coverage for the first time. Obamacare subsidies have made coverage more affordable for many. However, the fact that most major insurance companies have left the ACA individual business, and most that have stayed in have lost billions in high claims, make it hard to call the law an unqualified success.
It is reported by Republican lawmakers that they are facing large, angry crowds in constituent forums back home, upset over plans to repeal ACA. At least six Senate Republicans have stated that they will not vote to repeal the law without a viable replacement being put forth.
Republicans have put forth several disjointed concepts as to what to do to replace Obamacare, such as giving insurance companies the ability to sell across state lines, which, in my humble opinion, would do little to reduce costs. However, these ideas have not congealed into one formal, sensible program.
House speaker Ryan’s plans were to vote to repeal Obamacare in March, then reveal a replacement soon after. Now, that strategy is looking unlikely.
Republican, for the first time, have the power to repeal and replace the much-hated Obamacare. But exactly how to use that power remains a mystery.
Robert K. McNett, LUTCF
The McNett Agency
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