Browsing the blog archivesfor the day Monday, December 5th, 2016.

Can Obamacare Be Saved?

Health Care

The Republican plan, as I understand it, is to pass a law repealing Obamacare as soon as the next Congress is called into session. However, sniveling weasels that Republicans are, the law won’t go into immediate effect. They’ll put the end date sometime after the 2018 midterms, of course.

The latest is that Republicans will repeal Obamacare right away in January using a process called budget reconciliation, which lets them repeal budgetary items with just 51 votes in the Senate. Then, Republicans will enact a self-imposed deadline roughly three years from now before they have to pass a replacement plan. How much of the existing Obamacare elements will limp along until then remains unclear, and whether you can repeal some but not all of Obamacare without causing it to collapse is a big open question.

But such a scenario also creates a self-imposed crisis that Republicans hope will pressure Democrats into coming to the negotiating table down the road. This is where clarity is crucial. Three years from now, it’s not the Democrats’ crisis. It’s a Republican one. There is no health care cliff, Obamacare doomsday, congressional-health-care-death-spiral apocalypse unless Republicans create one by repealing Obamacare without a replacement plan.

And they’ve never been able to come up with a replacement plan. Time and time again they claim to have done so, but that plan always falls apart under scrutiny, forcing them to come up with another replacement plan.

The biggest bite to any Republican so-called plan always is that they can’t cover people with pre-existing conditions without either a mandate for everyone to buy insurance (which, of course, in their minds is Evil) or without putting uninsurable people into high-risk pools, which have been tried in several states and just plain don’t work.

And if they eliminate the mandate but keep the pre-existing condition requirement, the costs of policies would more than skyrocket. It would set the health insurance industry into chaos. See “Why Keeping Only the Popular Parts of Obamacare Won’t Work.”

But the real bite is that the guy Trump wants to head Health and Human Services is a five-alarm whackjob. In his perfect world, only young, healthy people (and the very rich) would have insurance and the rest of us would just be required to suffer and die.

Rep. Tom Price (R-GA), President-elect Donald Trump’s pick for health and human services secretary, already has a plan for how to abolish Obamacare. …

…Price will arrive at HHS with a clear blueprint for what comes next. He is the author of the Empowering Patients First Act, one of the most thorough and detailed proposals to repeal and replace Obamacare. …

… It would replace the law with a plan that does more to benefit the young, healthy, and rich — and disadvantages the sick, old, and poor. Price’s plan provides significantly less help to those with preexisting conditions than other Republican proposals, particularly the replacement plan offered by House Speaker Paul Ryan (R-WI).

The biggest cut to the poor in Price’s plan is the full repeal of the Medicaid expansion, a program that currently covers millions of low-income Americans, which Price replaces with, well, nothing.

I caught a few seconds of Paul Ryan’s interview on 60 Minutes yesterday, before I was able to change the channel. Ryan assured America that Obamacare would be replaced by “Patient-centered healthcare that gets everybody access to affordable healthcare coverage, so that they can buy whatever they want to buy.” And I want a pony, too.

But now the Republicans will have to put up or shut up, and they can’t do it. Whatever they do is going to hurt a lot of people.

So they’ll make a big show out of repealing Obamacare, except most likely it will still be in effect — mandate and all — for the next three years or so. But it’s possible enough of the whackjobs — like Tom Price — will insist on taking it apart sooner, which will cause widespread disaster and lots of suffering.

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