The Republican health-care challenge
It’s beginning to look like Republicans in Washington, DC are coalescing around the repeal and replacement of the Affordable Care Act (ACA) at essentially the same time, rather than pursuing a repeal-and-delay strategy.
On January 18, newly-elected Congressman John Faso, who represents Sullivan and parts or all of 10 other New York State counties, said in a radio interview that he did not think constituents would take kindly to repealing the healthcare law without having a replacement ready to go. He said the people who currently have coverage would not be “tossed under the bus.”
He said one of the features he wants to have implemented in a replacement plan would be “creating the ability of small businesses to once again band together to create association health plans, which were banned by the ACA. This is a very, very good thing for small businesses, and as you probably know in our district, most of the people who work for the private sector work for small businesses.”
He also criticized the ACA, saying, “The biggest problem with the ACA is, as you may recall, we were promised that if you liked your health plan, you could keep it. Politifact, an independent news organization, back in 2013 declared that ‘the lie of the year,’ because they said there were tens of millions of people that could not keep their existing plan because of the requirements of the ACA.”
That’s absolutely true. In fact, here at The River Reporter we were not able to keep the policy we had before ACA was fully implemented because our policy offered no mental health coverage. But, as it turned out, we were able to get a new policy that included mental health coverage for about the same price as our old policy, so for people insured at this small business in Sullivan County, ACA worked out well.
There were several important changes to all policies that came with ACA. Under the law, insurers are prohibited from denying people coverage because of pre-existing conditions, and children are allowed to remain on their parents’ policy until age 26. Like most politicians, Faso said he supports these provisions.
But there are many other laudable provisions. All health plans must now offer a large number of preventive treatments and services, such as yearly check-ups and other screenings at no additional cost.
Also, insurance companies are no longer allowed to place lifetime or annual limits on the amount of healthcare a person would receive.
Further, if a health insurance company wants to raise premiums by more than 10% in any given year, the increase must undergo federal review, and if insurers spend less than 80% of the premium revenue on actual health care (85% for group plans) ACA requires the insurer to refund the balance to the insured.
Also, if a person makes a minor error on paperwork when signing up for healthcare, insurance companies may no longer use that error as an excuse to cancel a policy.
It’s not clear if Republicans in Washington will keep any or all of these provisions, but they all benefit the public and they would not have been possible without the subsidies provided by the ACA.
Republican President Donald Trump and members of the Republican-controlled House and Senate have not talked about raising any revenues for the federal government. In fact, it appears that Trump, specifically, is looking in the opposite direction. According to the Tax Policy Institute, the tax plan Trump put forward in the campaign would decrease federal revenues by $6.2 trillion over 10 years.
So, when the Republicans repeal and replace ACA, will they be willing to infuse the healthcare system with more funding? Without it, they are setting themselves up to fail.
Trump has said under the replacement plan everyone will be covered. Other Republicans have said everyone will have “access,” but access is not the same as coverage and we still don’t know the details of any of the replacement plans under development.
Republicans now control the White House, the House and the Senate. If they come up with an ACA replacement that covers fewer people, offers fewer benefits or causes an increase in the cost of healthcare beyond what the increase would have been under ACA or Obamacare, they will have failed.
And we cannot afford them to do that. Contact your representatives and tell them these provisions work.