It is obvious to all American voters that the Republicans hate Obamacare (PPACA). When I do an online search for “why do Republicans hate Obamacare”, I do not get any specific details, only vague statements that skirt the details and incite the American people to join their mission. The vehemence of Republican hatred has me perplexed and my efforts to dig up answers to reveal the cause has left me with many unanswered questions.
I find it hard to believe that Obamacare (PPACA) is the horrific and un-American creation painted by Republican spin. There is no question that the law is imperfect, but probably not broken irreparably if bipartisan efforts had been made over the last six years. Which law is perfect when first passed anyway? Obamacare (PPACA) has “bad” and even “ugly” parts and ALL are the result of putting the financial interests of healthcare businesses ahead of the interests of the American people. This is business-as-usual in the murky “Swamp” of Washington politics. The law’s imperfections do not explain why Republicans hate Obamacare (PPACA).
Getting to the Specifics–“Why Republicans Hate Obamacare?”
Let’s look at a few of the Obamacare (PPACA) specifics and generate some questions we can ask our elected Republican Congressmen to get at the root of “why do Republicans hate Obamacare?”
- Creating the Health Insurance Marketplace and giving subsidies to Americans who cannot afford the cost of health insurance.
–Do Republicans object to the very existence of such an insurance Marketplace that brings together individuals who do not qualify under other group health insurance pools? Is it just this particular group effort that generates the hatred or do Republicans object to all group efforts (i.e., employer-sponsored, Medicare, Medicaid, Veterans Health, etc.)?
–Do Republicans object to providing taxpayer subsidies to uninsured Americans or is it the particular amount that is hated?
–Do Republicans hate how the insurance subsidies are funded– through taxes on the wealthy, taxes on various for-profit healthcare businesses, and cost containment measures that will decrease health spending if successful
–Do Republicans hate all cost containment (affordability) measures because they decrease income and profits in the healthcare industry?
- Individual insurance mandate.
–What exactly do Republicans hate about the individual mandate? Donald Trump’s website (accessed January 10, 2017) says the answer is “No person should be required to buy insurance unless he or she wants to.” Does this statement hold for all types of insurance (like auto insurance)? There are a lot of things that government makes me do (like pay taxes) that I only do as part of my obligation to the common good and not because I want to do it.
–What happens when a person chooses to forego purchasing health insurance and then needs healthcare he/she cannot afford? Will the person expect taxpayers to come to the rescue? Will the person be allowed to suffer and possibly die because they chose not to contribute to the health insurance risk pool?
–Do Republicans understand how health insurance works? Health insurance is a product that distributes the financial risk of a large financial loss with a large group of people. Without the young and healthy to subsidize the old and sickly within the risk pool, health insurance premiums would be astronomical. Without the individual mandate, the young and healthy will disproportionately opt out—until they get old and sick, of course.
–Keeping health insurance premiums to the lowest levels requires full participation of ALL Americans, ideally as one big risk pool. Are there any plans for a “Medicare for ALL” kind of healthcare plan that puts all Americans under one efficient risk pool?
- Affordability and quality of care measures.
–Do Republicans hate all Obamacare (PPACA) affordability measures? What specific affordability measures are they going to replace them with? Because affordability measures in Obamacare (PPACA) decrease profits and incomes for those in the healthcare industry, are Republicans planning to back off on them so that the private healthcare businesses can be free to charge whatever the “market will bear”? When it comes to life and death treatments, the prices can get very high in the healthcare “free market” they hold sacrosanct.
— Do Republicans hate the measures that reduce administrative, operational, and clinical waste and inefficiency in the healthcare system? These reforms should be the first order of business in any healthcare reform replacement. Does a Republican replacement for Obamacare (PPACA) include any measures to reduce waste and inefficiency in the healthcare system and what exactly are they?
–Are the Republicans going to demand improved quality of care for all Americans from the healthcare industry or are they happy with having some of lowest quality among industrial nations? Are cost-effective “best practice” guidelines (based on evidence-based clinical data) going to be applied across the nation so that over-treatment, over-testing, treatment detrimental to health, hospital-acquired conditions,errors, etc. are reduced?
— Are Republicans going to scrap Obamacare (PPACA) payment and quality reforms such as bundling and accountable care initiatives? What are they going to put in their place? Are Republicans happy with the fee-to-service payment model that has made doctors rich and over-treatment and over-testing the norm?
- Essential Health Benefits.
— Are Republicans going to scrap the concept of Essential Health Benefits (EHBs) for All Americans? If so, how will consumers be able to compare apples to apples when shopping for health insurance products? Before EHBs and a standard benefits package that was based on them, insurance companies were free to sell many low value health insurance products that even sophisticated consumers had trouble deciphering.
b. Should ALL Americans be guaranteed a minimum basic health care benefit that is affordable? If not, why?
- Medicare Part D “Donut Hole” Closure.
a. Why do Republicans hate Obamacare (PPACA) measures that benefit the Medicare beneficiaries? In addition to cutting waste and fraud, the law gives Medicare beneficiaries some prescription drug cost reduction by closing the “donut hole”. Will Republicans replace this “affordability” measure by enacting a law that allows the Medicare program to negotiate for lower prices for all Medicare beneficiaries (as Veterans Health Administration is allowed to do and Californians proposed to do) for the benefit of individual Americans?
Call to Action
The Obamacare (PPACA) specifics above are far from exhaustive. I have provided many questions that can be repeated to your elected representatives and if answered will given you a better handle on why Republicans hate Obamacare (PPACA). I would encourage you to demand specific answers to your specific questions. Be alert for answers that contain the following oft-repeated words and phrases: “free-market”, “market-driven”, “choice”, and “consumer-driven”. These words and phrases tell us nothing about specifics and are used to shut our questions down.
I would be very interested to get reports about what your individual elected representatives have answered. Perhaps we will learn why Republicans hate Obamacare (PPACA) so much and then again, perhaps not…
Contact your elected officials directly and join BB’s Healthcare Brigade to help strategize a plan of action. Let’s work together and fight for Affordable Health Care and Beyond for ALL Americans before the present set of elected officials TAKE AWAY what we already have through Obamacare (PPACA) legislation.