Delivering on Obamacare replacement today, House Republicans got the last laugh when Democrats jumped-for-joy March 24 after House Speaker Paul Ryan (R-Wis.) pulled the first version from a vote. House Minority Leader Nancy Pelosi (D-Calif.) pounded her chest hoping GOP chaos, especially the stubborn House Freedom Caucus led by Rep. Mark Meadows (R-N.C.), was unable to vote. Pelosi sang a different tune today as the GOP under Ryan’s leadership voted to approve an Obamacare replacement bill. Whether liked or not by the Democrats, the GOP delivered one of President Donald Trump’s key campaign promises to repeal-and-replace Obamacare. Republicans objected to Obamacare from Day 1 when former President Barack Obama signed the controversial health care bill March 23, 2010 into law without one Republican vote. House Republicans finally got even.
Working for a good month to fix the ill-fated original replacement bill, the GOP got the House Freedom Caucus to buy in, removing government subsidies for health care, replacing them instead with tax credits and health savings accounts. What went wrong with Obamacare was the lack of price controls on the insurance industry. With the government picking up the tab on subscribers, there was zero cost containment on the government. While it’s true that premiums skyrocketed, the main reason was not what you think. Insurance industry blamed premium increases on insuring too many sick people, those with so-called pre-existing conditions. No one in the employer-based insurance market of group plans complains about preexisting conditions, despite insuring sick people for years. Republicans accepted insurance industry propaganda that Obamacare plans were too costly.
Obamacare plans provide a modicum of coverage for basic health conditions, including emergency room visits, optometry, mental health and prescription drugs. Blamed as too costly and unnecessary for average folks, Obamacare insurers kept raising premiums, largely because they knew they’d get more reimbursement from the government. Instead of fixing the problems by installing price-controls, the Obamacare market kept spiraling out-of-control with premiums and deductibles going through the roof. Stripping $880 billion of Medicaid coverage over 10 years doesn’t please the American Medical Assn., American Nursing Assn, American Hospital Assn., etc., all worried about losing reimbursements for services. GOP’s American Health Care Act [AHCA] attempts to curtail government subsidies, something out-of-control with insurance-industry price gouging.
House conservatives expressed skepticism as the House bill moves to the Senate for reconciliation. “When the House passes a bill, I’ll review it and the we’ll go to work on the Senate bill,” said Sen. Lamar Alexander (R-Tenn.), promising whatever the House sent, it’ll look very different coming out of the Senate. “The Senate will have its own bill, I don’t think this is the final product,” said Sen. Bill Cassidy (R-La.). When the nonpartisan Congressional Budget Office viewed the first version of the AHCA, they determined it would cut some 24 millions subscribers from Medicaid over 10 years. While appealing the House Freedom Caucus, many Republicans don’t agree with cutting health care for poor people, especially doctors, hospitals and pharmacists. Ecstatic over passing anything, House officials led by Ryan touted the benefits of repealing-and-replacing Obamacare.
Knowing how the House debated-and-voted for the new AHCA, some senators expressed skepticism. “Any bill that’s been posed less that 24 hours, going to be debated three or four hours, and not scored [by the CBO] needs to be viewed with suspicion,” said Sen. Lindsey Graham (R-S.C.). Without the CBO taking a hard look, it’s difficult for senators to assess the House bill. “ It’s very difficult for me to analyze the bill in the absence of a CBO score, “ said Sen. Susan Collins (R-Maine). Freedom Caucus members wanted two things with the new AHCA: The wanted to end government subsidies and end Medicaid expansion. Both features are essential to covering the vast majority of poor people unable to afford coverage under current conditions. While the new AHCA has supporters like Sen. Rand Paul (R-Ky.), there are more senators that oppose the bill.
Paul’s major objection to the new AHCA involved insurance companies receiving government subsidies. Under Obamacare, there’s no way to control insurance-industry price gouging, raising premiums to bilk the federal government. “If we can bring the bill in our direction, I’m still open-minded,” said Paul, continuing to object to government subsidies. Senate Majority Leader Mitch McConnell (R-Ky.) signaled there’ll be no nuclear option when it comes to health care in the Senate. “When they send it over here, it’ll be a real big challenge on the Senate side as well,” said McConnell. Cutting funds for Planned Parenthood, also makes the AHCA popular with House conservatives but a non-starter in the Senate. Senators like Collins and Sen. Lisa Murkowski (R-Aka.) object to stripping women’s health coverage. Showing euphoria today, House Republicans could find themselves deflated in the Senate.
