Prior to the passage of the Affordable Care Act, most poor people relied on Medicare and used emergency rooms to get healthcare when needed. This meant more Americans were without regular health care and got help in the most expensive manner possible.
President Trump and the Republican Congress have desperately been trying to repeal and replace the ACA and have come up (in secret meetings) with the Better Care Reconciliation Act which we can call Mitchcare since Senator Mitch McConnell is its main proponent.
It calls for immediately defunding of Planned Parenthood for a year. It calls for major reductions in Medicaid funding and coverage. It eliminates the requirement that people get insurance coverage. The Republicans shrewdly propose to delay the biggest cuts to Medicaid and to subsidies for premiums until after the 2018 midterm elections.
GOP senators are facing difficulty when proposing to repeal and replace the ACA, or Obamacare, with Mitchcare. Republican Majority Leader McConnell canceled the call to have a quick vote on the proposal. He said GOP senators needed to get in “a comfortable place” before a vote.
The Congressional Budget Office projected that Mitchcare would push 15 million Americans off of health insurance by 2018 with that number rising steadily until 22 million insured Americans become uninsured again. That makes any politician nervous when selling the proposal to the people.
Of course, the GOP will call the projections “fake news.” It’s up to the people to figure out what is true and what is not. You cannot cut the taxes that support the expanded coverage and allow people to decline coverage and still be able to insure the millions of previously uninsured Americans.
Mitchcare would repeal the individual and employer mandates, and the taxes on drug companies, insurance providers, medical device manufacturers and wealthy individuals which helped pay for the ACA. States would be allowed to get a waiver from rules and requirements. States could impose work requirements on Medicaid recipients. However, the ACA tax on tanning would finally be lifted!
A repeal of the individual mandate would be popular but it would remove the mechanism needed to assure that healthy and unhealthy Americans join an insurance pool in order to even out the costs and contributions that is necessary to provide affordable healthcare to all Americans.
The repeal of ACA taxes will overwhelmingly benefit high income and wealthy Americans. It will hurt those Americans that rely on Planned Parenthood for services and poor persons who depend on Medicaid for services.
GOP House Speaker Paul Ryan told Fox News, nobody is “getting pushed off a plan … it’s that people … choose not to buy something they don’t like or want.”
American citizens do not choose to have no health insurance simply because there is no plan they like or want. If cost-sharing payments are eliminated, low-income people getting insurance on exchanges will face much higher deductibles even if their premiums remain the same, according to the CBO.
Many people may simply choose not to purchase insurance, not because it is their choice but because the healthcare available would become so much more expensive for them than it is now.
Mitchcare will hand enormous tax cuts to wealthy Americans and cut health care for other Americans. Taxpayers who earn more than $200,000 a year and insurance companies, drug companies and medical device makers will be relieved of the taxes that helped fund the insurance coverage of the ACA.
President Trump got elected by attacking Obamacare for raising costs and giving fewer health insurance options for millions of Americans. However, the ACA brought young people, poor people and people with pre-existing conditions under the umbrella of health care coverage. More than 20 million people gained coverage under the law. Mitchcare will rip that protection from most of them. The GOP will have to explain how that helps Americans.