Passage Of House Bill Revives Effort To Supplant Obamacare
Just six weeks after House Republicans pulled a bill to substantially overhaul the the nation’s health care system, they successfully — if narrowly — passed a revised version of the measure.
On May 4, 2017, the House passed a the bill by a 217-213 margin.
Republican leaders adjusted the bill following negotiations with both the conservative and moderate wings of the party.
The revised bill would do several things.
It would end subsidies provided to people who buy health insurance on the Affordable Care Act’s online marketplaces, replacing them instead with tax credits. It would repeal several taxes imposed under the ACA that primarily hit high-income taxpayers. It would allow states to obtain waivers to some requirements of the Affordable Care Act, including the “essential health benefits” provision that requires maternity care or mental health services. And it would curb further expansion of Medicaid that had been allowed under the Affordable Care Act, as well as eventually capping Medicaid expenditures in ways that would effectively end its status as an entitlement.
According to the Congressional Budget Office, the original version of the bill would have increased the number of uninsured people by 24 million by 2026. The changes made before passage might change that number, but the specific impact awaits a new score by CBO, which is expected in the coming days.
Why Is The Affordable Care Act So Despised By So Many Conservatives
IT HAS been called the most dangerous piece of legislation ever passed, as destructive to personal and individual liberties as the Fugitive Slave Act and a killer of women, children and old people. According to Republican lawmakers, the sources of each of these quotes, the Affordable Care Act , or Obamacare, is a terrible thing. Since it was passed by a Democratic Congress in 2009, it has been the bête noire of the Republicans. The party has pushed more than 60 unsuccessful Congressional votes to defeat it, while the Supreme Court has been forced to debate it four times in the acts short history. Obamacare was also at the heart of the two-week government shutdown in 2013. Why does the ACA attract such opprobrium from the right?
Why Do Conservatives Oppose The Law
Republicans say it imposes too many costs and regulations on business, with many describing it as a “job killer”. However, since the implementation of Obamacare jobs in the healthcare sector, at least, rose by 9% and a found that around 2.6 million jobs could be lost by 2019 if it is repealed.
Conservatives have also baulked at Obamacare’s rule requiring most companies to cover birth control for free.
The Trump administration tried to put in place new guidelines for organisations to opt out on moral grounds last year, but two federal judges blocked the move.
During the Obama presidency, the Republican-controlled House of Representatives took dozens of symbolic votes to repeal the law and provoked a partial government shutdown over the issue.
After repeated legal challenges, in 2012 the US Supreme Court declared Obamacare constitutional.
Despite having a majority on Capitol Hill under President Trump, a Republican repeal bid failed in dramatic fashion in 2018.
Democratic leaders have acknowledged Obamacare is not perfect, and have challenged Republicans to work with them to fix its flaws.
Trumps Executive Action Could Erode Marketplace Built Under Obamacare
Attempts to repeal portions of the Affordable Care Act have failed in the past several months, leading President Donald Trump to issue an executive order expanding access to cheaper, less comprehensive health care plans.
The order, signed on Oct. 12, instructs federal agencies to remove certain limitations on “association health plans” and expand the availability of short-term health plans, both of which can skirt certain minimum coverage requirements included in the Affordable Care Act and state laws.
These changes will not immediately take effect; federal agencies will have to figure out how to act on Trump’s directions.
The executive action orders agencies to explore ways in which the government can expand access to short-term health plans, which are available to individuals on a three-month basis and meant for people who are in-between health care coverage plans. Under the instructions, association health plans would be allowed to sell plans across state lines; those plans allow small businesses to band together to create cheaper health care plans that offer fewer benefits.
The order was intended to create more options for individuals seeking health insurance and help stimulate competition among insurers. Some health policy advocates worry that it could disrupt the insurance marketplace in a way that would drive up health care costs for elderly individuals and people with medical conditions.
It will be months before changes are seen in the marketplace.
This Is Why Republicans Couldnt Make A Better Replacement
Republicans have made a lot of political hay out of pointing out that the plans available under the Affordable Care Act are, in many ways, disappointing. Unsubsidized premiums are higher than people would like. Deductibles and copayments are higher than people would like. The networks of available doctors are narrower than people would like.
These problems are all very real, and they all could be fixed.
They are not, however, problems that the American Health Care Act actually fixes. While Republicans have made several changes to the AHCA to cobble together a majority of House votes, the core of the bill remains the same: it offers stingier insurance to a narrower group of people.
This is because the AHCA does what Republicans want: it rolls back the ACA taxes. But under those circumstances, its simply not possible for the GOP to offer people the superior insurance coverage that it is promising.
The bill the House is voting on Thursday doesnt get rid of the ACAs tax credits to make it easier to buy health coverage, but it bases them on age, with younger people getting bigger credits, rather than income which means poorer Americans. especially elderly ones, will have a bigger tax burden and more difficulty affording the insurance they need.
Do Republicans Really Want To Repeal Obamacare Maybe Not
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WASHINGTON, DC – JANUARY 07: Speaker of the House Paul Ryan shares a laugh with… Republican members of Congress after signing legislation to repeal the Affordable Care Act, also known as Obamacare, and to cut off federal funding of Planned Parenthood during an enrollment ceremony in the Rayburn Room at the U.S. Capitol January 7, 2016 in Washington, DC. President Barack Obama has promised to veto the bill.
Here is something that may surprise you. Did you know that in the 6 ½ years since the passage of Obamacare, Republicans have not held a single hearing on the problems the law has created for ordinary people? No hearing in the House of Representatives. None in the Senate. None anywhere else. Zip. Zero. Nada.
There certainly has been no shortage of problems. It seems like every other week the New York Times brings us a new investigative report complete with gory details and eyewitness reports of victim after victim of President Obamas signature legislative accomplishment. But if you look over the subject matter for the committee hearings in Congress for the past several years, you would never know an Obamacare problem even exists.
Why is that? There have been no shortage of votes to repeal Obamacare. At last count the House has voted to repeal some or all of the hated legislation 60 times!
So lets return to the titular question.
Would House Republicans really vote to take health insurance away from 20 million people?
Eliminating Health Care Penalties
The Affordable care Act, required most Americans to be enrolled in Health Insurance since it was made affordable, otherwise a penalty would be induced. Effective 2017, congress attempted to eliminate financial penalties that were related to complying with the mandated law that every individual needs to be enrolled in Health insurance, this law however did not become effective until 2019. This policy is still valid, the penalty for having no health insurance was reduced to 0$. Individual mandates effects the decisions made by individuals regarding healthcare in that some people will not enroll since health insurance plans are no longer mandatory.
On March of 2020, the nation has undergone a global pandemic, however, several Republican-led states and the Justice Department are making the case for invalidating the ACA. This will cause at least 60 million people to not be able to afford being hospitalized, or treated which increased the number of COVID-19 cases nationwide.
This Is Why Republicans Cant Make A Better Replacement
Republicans have made a lot of political hay out of pointing out that the plans available under the Affordable Care Act are, in many ways,disappointing. Unsubsidized premiums are higher than people would like.Deductibles and copayments are higher than people would like. The networks of available doctors are narrower than people would like.
These problems are all very real, and they all could be fixed.
They are not, however, problems that any of the GOP replacement plans fix. Instead, while Republican alternatives vary in many important ways, they all fundamentally offer stingier insurance to a narrower group of people.
This is because the Republican plans all envision rolling back these ACA taxes. But under those circumstances, it’s simply not possible for the GOP to offer people the superior insurance coverage that it is promising.
Phil Klein, a top conservative health policy journalist, has urged Republicans to solve their overpromising problem by “stating a simple truth, which goes something like this: ‘We don’t believe that it is the job of the federal government to guarantee that everybody has health insurance.'”
Gop Wants To Repeal Obamacare Without A Backup Plan But Some Republicans Say That’s A Bad Idea
U.S.CoronavirusHealth CareObamacareCongress
A Republican-led lawsuit is leaving the fate of the Affordable Care Act hanging in the balance of the courts amid a pandemic that’s ravaged the globe and exacerbated the need for health care.
Yet GOP lawmakers on Capitol Hill concede they do not have safety net legislation ready to catch the millions of Americans who would find themselves suddenly without health insurance during a potential second coronavirus wave.
Some Republicans, however, believe that needs to change.
“We need to have a plan in place to make sure that people don’t lose coverage,” said Senator Mitt Romney .
Pre-existing conditions are the “most important thing” to cover, said Senator Martha McSally. But, the Arizona Republican added, “there are many other contingencies that we need to be looking into,” referring to a wide array of issues that could arise without the law.
Republicans have tried unsuccessfully over the years to repeal and replace Obamacare with health provisions of their own. But more than three years into President Donald Trump’s first term, they acknowledge there is neither a discussion nor a plan available to simply replace the expansive health care law that is Obamacare, should it be struck down.
Senator Rick Scott , a former hospital CEO, said he’s “come up with lots of proposals. But there’s no proposal here,” he added.
Does President Trump Really Want To Repeal The Aca
Feb 25, 2020
When he introduced the 2020federal budget President Trump re-emphasized his intention to repeal theAffordable Care Act, known more popularly to most of us as Obamacare.
Perhaps that is the issue! Trumpand Obamacare!
The Affordable Care Act is irrevocably associated with the Democratic Party and ex-President Obama in particular. Most citizens benefit from it one way or another.
Since the swing to theDemocratic Party at the Mid-Term elections in 2018 President Trump has beenremarkably quiet on his plans for replacing Obamacare if he is granted a secondterm by the American public. Indeed, hehas made it clear that there will be no new legislation until at least 2021.
In the meantime, he will bewatching the polls and judging the voters intentions as the Democratcandidates put their healthcare policies on display.
Nobody claims the AffordableCare Act is perfect. All agree it can beimproved. At the 2018 mid-term electionsmore than half the voters claimed that healthcare was the major factor in theirvoting decision. That is why it stays atthe top of the political agenda. After all, our spending on healthcare accountsfor nearly 20% of the way in which we spend the countrys income .
This may be true but there arelimits to savings from increased efficiency and inflation is inevitable. The outcome is, necessarily, reduction inbenefits or in enrollment.
There are signs that Trump mightbe prepared to keep the subsidies and allow income-related tax relief.
Gridlock In House Stalls Trump’s Pledge To Repeal Obamacare
As a candidate for president, Donald Trump said that “real change begins with immediately repealing and replacing the disaster known as Obamacare.”
On March 24, the nation learned that it’s not happening immediately. And the road forward isn’t clear either.
Capping a frenzied week of negotiations between three House Republican factions — the party leadership, the hardline conservative House Freedom Caucus, and members of the more moderate, pragmatic wing of the party — House Speaker Paul Ryan, R-Wis., announced that he would not bring the American Health Care Act to the floor for a vote, as he had planned.
That March 24 announcement came one day after the floor vote had been pushed back to allow for last-minute changes and arm-twisting, and half a day after Trump had issued an ultimatum to House Republicans — pass the bill or he’ll move on.
In the run-up to Ryan’s announcement, vote counting by media outlets had concluded that the House GOP would lose too many votes to pass the bill if it tried.
“We came really close today, but we came up short,” Ryan said at a press conference. “I will not sugarcoat this. This was a disappointing day for us.”
For members on the party’s right flank, the American Health Care Act left in place too much of the infrastructure of the Affordable Care Act, President Barack Obama’s signature health care law and the target of intense Republican opposition for seven years.
The Real Reason Republicans Couldnt Kill Obamacare
Democrats did the work, Republicans didntand that says a lot about the two parties.
Adapted from The Ten Year War: Obamacare and the Unfinished Crusade for Universal Coverage, St. Martins Press 2021.
The Affordable Care Act, the health-care law also known as Obamacare, turns 11 years old this week. Somehow, the program has not merely survived the GOPs decade-long assault. Its actually getting stronger, thanks to some major upgrades tucked in the COVID-19 relief package that President Joe Biden signed into law earlier this month.
The new provisions should enable millions of Americans to get insurance or save money on coverage they already purchase, bolstering the health-care law in precisely the way its architects had always hoped to do. And although the measures are temporary, Biden and his Democratic Party allies have pledged to pass more legislation making the changes permanent.
The expansion measures are a remarkable achievement, all the more so because Obamacares very survival seemed so improbable just a few years ago, when Donald Trump won the presidency. Wiping the law off the books had become the Republicans defining cause, and Trump had pledged to make repeal his first priority. As the reality of his victory set in, almost everybody outside the Obama White House thought the effort would succeed, and almost everybody inside did too.
That was no small thing, as Republicans were about to discover.
Baby Boomers And The Aging Population
Robert Reich failed to mention the aging population. 76M boomers were born after WW-II, between 1946 and 1964, and America wasnt prepared for that growth. Neither were other nations. There werent enough hospitals, pediatricians, schoolteachers, textbooks, playgrounds, or even bedrooms in our homes. Now, as 11,000 more baby boomers turn age 65 every day, retire, and go on Social Security and Medicare, the ability to pay for public assistance becomes more difficult. By 2029, more than 20% of the US population will be over 65 . That 1-in-5 number is up from 1-in-7 today; and by 2035, 1-in-3 US households will be headed by someone 65 or over.
Thats because people are living longer . But were also less active and have higher rates of chronic disease and disability. Almost 39% of boomers are obese, compared to about 29% in the previous generation, and 40% of them are low-income , meaning theyll need more public assistance.
The age 85+ population needing the most medical care will grow the fastest over the next few decades, equaling 4% of population by 2050, or 10 times its 1950 share 1.9M Americans are already 90+, an in 2010, people 90+ had a median income of just $14,760, about half of it from Social Security. This is a worldwide phenomenon thanks largely to longer average longevity. The United Nations says that by 2050, the older generation will be larger than the under-15 population.
Why Republicans Wouldn’t Actually Repeal Obamacare
It would be a political disaster, but it hasn’t yet stopped them from trying.
Last week, in a bold example of their governing prowess, congressional Republicans took their 62nd vote to repeal the Affordable Care Act, and this time they actually passed it through both houses and sent it to President Obama to be vetoed. Naturally, they were exultant at their triumph. Speaker Paul Ryan admitted that there is as yet no replacement for the ACA, but they’ll be getting around to putting one together before you know it. The fact that they’ve been promising that replacement for more than five years now might make you a bit skeptical.
What we know for sure is this: If a Republican wins the White House this November, he’ll make repeal of the ACA one of his first priorities, whether there’s a replacement ready or not. To listen to them talk, the only division between the candidates is whether they’ll do it on their first day in the Oval Office, in their first hour, or in the limo on the way back from the inauguration.
But I’ve got news for you: They aren’t going to do it, at least not in the way they’re promising. Because it would be an absolute catastrophe.
Now imagine that ten million people, the number signed up for private coverage through the exchanges, all had their coverage simultaneously thrown into doubt. Think that might cause some bad press for the party and the president who did it?
Everything You Need To Know About Why Conservatives Want To Repeal The Presidents Health Care Law
Photo by Larry Downing/Reuters
Though the Affordable Care Act passed into law in 2010, conservatives continue to fight it at every opportunity: in the courts, in state legislatures, and in Congress. Its a safe bet that as the race for the 2016 GOP presidential nomination kicks off, a cavalcade of Republican hopefuls will torment innocent Iowans with tales of how theyve fought Obamacare in the past and why theyre the ones who can finally drive a stake through its heart. But if you dont read the conservative press, you might have no idea why those of us on the right side of the political spectrum are so worked up about Obamacare. To promote cross-ideological understanding, Ive prepared this little FAQ.
Why do conservatives oppose Obamacare?Not all conservatives are alike, and there are at least some, like Avik Roy of the Manhattan Institute, who believe Obamacare should be reformed and not repealed. But as a general rule, conservatives oppose the law and would like to see it repealed for several reasons.
First, some conservatives oppose it for the same reason that liberals favor it: Through the Medicaid expansion and the exchanges, it subsidizes insurance coverage for people of modest means by raising taxes on people of less-modest means and by curbing the growth in Medicare spending. Conservatives tend not to be enthusiastic about redistribution, and theyre particularly skeptical about redistribution that isnt transparent.
Why Republicans Cant And Wont Repeal Obamacare
Editor’s Note:
This article was originally posted on Real Clear Health on January 16, 2017.
Now that the Republicans control both the presidency and both houses of Congress, they must put up or shut up on their promise to repeal and replace Obamacare. Here is a flat-footed prediction: the effort will fail for three reasons. First, the Affordable Care Act has largely succeeded not failed, as president-elect Trump and other Republicans falsely allege. Second, it is impossible for the stated goals of repeal to be achieved. Finally, the political fallout from the consequences of partial or total repeal would be devastating. When it comes to casting votes, enough Republicans will conclude that repeal is a bad idea and will join Democrats to sustain the basic structure of the health reform law.
Second, the stated objectives of repealing Obamacare are mutually inconsistent. Three provisions comprise the core of Obamacare. First, rules barring insurance companies from refusing to sell insurance to people because of preexisting conditions or varying premiums based on those conditions. Second, a requirement that everyone carry health insurance who can afford it. And third, subsidies for those with moderate incomes to help make such insurance affordable. The law contains many other provisions as well, but these three are core.
Trump Administration Asks Supreme Court To Strike Down Affordable Care Act
If successful, the move would permanently end the health insurance program popularly known as Obamacare and wipe out coverage for as many as 23 million Americans.
WASHINGTON The Trump administration asked the Supreme Court late Thursday to overturn the Affordable Care Act a move that, if successful, would bring a permanent end to the health insurance program popularly known as Obamacare and wipe out coverage for as many as 23 million Americans.
In an 82-page brief submitted an hour before a midnight deadline, the administration joined Republican officials in Texas and 17 other states in arguing that in 2017, Congress, then controlled by Republicans, had rendered the law unconstitutional when it zeroed out the tax penalty for not buying insurance the so-called individual mandate.
The administrations argument, coming in the thick of an election season as well as a pandemic that has devastated the economy and left millions of unemployed Americans without health coverage is sure to reignite Washingtons bitter political debate over health care.
In his brief, Solicitor General Noel J. Francisco argued that the health laws two remaining central provisions are now invalid because Congress intended that all three work together.
The court has not said when it will hear oral arguments, but they are most likely to take place in the fall, just as Americans are preparing to go to the polls in November.
Is The Supreme Court Likely To Save Obamacare
The Supreme Court is likely to leave in place the bulk of Obamacare, including key protections for pre-existing health conditions.
Conservative justices John Roberts and Justice Brett Kavanaugh appeared in two hours of arguments to be unwilling to strike down the entire law a long-held Republican goal.
The courts three liberal justices are almost certain to vote to uphold the law in its entirety and presumably would form a majority by joining a decision that cut away only the mandate, which now has no financial penalty attached to it.
Leading a group of Democratic-controlled states, California and the Democratic-controlled House of Representatives are urging the court to leave the law in place.
A decision is expected by late spring.
Repealing Obamacare Is A Huge Tax Cut For The Rich
This did not play a major overt public role in the 2009-’10 debate about the law, but the Affordable Care Act’s financing rests on a remarkably progressive base. That means that, as the Tax Policy Center has shown, repealing it would shower moneyon a remarkably small number of remarkably wealthy Americans.
The two big relevant taxes, according to the TPC’s Howard Gleckman, are “a 0.9 percent payroll surtax on earnings and a 3.8 percent taxon net investment income for individuals with incomes exceeding $200,000.” That payroll tax hike hits a reasonably broad swath of affluent individuals, but in a relatively minor way. The 3.8 percent tax on net investment income , by contrast, is a pretty hefty tax, but one that falls overwhelmingly on the small number of people who have hundreds of thousands of dollars a year in investment income.
For the bottom 60 percent of the population that is, households earning less than about $67,000 a year repeal of the ACA would end up meaning an increase in taxes due to the loss of ACA tax credits.
But people in the top 1 percent of the income distribution those with incomes of over about $430,000 would see their taxes fall by an average of $25,000 a year.
