Have you ever watched a dog chase its tail and wondered what he would do if he ever caught it? For seven years Republicans in Congress chased the Affordable Care Act with malice in their eyes, vowing to kill "Obamacare" and replace it with something better. Now that they have caught the ACA, it's clear that, like a tail-chasing dog, they don't know what to do with it.
Legislation to repeal key parts of the ACA was steamrolled through both the House Ways and Means and House Energy and Commerce committees Thursday. The bills are an abomination that will make it even harder for millions of Americans to get adequate health care. The haste to act early in the Trump administration regardless of the potential consequences confirms that politics fueled much of the vehement opposition to the ACA.
After swearing to the Almighty that Obamacare was so thoroughly putrid that it had to be repealed in its entirety, House Republicans have passed bills that retain the most popular features of the ACA, including allowing young adults to stay on their parents' policies until age 26, banning lifetime coverage caps, and prohibiting insurance companies from denying coverage or charging more to people who have preexisting medical problems.
House Republicans have insisted for years that the ACA must be blown up, all the time knowing that unless they left those popular provisions intact any replacement legislation probably would be doomed. Still, there's enough wrong about the rest of the American Health Care Act, or what some are calling Trumpcare, that any sensible representative or senator should vote it down.
The legislation would repeal the ACA's mandate that individuals must have health insurance or face tax penalties. Instead, tax credits ranging from $2,000 to $4,000 per year, based on a person's age, would be available to help pay for health care or insurance. That approach ignores the fact that many healthy adults who could afford insurance choose not to buy it. They are unlikely to apply for tax credits to pay for something they don't think they need. Without that healthy cohort among insurance purchasers, premiums will likely remain high.
The House legislation adds to the GOP's reputation as the party of the rich. While giving generous tax cuts to pharmaceutical companies and health insurance executives, it installs a block-grant system that in effect would reduce the Medicaid funding each state receives from the federal government. Some states will be forced to cover fewer people, reduce services, or both. The bill also repeals subsidies for people who need help to pay deductibles and other costs for insurance purchased through the government exchanges.
With President Trump and House Speaker Paul Ryan beating the drum for the AHCA, it seems destined for House passage even though some Republican governors are criticizing possible Medicaid cuts. A better chance of derailing this train exists in the Senate. Four Republicans say they won't support any reversal of Medicaid expansions in their states.
Conservatives opposed to subsidized health are calling the ACHA Obamacare Lite. It's a callous effort to fulfill a Trump campaign promise regardless of the damage it does to the American public.