It’s been widely reported that Republican efforts to repeal and replace Obamacare are dead, but they couldn’t be more wrong.
The White House is still placing enormous pressure on Congress to cut Medicaid, and multiple opportunities to attach pieces of failed bills are coming soon. While having nothing to do with Obamacare, conservative proposals to cap Medicaid appeal to small government proponents and fill the need to pay for promised tax cuts.
In May, the House passed a devastating Obamacare repeal bill that would have caused 23 million Americans to lose health coverage and cut $834 billion from Medicaid. Last month the Senate failed to pass a repeal bill by just one vote. Senators Bill Cassidy and Lindsey Graham are currently working on a very similar bill they believe can pass, that would cut Connecticut Medicaid $2.5 billion over the next decade. And in a few weeks, a Senate committee will hold hearings on the issue.
Much of the momentum to repeal and replace Obamacare is based on the mistaken notion that it is broken. Since Obamacare millions more Americans have meaningful coverage without annual or lifetime caps, people are no longer denied insurance because they need it, medical bankruptcies are down sharply, and disparities are narrowing.
Obamacare has never been more popular among Americans. Concerns about counties in other states with no health insurers turned out to be premature. Governors and State Insurance Commissioners in at-risk states successfully recruited new insurers for all those counties, ensuring that every American will have access to insurance next year. Critics are right that 2018 insurers’ rate increases are steep, but at least half those increases are caused by uncertainty from the administration’s undermining.
While there are also hopeful bipartisan efforts to support Medicaid and stabilize the health insurance markets, the administration continues to undermine Obamacare without legislative action. Undermining a commitment to the American people, the administration’s month-to-month uncertainty about funding for cost sharing provisions set in law will add 20 percent to premiums and raise the federal deficit by $6 billion next year. It’s offensive to violate a commitment, increase Americans’ tax liability, and hike insurance costs just to make a point.
I’m not convinced that it matters in a significant way, but the administration’s refusal to enforce the law’s individual mandate is driving insurers to raise premiums even further. Adding bureaucratic barriers such as narrowing the window to sign up for coverage and starving resources to inform people will erode Obamacare’s success.
Are these sincere efforts to move away from Obamacare or a deliberate self-fulfilling plan to force failure?
I get Obamacare repeal-fatigue — this fight has been going on for seven months. But that’s the good news — it’s been seven months and these destructive bills haven’t passed. Obamacare isn’t perfect, but it’s better than the alternatives offered so far. We need to regroup and press on. Health care is complicated — who knew?
Ellen Andrews, PhD, is the executive director of the CT Health Policy Project. Follow her on Twitter @CTHealthNotes.
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