While the 115th United States Congress is moving fast to destroy Obamacare (PPACA) as soon as possible, what happens after Obamacare (PPACA) is still unclear. “After Obamacare (PPACA)” is a situation that is being orchestrated by the Republican-controlled Congress and the new Republican President-elect Donald Trump. Yesterday, the Republican-controlled Senate started the ball rolling by approving a budget resolution that requires separate committees in the House and Senate to begin drafting legislation that would overturn the bulk of Obamacare (PPACA). To the Republicans in Congress, it is obvious that no immediacy has been attached to any “after Obamacare (PPACA)” plans. Perhaps the Republicans are finding out that complaining about Obamacare (PPACA) for six years was a lot easier than delivering a completely new reform law that works as well as the one it is replacing. Perhaps the Republicans are hoping to never have to deliver a “after Obamacare (PPACA)” plan–a comparison might find their new plan wanting.
In the “after Obamacare (PPACA)” vacuum that will follow, millions of people, insured through the Health Insurance Marketplace and through the expansion of Medicaid will be the first to suffer. Recent polls show that three quarters of the respondents either oppose repeal altogether (47%) or want to wait to repeal the law until the replacement plan’s details are known (28%). Our Republican Senators don’t seem to be listening to the electorate.Leery of politicians’ motives and rhetoric, I guess Americans have come to appreciate the saying “better the devil you know than the devil you don’t”.
When I asked my Republican Senator what were the plans “after Obamacare (PPACA)”, his response was that he was too busy “supporting our troops in the War on Terror, repairing our economy and creating jobs, strengthening Social Security, lowering the tax burden on American families, and making the federal government more accountable and efficient.” to address my concerns. I guess the loss of healthcare benefits, quality of care initiatives, and affordability measures are not that important to my Republican Senator.
Simply destroying one healthcare reform law without putting another in its place is irresponsible and dangerous to the well-being of our nation’s population. We all know that Republicans have waited six long years to “stick it” to the Democrats. Our newly elected Republicans need to go past the “nyah-nyah-we-won” taunting of Democrats and move on to implementing a well-defined “after Obamacare (PPACA) healthcare plan that delivers affordable, quality healthcare for ALL Americans.
Healthcare reform is not an Us versus Them issue—it is an American people issue. Americans want affordable, quality healthcare–not Republican affordable, quality healthcare or Democratic affordable, quality healthcare. Americans do not want to start from scratch again in four years after the Republicans in Congress are kicked out because their “after Obamacare (PPACA)” solution makes Americans worse off.
We Don’t Want Repackaged Obamacare
After Obamacare (PPACA), the Republicans are taking on the important responsibility that comes with creating a healthcare law that is “better” than the one they scrapped. By repealing Obamacare (PPACA), the Republicans are saying that the law is too flawed to be improved. It is impossible to predict how reform after Obamacare (PPACA) will be better because Republicans have been vague about everything except their hatred of the law since its inception six years ago.. Is it possible to craft totally different healthcare reform legislation that delivers affordable, quality healthcare to ALL Americans built upon our present fragmented, private healthcare system without it looking like a “repackaged” Obamacare?
How will the funding for an “after Obamacare (PPACA) reform plan differ? Under Obamacare (PPACA), funding is through a combination of taxes and cost-reduction measures and is designed to not increase the size of the budget deficit (i.e, be revenue neutral). Revenues come from (1) a 3.8 percent tax on individuals who earn more than $200,000, (2) penalties on employers who fail to provide health care to their employees and individuals failing to obtain health insurance and (3) taxes/fees on various health care companies, such as drug manufacturers, medical device manufacturers and insurance providers. The cost-reduction measures are largely obtained in the Medicare program through changes from a fee-for-service reimbursement model to one that is value-based (i.e., tied to quality of care delivered). Who will end up paying for the “after Obamacare (PPACA)” reform law and how will it be different? American taxpayers and patients will be worse off if the “after Obamacare (PPACA)” plan increases patient cost-share, reduces benefits, takes away patient protections, and/or does not reduce total per capita health spending.
Any healthcare reform law that forces Americans to postpone or forego healthcare because of unaffordablility is NOT healthcare reform. If Republicans simply want to “repackage” Obamacare, then we would be better off keeping the functioning Obamacare (PPACA) they inherited and improving it.
Totally “New” Healthcare Reform?
If Republicans truly want to give Americans “better” healthcare, then they will have to do more than simply “repackage” Obamacare. Americans have had enough of healthcare policy that protects the profits and income of healthcare businesses OVER the interests of the American people.
In the “after Obamacare (PPACA)” environment, the Republicans would have to start with a clearly defined national healthcare policy that ALL Americans can read and evaluate (e.g., take a look at the NHS Constitution for England, a document I actually got goosebumps reading). This healthcare policy should put the social and economic well-being of individual Americans first and not the financial interests of the individual businesses that generate profits and income in the healthcare industry. It is time for all Americans to belong to one coherent “American” healthcare system that includes all groups of Americans—Medicare and Medicaid beneficiaries, employees with employer-sponsored insurance, those who fall in the non-group insurance market and buy on the Health Insurance Marketplace, veterans, American Indians, military personnel, and even the uninsured. Taxpayer funds should be used to make sure all Americans have access to affordable, quality basic care.
Politicians should be well aware how quickly American opinion can turn, especially when their pocketbooks are affected and promises are not kept. Healthcare reform is critical for the social and economic well-being of the American people and the stakes are too great to let political gamesmanship and partisanship define healthcare policy.
Once that Donald Trump becomes the President of the United States, he and the Republican-controlled Congress will be in position to create healthcare reform that has the potential for transforming our fragmented healthcare system into one that is truly the “best” in the world. It is not now. The American electorate is praying that you succeed in this mission.