My First Take on the Republican American Health Care Act

(My apologies, but this is a copy of a Facebook post I published a short time ago.  It’s from the hip and I am sharing it as such.  I welcome comments, corrections, and debate.)

If you don’t like politics, you don’t have to read this post. However, below is a release from Paul Ryan and the GOP introducing their health care plan. This misleading BS cannot be left unchallenged. (Sandy, excuse the typos…I’m not editing it.)

Let’s take a look!

First, the claims that the Affordable Care Act (ACA, which is also known as Obamacare) is responsible for driving up health insurance premiums is at best a misleading claim. In fact, health insurance premiums have been increasing annually for decades. Indeed, the rise of overall costs slowed since 2010, not increased. The law did eliminate a class of insurance plans that were high deductible, low benefit plans. People were “forced” off of those and the plans left generally were more expensive. True. However, lower income people who were on those crappy plans often qualified for subsidies to help pay for the better plans which reduced the out-of-pocket increase they actually paid. Many, in net, paid less. This is true because people who could afford quality insurance or had it from an employer were not buying the crappy plans in the first place…unless they were young. And more about that in a moment.

The GOP argues that 1/3 of counties in the United States have one insurance provider on the state exchanges and a third of doctors do not accept Obamacare. This is a problem TO FIX in the existing law, not a reason to dump it. However, for many of the people who face these limits, having some insurance versus no insurance is not a bad thing. (Ask one of the 20+ million Americans who got insurance through ACA about this.)

The GOP release continues to harp on the “disastrous” and “failing” health care law. Reduced costs and higher numbers of American insured hardly seems like a failure. Plus, the non-partisan Congressional Budget Office (CBO) estimates that ACA saves billions annually, a number that will strengthen as more Americans are healthier. The Kaiser Family Foundation is another solid source of stats and information about health care in the United States.

You see, healthy people are good for you whether you get sick or not because sick people — especially those without health insurance — are very, very expensive.

(As an aside, I noticed a laugher in this release. The GOP says something about this plan containing “reforms President Trump laid out.” Hahaha! What the hell were those reforms? When did he lay them out? Tweet. Tweet.)

Next: “Dismantle the Obamacare Taxes.” Did you know that these taxes were written in negotiations with lobbyists from the for-profit health care industry? They called them paybacks. Because Obamacare was going to increase patients — i.e., increase customers — the health care industry saw a windfall coming. Of course they didn’t volunteer to give up money, but they did see what was good for business and played along. If there was going to be health care reform, they were not going to be left out. Something like that. So the taxes the ACA introduced were not the product of an imperial presidency unilaterally picking on free enterprise.

Next: “Eliminate the individual and employer mandate penalties, which forced millions of workers, families, and job creators into expensive, inadequate Obamacare plans that they don’t want and cannot afford.” This could easily be called a lie, but let’s be generous. For some people, rates did increase and that has been addressed above.

One might complain that thirtysomethings being forced to either be insured or pay a penalty is an overreach, but it really is how insurance works. If thirtysomethings don’t really need insurance, they will wait until they are more likely to need it (when they age) to buy it. So the law pushes healthier, younger people into the insurance market to spread risk. If you don’t think this is a good idea, then you won’t like this part of the law. But it does have a long-term benefit for everyone, including today’s younger, healthier Americans.

Also implied here — but not specifically stated — is the ruse that Obamacare was a job killer. It did not turn out that way. In fact, it fits the economy rather well. Perhaps that’s why this release only nods at this complaint indirectly. Facts can be uncomfortable things.

Ok…next the release highlights all the positive things in Obamacare that the GOP says it will keep because people will be so angry if they are taken away. (How they’ll pay for it? They literally say they are working on that part.)

Next: “Empower families and individuals.” This is the Health Savings Account (HSA) gimmick. I mean…where do you start?…think about this, the GOP is going to double the amount you can save in a health savings account. Well, what if you couldn’t save even a quarter of the old limit?? “Hey, guess what Edith, we can now save $13,000 a year in our HSA!” Edith might remind Archie that they only make double that in a year…how will they save it all for medical bills? What problem would that solve if they could? Exactly how does that “empower” anyone who does not have money to pay for health care in the first place?

The truth is Americans had been “empowered” by this pay-it-alone approach for decades and many millions could not afford care and many thousands died each year because of it. That’s empowerment! That’s freedom.

But let’s move on because it looks like the GOP has a solution…

Next: “Help Americans access affordable, quality health care by providing a monthly tax credit.” Jesus! WTF…I am so tongue-tied I could spit! They offer a tax credit of something between $2000 and $4,000 a year. (The details here are being “worked out”.) On the face of it, this seems like a good idea. You get the credit and you go shopping. However…well, it isn’t likely to work. Certainly the for-profit insurance market will adjust to the newly found money and rates will adjust accordingly. Indeed, there is nothing in here that talks about cost controls…and I doubt you will ever see it from the GOP. The so-called “free market” and competition will keep costs down. Well, that hasn’t done much to control costs so far, has it? In fact, do you know what has helped control costs? Obamacare, damn it! And, unlike the GOP plan, it is paid for.

All right, that’s all that I have for you now. I’m going to download the bill next. It is only 123 pages of large double-spaced print so it shouldn’t be that bad…or have much to say. I am eager to find out.

Check back here for updates. And whatever you do…for Pete’s sake and mine, pay attention!

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