Thursday, May 4, 2017


‘The president promised to protect preexisting conditions and preserve Medicaid. The G.O.P. bill does neither.’

The celebratory glee today by Trump and House Republicans in the Rose Garden over the passing of the House’s health care bill to repeal and replace Obamacare was disgusting. They were celebrating their accomplishment of a bill that has yet to be scored by the Congressional Budget Office and, according to sources, will do none of the things they claimed the bill will do. It is questionable if Trump and those who voted for the bill really understand the bill they passed.   

The Vanity Fair article by Abigail Tracy provides a great overview of the health care bill passed today. Professor of Public Policy at the University of California at Berkeley Robert Riech’s post on Facebook also provides an “important background for understanding what happened today in the House.”

Here are the closing and ending paragraphs of Tracy’s writing.

“The Republican push to repeal Obamacare was always more about about politics than policy. For seven years, G.O.P. lawmakers held symbolic votes to kill Barack Obama’s signature legislation, and successfully ran against the bill in two midterm elections, but never offered up alternative legislation of their own. They struggled to come up with a plan when Donald Trump unexpectedly assumed the presidency, and rushed to hold a vote on a slapdash repeal bill to coincide with the seventh anniversary of Obamacare’s signing—the ultimate “screw you” to Trump’s predecessor. Lost in the political theater was any effort to actually improve health care coverage, which the G.O.P. bill would have stripped from some 24 million people.

“House Speaker Paul Ryan famously pulled the American Health Care Act after conceding that he didn’t have the votes in the House. But efforts to revive the zombie Trumpcare bill limped on, surviving multiple rounds of negotiations with conservatives who insisted the legislation cover fewer people and provide fewer benefits. Now, after a series of starts and stops, the House finally voted Thursday to repeal and replace Obamacare, passing the A.H.C.A. by 217-213. In the end, 20 Republicans voted “no.”

“The question remains, of course, whether the bill can make it out of the Senate. The conventional wisdom was that moderate Republicans in the upper chamber would never allow such a bill to pass, but the political winds have appeared to shift, and some lawmakers have been appeased by the extra flexibility the most recent revision gives to states. Recent reports suggest the legislation is hardly dead on arrival, though leadership will have to win over a few recalcitrant G.O.P. senators, including Susan Collins, Ted Cruz, Rand Paul, and Mike Lee to pass. (Republicans can only lose two senators from their camp for the bill to fail.)

“Should the G.O.P. health-care bill become law, there is a thin silver lining for Democrats: public opinion is on their side, and it is impossible to continue obfuscating the bill’s effects once they begin to be widely felt. With support for Obamacare at an all-time high and only a small sliver of voters backing A.H.C.A., a successful repeal vote would almost certainly set Republicans up for an electoral Waterloo in 2018 and 2020. The human tragedy that would take place in those intervening years is hard to fathom.”

Robert Reich:

Important background for understanding what happened today in the House:

America has the only healthcare system in the world designed to avoid sick people. Private for-profit health insurers do whatever they can to insure groups of healthy people, because that’s where the profits are. They also make every effort to avoid sick people, because that’s where the costs are.

The Affordable Care Act puts healthy and sick people into the same insurance pool. But under the Republican bill that just passed the House, healthy people will no longer be subsidizing sick people.

Healthy people will be in their own insurance pool. Sick people will be grouped with other sick people in their own high-risk pool – which will result in such high premiums, co-payments, and deductibles that many if not most won’t be able to afford the cost.

Republicans say their bill creates a pool of money that will pay insurance companies to cover the higher costs of insuring sick people. Rubbish. Insurers will take the money and still charge sick people much higher premiums. Or avoid sick people altogether.

The only real alternative here is a single-payer system, such as Medicare for all, which would put all Americans into the same giant insurance pool. Not only would this be fairer, but it would also be far more efficient, because money wouldn’t be spent marketing and advertising to attract healthy people and avoid sick people.


By Abigail Tracy