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?
What Does The Existing Law Do
The Patient Protection and Affordable Care Act, known as Obamacare or the ACA, was the largest overhaul of the US healthcare system since the 1960s.
It aimed to eventually slow the growth of US healthcare spending, which is the highest in the world.
Obamacare intended to extend health insurance coverage to the estimated 15% of Americans who lacked it and were not covered by other health programmes for the poor and elderly.
The law created state-run marketplaces – with websites akin to online shopping sites – where individuals can compare prices as they shop for coverage.
Some of the more popular provisions include:
- Children can stay on their parent’s healthcare plan until age 26
- No one who is sick or has a medical condition can be denied insurance
- Companies can no longer charge women more than men
- Businesses with more than 50 full-time employees must offer health insurance
#2: Partisans Are Split On The Supreme Court Overturning The Aca
In June 2020, the Trump administration issued a brief asking the U.S. Supreme Court to overturn the ACA. The brief was filed in support of an ongoing challenge to the ACA by a group of Republican attorneys general in California v. Texas, a case that challenges the legality of the ACA in light of the zeroing out of the individual mandate penalty in the 2017 Tax Cuts and Job Acts. The death of Supreme Court Justice Ruth Bader Ginsburg on September 18 and the possibility of the Senate confirming a new Justice appointed by President Trump before the presidential election has brought heightened attention to the potential outcome of this case and the future of the ACA. In October 2020, a majority of the public said they do not want to see the Supreme Court overturn the 2010 health care law, and eight in ten said they do not want to see the ACAs protections for people with pre-existing conditions overturned. There are partisan differences on both questions, with the majority of Democrats and independents saying they dont want the Court to overturn the ACA or pre-existing condition protections. However, among Republicans, three-fourths say they want to see the ACA overturned, but two-thirds say they do not want to see pre-existing condition protections overturned.
Figure 2: Majorities Do Not Want Court To Overturn ACAs Pre-Existing Condition Protections, Republicans Want Entire Law Overturned
Democratic Resistance To Obamacare
Republicans are not the only ones calling for reform or replacement of the Affordable Care Act. The National Review cited a Washington Post/ ABC News survey done not long after the act went into effect that said party support for the act only amounts to about half of Democrats polled. According to the article, 56 percent of those surveyed were concerned about their personal health care under the new law. One Democratic contender put it this way: Obamacare is extremely problematic. It is expensive. It is a $500 billion cost than we originally anticipated. Its cutting into Medicare benefits, and its having companies lay off their employees because they are worried about the cost of it. That is extremely problematic. It needs an enormous fix.
Republican Views On Obamacare
The Republican Partys view on the Patient Protection and Affordable Care Actcommonly known as Obamacareis that its implementation was less about providing healthcare to millions, and more a result of power as the government sought to expand its reach over one sixth of the economy. The party claims that Obamacare has resulted in an attack on the Constitution of the United States because it requires U.S. citizens to purchase health insurance, and its impact on the health of the nation overall has been detrimental. The party is in agreement with the four Supreme Court justices who dissented in the ACA ruling. The justices stated, In our view, the entire Act before us is invalid in its entirety. As of 2012, the partys stance was that Obamacare was the result of outdated liberalism, and the latest in a series of attempts to impose upon the people of America a euro-style bureaucracy to micromanage all aspects of their lives. One of the partys biggest issues with Obamacare is its unpopularity among the peoplewhen polled on the subject, pluralities and even majorities often state they do not like the law.
The Acas Protections Changed Public Opinion In Its Favor Republicans Are Keeping Up
For more than a decade, the Affordable Care Act has been the Republican Partys nemesis. As it was first debated in Congress in 2009, when it was enacted in 2010 and through the next six years of implementation, Republican leaders rallied supporters by vociferously opposing it and calling for repeal. The Trump administration and states controlled by Republicans remain hostile to the ACA.
But the coronavirus pandemics fast-moving destruction has pushed Republicans to rely on Barack Obamas signature law to respond to the crisis, even taking action to strengthen it. The law, as written, requires that Americans who have recently lost jobs and insurance coverage to be permitted to enroll in its insurance marketplace, and they are doing so in swelling numbers. Meanwhile, Republicans recently backed that increased federal funding for a critical part of the ACA: Medicaid for lower-income people. And Trump administration regulators have used their authority to insist that insurance plans pay for coronavirus tests as an essential health benefit under the ACA a Republican target in the past.
Our research shows that this about-face cannot be explained by the pandemic alone. The partys rank-and-file and many other Americans have shifted to supporting the ACA and expanded government payments for health care. The pandemic is giving Republicans cover to follow changing public opinion.
Republicans have spent 10 years trying to kill the Affordable Care Act
What If It Is Repealed
If Obamacare is repealed and not replaced with an alternative, the government would see a huge increase in the deficit because the repeal would devastate Medicaid, according to Healthline.com. The federal government currently provides states with 90 percent of their Medicaid funding through the ACA provisions. If Obamacare is repealed, states will not receive that funding. Insurance companies could rescind coverage of people with pre-existing conditions and raise premiums. It is feasible that millions of people could lose their coverage. Hospitals and healthcare providers would be affected because they would have fewer patients with insurance. Premiums and deductibles could go up. Those are depressing forecasts.
Some people, however, support the repeal believing things will be fine. They say the federal government should not be involved in healthcare, and that if Obamacare was repealed the states would take over the insurance exchanges and Medicaid. They believe in a self-leveling effect in which the insurance companies would go back to offering more variety in coverage and individuals would have choices. The problem with the scenario, however, is Medicare. The healthcare system for those 65 and older is what moves the healthcare industry. Reforms should be made, including giving people an opportunity to simply refuse it. These changes would bring the free-market principle back into healthcare and should drive costs down.
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.
Younger Americans Could Get Cheaper Plans
Obamacare was designed so that younger policyholders would help subsidize older ones. That would change under the Republican bill because it would allow insurers to charge older folks more.
This means that younger Americans would likely see their annual premiums go down. Enrollees ages 20 to 29 would save about $700 to $4,000 a year, on average,according to a study by the Milliman actuarial firm on behalf of the AARP Public Policy Institute.
Those under age 30 would also get a refundable tax credit of up to $2,000 to offset the cost of their premiums, as long as their income doesnt exceed $215,000 for an individual.
The GOP tax credits would also likely be more generous than Obamacares subsidies for these folks. For example, a 27-year-old making $40,000 a year would receive $2,000 under the GOP plan, but only gets a $103 subsidy from Obamacare, on average, a Kaiser analysis found.
Also, the bill keeps the Obamacare provision that lets young adults up to age 26 stay on their parents insurance plan.
Trumps Promise To Repeal Obamacare Is Now In Limbo
President Donald Trump expressed disappointment after Republican lawmakers’ failure to muster enough votes to repeal Obamacare placed one of his loftiest campaign promises in limbo.
A series of defections by Senate Republicans scuttled two separate efforts to dismantle the sweeping U.S. health care law put in place by Trump’s predecessor, President Barack Obama.
“We’ve had a lot of victories, but we haven’t had a victory on health care,” Trump told reporters July 18, as it became clear the latest Republican legislative efforts would fail. “We’re disappointed.”
A slim margin of error constrained GOP efforts to repeal and replace Obamacare and forced a delicate balancing act between the party’s conservative and moderate members.
But defections by Sens. Jerry Moran of Kansas and Mike Lee of Utah on July 17 brought to four the number of Republican senators to publicly oppose the bill , effectively killing the repeal-and-replace plan. Senate leadership could only afford to lose two Republican votes for passage.
Senate Republicans then turned their attention to a measure that would repeal major parts of Obamacare over two years, in theory buying lawmakers enough time to agree on a replacement plan before the Affordable Care Act, often called Obamacare, was largely dismantled.
“I did not come to Washington to hurt people,” Capito said in a statement. “I cannot vote to repeal Obamacare without a replacement plan that addresses my concerns and the needs of West Virginians.”
What Would Trumpcare Look Like Follow Gop’s ‘choice And Competition’ Clues
Eliminating the penalty also caused insurance premiums to rise, says Sabrina Corlette, director of the Center on Health Insurance Reforms at Georgetown University. “Insurance companies were getting very strong signals from the Trump administration that even if the ACA wasn’t repealed, the Trump administration probably was not going to enforce the individual mandate,” she says. Insurance companies figured that without a financial penalty, healthy people would opt not to buy insurance, and the pool of those that remained would be smaller and sicker.
So, even though the $0 penalty didn’t actually go into effect until 2019, Corlette says, “insurance companies in anticipation of the individual mandate going away and in anticipation that consumers would believe that the individual mandate was no longer going to be enforced priced for that for 2018.” According to the Kaiser Family Foundation, premiums went up about 32%, on average, for ACA “silver plans” that went into effect in early 2018, although most people received subsidies to offset those premium hikes.
Republicans Are Still Trying To Repeal Obamacare Heres Why They Are Not Likely To Succeed
Conservatives are still trying to repeal the Affordable Care Act even after the Republican-majority Congress failed to overturn the law in 2017. A coalition of conservative groups intends to release a new plan this summer. The groups will reportedly propose ending the laws expansion of Medicaid and convert Medicaid funding into block grants to the states. And just last week the Trump administrations Justice Department argued in a legal filing that key provisions of the law its protections for persons with preexisting conditions are .
Why are Republicans still trying to undo the ACA? We argue in a forthcoming that the laws political vulnerabilities and Republican electoral dynamics drive conservative efforts to uproot it.
In the past, conservatives have thrown in the towel
As politicians and political scientists both know, the can never be taken for granted. Even so, the duration and intensity of conservative resistance to the ACA is historically unusual. The ACA is a moderate law, modeled on that Republicans once supported, such as insurance purchasing pools. Whats more, many red states refuse to accept the ACAs funding to expand Medicaid to more of their citizens such as , which has a large number of uninsured residents even though you would think they would want those federal benefits.
So why is the ACA still politically vulnerable?
The answer lies partly in the way the program was designed.
Is repeal likely?
If The Affordable Care Act Is Struck Down Tens Of Millions Of Americans Would Lose Coverage And Protections For Pre
As the public health and economic toll of the coronavirus pandemic becomes more grim with each passing day, Republicans are doubling down on their decade-long effort to repeal the Affordable Care Act. Democrats, meanwhile, are working to shore it up by introducing legislation to lower costs, expand coverage, and strengthen protections for those with pre-existing conditions.
The White House this week is expected to file legal briefs officially asking the Supreme Court to end the ACA, even as more than 40 million Americans have filed for unemployment benefits since March. As many as 27 million Americans could lose their employer-sponsored health insurance during the pandemic, according to an estimate from the Kaiser Family Foundation.
The legal briefs, which are expected to be filed on Thursday, come as part of a case brought by a coalition of 18 Republican-led states that are suing to repeal the ACA. The case has the support of President Donald Trump, who said in May that he wants to terminate the ACA, even as it becomes a potential lifeline for millions of newly uninsured Americans.
Passed in 2010 under President Barack Obama, the ACA was the most comprehensive healthcare legislation enacted in decades. Studies havefound that it saved tens of thousands of lives and billions in healthcare costs.
Under the ACA:
Some within the GOP have acknowledged the dangers of trying to take away healthcare coverage during a pandemic leading into an election.
Why Does Trump Want To Repeal Obamacare
President Trump has called Obamacare an incredible economic burden, and claims that it has tragically but predictably resulted in runaway costs, websites that dont work, greater rationing of care, higher premiums, less competition and fewer choices.
Republicans have opposed the reforms since they were first proposed at the start of Mr Obamas presidency in 2009.
Right-wing politicians described the law as a job-killer despite a 9 per cent rise in health care sector employment since the act was implemented.
They object to the states intrusion into the private affairs of businesses and argue that firms have been burdened with too many costs.
President Donald Trump waves as he walks with first lady Melania Trump and son Barron during the inauguration parade.
Groups Opposing The American Health Care Act
Over 50 organizations oppose the proposed healthcare plan that will make Americans will pay more for less. The list includes nurses, doctors, hospitals, teachers, churches, and more. You can see a few here:
AARP: AARP opposes this legislation, as introduced, that would weaken Medicare, leaving the door open to a voucher program that shifts costs and risks to seniors.
Before people even reach retirement age, big insurance companies could be allowed to charge them an age tax that adds up to thousands of dollars more per year. Older Americans need affordable health care services and prescriptions. This plan goes in the opposite direction, increasing insurance premiums for older Americans and not doing anything to lower drug costs.
On top of the hefty premium increase for consumers, big drug companies and other special interests get a sweetheart deal.
Finally, Medicaid cuts could impact people of all ages and put at risk the health and safety of 17.4 million children and adults with disabilities and seniors by eliminating much-needed services that allow individuals to live independently in their homes and communities. Although no one believes the current health care system is perfect, this harmful legislation would make health care less secure and less affordable.
AARP stands ready to work with both parties on legislation that puts Americans first, not the special interests.
That just wont do.
That is, above all, why physicians must be involved in this debate.
National And State Level Coverage Losses
Because the economic crisis stemming from the pandemic is driving millions of people onto coverage programs supported by the ACA, CAP estimates that approximately 3 million more people stand to lose coverage from the health care repeal lawsuit than the 20 million previously estimated. According to a March 2019 analysis by the Urban Institute, full repeal of the ACA would cause enrollment in Medicaid and the Childrens Health Insurance Program to fall by 22.4 percent and enrollment in individual market coverage, including for the ACA marketplaces and other insurance people purchase on their own, to drop by 35.4 percent.
The economic stress of the pandemic has pushed the United States into a recession. The Congressional Budget Office projects that the unemployment rate in the second and third quarters of this year will average 15 percent higher than it was during the Great Recession. At an unemployment rate of 15 percent, 17.7 million people would lose employment-based health insurance coverage, according to a recent report by the Urban Institute. With access to ACA coverage options, most of these people would find new forms of insurance. Urban estimates that 8.2 million would end up with Medicaid/CHIP coverage, and 4.3 million would gain coverage through the ACA marketplaces or other private coverage. About 5.1 million would remain uninsured.
#3: Most Say It Is Important That Pre
If the Supreme Court overturns the ACA, a host of provisions could be eliminated, including the laws protections for people with pre-existing medical conditions. These provisions prohibit insurance companies from denying coverage based on a persons medical history and prohibit insurance companies from charging those with pre-existing conditions more for coverage . The July 2019 KFF Health Tracking Poll found that a majority of the public says it is very important for many of the ACA provisions to be kept in place, including the guaranteed issue provision and community rating . While partisans divide over the importance of keeping many provisions of the ACA in place, majorities of Democrats, Republicans, and independence say it is very important to continue each of these protections for people with pre-existing conditions.
Figure 3: Most Say It Is Important That ACA Provisions Remain In Place
How Likely Is It That The Affordable Care Act Will Be Repealed And Replaced
Concerned United States citizens want to know how likely is it that the Affordable Care Act will be repealed and replaced. Though speculative, the answer to the question is not an impossible one. The repeal of the Affordable Care Act, also known as ACA or Obamacare, is a subject that is under much scrutiny.
Trump Signs Executive Order On Obamacare; Impact Unclear
On his first day in office, President Donald Trump signed an executive order that gave federal agencies broad authority to defer or delay any part of the Affordable Care Act that costs anybody any money.
More formally, the order tells agencies they can “waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.”
That’s a mouthful, but what does it mean, and how far does it go to repeal Obamacare?
Larry Levitt, senior vice-president at the respected and neutral Kaiser Family Foundation, said in a series of tweets that while the impacts are unclear, it shows the administration is “moving to unwind the Affordable Care Act, but it won’t be immediate.”
Levitt added, “One sure outcome is it creates uncertainty for insurers at a critical time.”
Health care analyst Sabrina Corlette at Georgetown University echoed Levitt’s point.
“For insurers already uncertain about their future in the Affordable Care markets, the uncertainty this executive order generates doesn’t help,” Corlette said. “At a minimum they’ll have to factor it into their 2018 premiums, which are due to be filed by May 3 in most states.”
But that hasn’t happened yet.
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.