When U.S. House Speaker Paul Ryan describes repealing and replacing the Affordable Care Act, he gives the signature legislation of President Barack Obama a wack assessment. The Wisconsin Republican in January 2017 said Obamacare “is in what the actuaries call a death spiral,” Politifacts said that his statement was flat out False. Ryan even went so far as to say on Jan. 27, 2017 that it is “basically a spectacular failure,”
There are many ways, of course, to evaluate the Affordable Care Act, (ObamaCare) which became law in 2010 though many changes were phased in later. But two of the major ones are coverage (Do more people have health insurance?) and costs (How much do you pay for insurance and what does it cover?)
The fact is the President’s Council of Economic Advisers credits ObamaCare for what it says is a one-third drop nationally since 2010 in the share of Americans reporting that they have forgone medical care due to cost. And the U.S. Department of Health and Human Services has estimated that during the first six years of Obamacare, 20 million Americans gained health insurance as a result of the law. during the 2016 presidential campaign, Hillary Clinton said a record 90 percent of Americans had health insurance. PolitiFact National rated that True. A month later, in November 2016, a U.S. Centers for Disease Control and Prevention report, based on its annual survey, found 8.9 percent of Americans did not have health insurance in 2016.
When former GOP presidential candidate Carly Fiorina said in a Milwaukee debate in December 2015 that “Obamacare isn’t helping anyone,” she earned a Pants on Fire report from Politifact! At the time, 10 million people had been put on Medicaid as a result of Medicaid’s expansion under the law; and 9.5 million were enrolled in policies bought on the marketplace (including 8 million who were receiving subsidies under the law).
In addition, the law as it stands now has meant millions of Americans are no longer at risk of being denied coverage due to pre-existing conditions (a Promise Kept for Obama); or are no longer at risk of being kicked off policies for developing expensive medical conditions.
So today, Republicans bent on repealing Obamacare have ironically kept a lot of it because the people fought like hell for them to keep it, and if they only had worked with Obama instead of against him, even what’s wrong with the bill could have likely been fixed. Walking a fine line between the free market and a safety net, Republicans on March 6 released their legislative plan to replace Obamacare — more formally known as the Affordable Care Act — without throwing millions of people off their health insurance coverage.
It’s too soon to tell how much the plan will cost or if people currently covered will retain their coverage, and at what cost. That information will come later, after the nonpartisan Congressional Budget Office finishes analyzing the plan.
But we can draw a few initial conclusions about the plan, which the Republicans are calling the American Health Care Act, or AHCA.
The requirement to buy insurance goes away. People will no longer be fined on their tax returns if they lack insurance under the plan. Large companies will no longer have to pay penalties for not offering insurance.
There are still tax credits for people to buy insurance. The plan includes an “advanceable” tax credit, based on age and families size, which people can use to buy insurance. Whether it’s as bigger or smaller than Obamacare will depend on specific circumstances. The plan’s advocates say the credit will be between $2,000 and $14,000 a year “for low- and middle-income individuals and families who don’t receive insurance through work or a government program.”
Insurers still have to cover pre-existing conditions, but they will be able to charge more for people who are recently uninsured. The plan allows insurance companies to charge higher rates if a person has a significant lapse in coverage. Higher rates will be charged if a person was uninsured for 63 continuous days during the previous 12 months.
Move toward allowing different types of policies, such as catastrophic policies. The Obama administration required insurance companies to cover basic care without exclusions; they called it “essential health benefits.” Those rules stay in place for now for private insurance. But the GOP plan ends essential benefits for some in Medicaid, and Republicans have said they intend to encourage more limited policies and policies that kick in only in cases of major illness or injury.
Adult children and college students can stay on their parents’ plans. As under Obamacare, children will be able to stay on their parents’ health insurance until they turn 26.
Medicaid will eventually be reduced, but it might expand first. The Medicaid expansion remains at first but new enrollment freezes in 2020. Other limitations will also be applied to the program.
The taxes from the 2010 health care law will be repealed. That includes taxes on prescription drugs, over-the-counter medications, health-insurance premiums and medical devices. As for how the plan will be paid for, an explanation on the House GOP website says, “We are still discussing details, but we are committed to repealing Obamacare and replacing it with fiscally responsible policies that restore the free market and protect taxpayers.”
Let’s keep their feet to the fire!