A better plan for America's health care

In a battle waged since the 2010 passage of the Affordable Care Act, Democratic President Barack Obama's signature domestic policy achievement, Republicans including President Donald Trump have long vowed to repeal and replace the law. If the Democrats succeed, she sees three scenarios: Republicans do nothing; they go back to the drawing board; or they reach out to Democrats to fix the current law, dubbed "Obamacare". Well, now that the Republican party has control of each level of government: presidency, house of representatives, senate, and a tie in supreme court with a vacant seat to be filled by Trump and congress.

The Republican plan backed by President Donald Trump to overhaul the United States healthcare system cleared its first hurdles in Congress on Thursday afternoon after it was approved on a party-line vote by the House energy and commerce committee.

Instead of giving individuals subsidies to help purchase insurance, people will receive tax credits based in part on the buyer's age.

Ryan's problem, though, is that virtually all conservative health care experts hate the plan.

The chart summarizes, in bullet points, what parts of the ACA the new bill will keep, discard, and change. Also unclear is where President Trump stands on numerous details. But if Republicans say they don't share the view that health care is a right and not a privilege, "then we don't have much to talk about".

"It appears that the effort to restructure the Medicaid program will have the effect of making significant reductions in a program that provides services to our most vulnerable populations, and already pays providers significantly less than the cost of providing care", wrote Richard J. Pollack, CEO of the American Hospital Association. Action on Obamacare was an "urgent necessity" he said.

Of the 11.2 million people during that period who were transitioning into getting health coverage - and would be affected by the 30% penalty - the majority, or about 74%, had been uninsured for five or more months.

Just before the plan was unveiled, four moderate Senate Republicans signed a letter saying that an earlier draft of the repeal bill would not adequately protect people in states like theirs that had expanded Medicaid under the PPACA. They say that will give more flexibility to people and drive down costs. "But this would take a while - they wouldn't change the tax credits or change the Medicaid provisions for another two years under this bill".

"We're going to have insurance for everybody", President Trump said in January. The Republican proposal does retain Obamacare's requirement that insurers cover people with pre-existing conditions. It encourages people to set up health savings and flex savings accounts to pay for health care.

After all of the rhetoric pushed by Republicans, Paul Ryan and others must now actually provide a plan.

And in a telling mirror image, Democrats immediately dubbed the new plan "Trumpcare".

Craig Garthwaite of Northwestern University said the proposed tax credits, which would range from $2,000 to $4,000, were "frankly not enough for a low-income person to afford insurance".

  • Leroy Wright