It happens that in the weeks since first approaching Salem Weekly about submitting current issues columns, the stumbling, fumbling attempt of House Republicans and the Trump Administration to replace Obamacare has faded into the background.
Had the House bill passed this probably would have been about how terrible and inequitable it was. But it was yanked out of sight, so that raises the question of what Obamacare supporters should do next.
Any glee over the bill’s failure, any satisfaction over unmasking of how it benefited the younger healthier, and wealthier over the older, sicker and poorer, ought be short-lived.
Republicans are still seeking votes and Democrats can’t afford to confine themselves to just defending Obamacare while Trump and the GOP Congress are in position to sabotage it and run against it again in 2018.
It’s time Democrats countered by offering a plan showing how the Alternative Care Act can be fixed rather than be replaced by the draconian Republican alternative.
A state agency analysis estimated the House replacement bill would mean an increase in uninsured in Oregon from five percent to 15 percent, create a $2.5 billion state budget hole and put 23,000 health care jobs at risk.
The Oregon Center for Public Policy estimated nearly one million Oregonians would go uninsured or suffer higher costs and the state could lose up to 41.8 percent of federal funds for the Oregon Health Plan.
Rural hospitals would be hit especially hard and nearly one-third of residents in Oregon’s rural counties rely of the OHP.
A bullet dodged, but a gun still loaded. Republicans will keep trying because they need the bill for their tax reform. They’re counting on reductions they propose in federal health care assistance to those who need it most to help finance the tax cuts for corporations and higher income brackets.
They don’t have their bill yet, but they can make Obamacare, as Trump put it, “explode.”
Trump ordered federal agencies to relax Obamacare regulations. The IRS responded by saying it won’t reject tax returns that don’t include information needed to enforce the health care mandate critical to making the ACA work. Toward the end of the 2017 sign-up period, his administration pulled advertising and outreach efforts to increase participation.
The biggest threat comes from withdrawing funds for additional support for the poorest enrollees who qualify for reductions in out of pocket costs like deductibles and copayments. These payments go to insurers rather than the policy-holder.
The Obama administration asserted these payments didn’t require Congressional appropriation because they are permanently required. However, House Republicans filed suit and won a lower court decision declaring the funds can’t be distributed because they weren’t appropriated.
The Obama administration appealed, but Trump can now simply abandon that appeal. Or, Congress could refuse to fund it. Nearly 60 percent of the some 10 million using the health care exchanges receive this assistance. Stopping it would cost insurers an estimated $5 billion a year and could cause a mass exit from the market.
The Congressional Budget Office expects ACA health care markets to stabilize and Democrats keep saying there are ways, including a public option offer, to fix what ails Obamacare.
The negative reaction to the House bill created an opening. Sooner or later Democrats will have to offer their own solutions in order to hold the president and the GOP Congress accountable for any subsequent efforts to undermine the Obamacare effort to provide health insurance for all.