Introduction
The AMA is against it, the American Association of Retired People is against it, the American Hospital Association, the Association of American Medical Colleges, the Catholic Health Association of the United States and the Children's Hospital Association are all against it. So, too, are a good number of Republican senators against it, as are other organizations and Red state citizens who supported Trump and bought into his simplistic campaign promises. Of course, Democrats are against it, even though they realize that will gain in time from the poo poo storm the Republicans will bring down upon themselves if this horrendous Obamacare replacement becomes law.
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Republicans claim this is what they promised voters when they said, "Vote for us and we'll repeal the Affordable Care Act." The voters who thought this was a great idea were given few clues as to what would come next, other than Trump's usual "it will be great, stupendous, the best, fantastic." Promising more care, better doctors, improved service, cheaper prices and a chicken or two for the pot after every doctor visit, voters in the Doomsday states of Pennsylvania, Michigan, Wisconsin, Ohio and Iowa cast their lot with the Republicans repealers. Republicans gave no hint that their substitute system would take away health insurance from millions of Americans, offer fewer protections and increase costs for all but the very well off.
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The Process and the Result
The Republicans ran their ACT replacement bill through committees so fast that no Republicans and not even the Congressional Budget Office (CBO) have had time to figure out what it will cost. Democrats are labelling the RyanCare legislation as the "Pay More for Less GOP Repeal Bill."
Key features of this mean-spirited plan that will cost more for much less include:
* Massive cuts in Medicaid services.
* Steep increases in the cost of health insurance for everyone, especially older Americans.
* No tax credit for tens of millions who enjoyed subsidies from the healthcare.gov insurance marketplace.
* Elimination of $370 billion that now goes to states for children, nursing home patients and the disabled.
* Penalties that enrich insurance companies, such as a "continuous coverage" requirement that will allow insurance companies to charge a 30 percent premium surcharge on anyone with a break in coverage at any time.
* Weaker age-rated protections designed to make health care unaffordable for a large segment of older adults.
* Elimination of all support for Planned Parenthood.
Costs
Estimates released by the congressional Joint Committee on Taxation projects how much revenue the government will lose under the Republican bill, which the Party calls "the American Health Care Act." * Nearly $25 billion over 10 years as a result of repealing taxes on drug makers.
* From repealing taxes on insurers - nearly $145 billion.
* From repealing taxes on makers of medical devices - nearly $20 billion.
* From high-income households - more than $270 billion (from taxes on earned income and investment income).
Why do you suppose Republicans want to remove these sources of revenue, which could help to fund their substitute for Obamacare? Silly - you know why! Because Republicans do not represent the people whom this bill harms - they are owned by and thus represent big money and big business interests who will grow richer if this bill is enacted into law.
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Resistance The AMA, one of the many groups opposing the Republican plan, wrote to the leaders of the two Congressional committees expressing opposition "because of the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations." In a letter to Congress, the Association that represents retired people (E-Zine forbids the acronym) stated that the bill would increase health costs for people ages 50 to 64, would lead to cuts in Medicaid coverage of long-term care and would allow insurers to charge older people five times as much as younger ones.
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Thomas Huelskoetter of "Think Progress" summed up this sorry excrescence of a bill as follows: "This isn't a real plan. The lack of details is embarrassing, and the details that do exist are worse. Even more embarrassing is the fact that Paul Ryan knows it's not a real plan, that's why he starts off the paper by calling his broad outline "the beginning of the conversation, not the end." But, as noted, if it passes, there is a one mild consolation: The rebellion by Trump voters against the Republican Party for creating this codswallopian horror program will be the delicious satisfaction is seeing the bums run out of town, that is, defeated, in the 2018 mid-term elections. Schadenfreude is a guilty pleasure and, in this case comes at a high cost, but it is some consolation. As Ingersoll has advised, "hope is the consolation of the world."