To Americans– young and old, Republican and Democrat, rich and poor, urban and rural dweller—healthcare reform is a serious matter. We all want accessible, quality health care that is affordable. Unfortunately, the more I uncover, the more I see that the Obamacare repeal process is just a game Republican politicians have been playing for political gamesmanship and control. President Trump recently admonished Senate Republicans to do their job and deliver an Obamacare repeal law by stating “I am sitting in the Oval Office with a pen in hand, waiting for our senators to give it to me.” It seems that President Trump wants a “win” (and a TV celebration) more than he wants his promised “better” health care. Now that Republicans have control of both Congress and the presidency, the game Republican politicians are playing in healthcare reform is revealing their general disregard for the needs of Americans while forwarding a hidden political agenda.
Before the beginning of this year, most Americans had no idea what Obamacare really did (or didn’t do). In fact, a third of Americans didn’t even know that Obamacare and the Affordable Care Act were different names for the same law. This lack of public information is a necessary ingredient for the successful completion of the game Republican politicians are playing in healthcare reform. Once that the Republican-controlled Congress started making the repeal of Obamacare imminent with proposed replacements (the House’s American Health Care Act and the Senate’s Better Care Reconciliation Act), Americans started taking notice. Americans took note and saw that the Republican replacements simply tweaked Obamacare provisions (e.g., switching from a tax penalty (individual mandate) to a premium-hike penalty to encourage people to buy insurance) while retaining its basic structure. In addition these bills included Republican political agenda items like giving tax breaks for rich Americans and companies that benefit from health spending at the expense of healthcare funding for our most vulnerable citizens (Medicaid). This game Republican politicians are playing in healthcare reform requires swift action (so that Americans do not get wise about the replacement fine print), blaming others for their actions (and inactions), and making Americans think that they really care about their health care.
Example of One Game Republican Politicians are Playing in Healthcare Reform
The one complaint about Obamacare (PPACA) that I heard many times (and agreed with) was that the health insurance plans offered on the Health Insurance Marketplace (also called the Exchange) cost too much. Premiums were high and the cost sharing (deductibles and co-insurance) was unaffordable even with government subsidies (premium tax credits for people with household income at 100-400% Federal Poverty Level (FPL) and cost-sharing subsidies for people with household income at 100-250% FPL). I might add that the same can be said for health insurance in other markets as well because the root cause of these unaffordable costs are built into the for-profit United States healthcare system which Obamacare (PPACA) did not reform. When most people cried for Obamacare repeal, they were really asking for more affordable health care and assumed that the Republicans were going to give it to them.
In the following example of a game Republican politicians are playing in healthcare reform, you will see that bringing affordability to the American people is not part of their agenda. This example starts with one of the many actions taken by congressional Republicans to cripple Obamacare over the past seven years; namely, when the House Republicans sued the secretaries of the Treasury and Health and Human Services in 2014 for illegally authorizing cost sharing subsidies Congress did not fund (they did authorize the program, but not the funding). In other words, the Republicans wanted to take away a federal government subsidy that makes Obamacare (PPACA) more affordable to people making 100-250% FPL just to cripple Obamacare (PPACA)!
I would suspect that most people crying for a more affordable alternative to Obamacare (PPACA) had no idea that the party that was supposed to deliver a “better” healthcare reform plan was in fact taking actions to make health care LESS affordable for those in most need. Through 2016, the cost sharing subsidies had continued only because the Obama administration appeal to the court ruling was still pending.
What do you think happened when the Republican-controlled Congress and President Trump took over? They were now in the position to get their way and stop the cost sharing subsidies by simply withdrawing the administration’s appeal of the earlier court decision and not funding the subsidies. To do so now, when the ramifications cannot be blamed on the Democrats, would result in serious political fallout. If many people lose their cost share subsidies, the Republicans would be directly to blame and they know it. Instead, the Republicans postponed a decision about the appeal and the Republican-controlled Congress also postponed funding the subsidies. Because these cost share subsidies are paid directly to the health insurance companies, the actions by President Trump and his administration left the insurance companies wondering if they would get the cost sharing subsidies or not. This Republicans’ indecisiveness created uncertainty and is one of the reasons that many health insurance companies are leaving the Health Insurance Marketplaces across the country. If (or when) President Trump decides not to continue the appeal, then the cost sharing subsidies will end and many Americans will find their health insurance more unaffordable.
Game Republican Politicians are Playing in Healthcare Reform
It is becoming increasingly obvious that the Republicans in Congress and President Trump are not interested in delivering a “better” healthcare reform law after they repeal Obamacare. The game Republican politicians are playing in healthcare reform is simply about getting rid of Obamacare (PPACA) at all costs and furthering hidden Republican agenda items like giving tax breaks to the richest Americans while eliminating federal government obligations to health care. Healthcare reform to the American consumer serious business and the game Republican politicians are playing in healthcare reform makes light of our concerns. I do not trust the Republicans in Congress to ever deliver a “better” healthcare plan than Obamacare (PPACA).