Even GOP Governors and Lawmakers Want Repeal Efforts to Slow
As the Republican led Senate voted along party lines last week to take the first step toward repealing the Affordable Care Act, commonly referred to as Obamacare, opposition to a repeal has been building including among some prominent GOP lawmakers and governors. The 51-48 vote was a procedural motion to start Senate debate for a budget resolution that could result in overhauling the law. Broader based legislation to repeal and replace Obamacare would require 60 votes in the Senate, and the GOP doesn’t control enough seats to make that happen or to stop a filibuster by Democrats. However, a budget resolution only requires a simple majority to pass. The vote came after both President Barack Obama and Vice President-elect Mike Pence traveled to Capitol Hill to garner support from their respective parties on the issue.
Tennessee Republican Senator Lamar Alexander, prominent chairman of the Senate Health Committee, has publicly stated his position that it would be a mistake to repeal Obamacare before the GOP is able to craft a replacement. Another Republican, Kentucky Senator Rand Paul broke with the party, becoming the only Republican to join with the Senate Democrats in opposition.
A spokesperson for Sen. Paul told NCRM Thursday, “The Senator did not support the legislative action as it did not address the greater issue of balancing the underlying budget.â€
Not withstanding Alexander’s concerns, in a written statement to NCRM that reiterated his public statement earlier in the week, Senate Budget Committee chairman Mike Enzi (R-WY) said that Republicans are committed to fixing what the GOP sees as a “broken” national health care system.
“Americans face skyrocketing premiums and soaring deductibles,” the Wyoming Republican said. “Insurers are withdrawing from markets across the country, leaving many families with fewer choices and less access to care than they had before – the opposite of what the law promised.”
Enzi did not note that since the inception of Obamacare Republicans have rebuffed attempts by Democrats to tweak portions of the health care law.
The problem that confronts Congressional Republicans is finding and enacting a suitable replacement for the healthcare law, which they initially claimed was unnecessary before it was signed into law in 2010. Democratic House Minority Leader Nancy Pelosi, (D-CA) speaking to reporters during a news conference Wednesday, said that the GOP may not have enough votes for a replacement to the law.
“They don’t have the votes for a replacement plan,” Pelosi said. “So to repeal and then delay is [an] act of cowardice.”
The lack of a suitable replacement plan to replace the present law has long bedeviled GOP lawmakers. President Obama indicated he would consider an endorsement of a repeal, provided that the Republicans can come up with one, and then convince him theirs is a better plan.
“If they can show that they can do it better, cheaper, more effective, provide better coverage, why wouldn’t I be for it?†Obama told web based Vox media Friday. “If in fact there is going to be a massive undoing of what is one-sixth of our economy, then the Republicans need to put forward very specific ideas about how they’re going to do it.â€
The President also urged debate comparing any Republican replacement to the current law.
“I am saying to every Republican right now, if you in fact can put a plan together that is demonstrably better than what Obamacare is doing, I will publicly support repealing Obamacare and replacing it with your plan. But I want to see it first,†he said.
Former GOP presidential candidate, Ohio’s Governor John Kasich also cautioned Congressional Republicans lawmakers against repealing the law without a replacement.
“There’s room for improvement, but to repeal and not to replace, I just want to know what’s going to happen to all those people who find themselves left out in the cold,†Kasich told reporters Wednesday, according to an audio file provided by the Governor’s Press Office.
Kasich’s office said Friday that more than 700,000 Ohioans have gained coverage from the Medicaid expansion under Obamacare. In his remarks, the Governor specifically mentioned those constituents;
“Let’s just say they got rid of it and didn’t replace it with anything, what happens to those 700,000 people?†Kasich said. “What happens to drug treatment, what happens to mental health counseling?â€
He also took aim at Republican plans that have been floated to replace the law, noting that there are still no details about a proposed tax credit to help people afford coverage as part of a replacement.
“Now there’s some talk that they would have some sort of a tax credit, OK, well how far does that go?†Kasich said. “There’s a lot of details to be worked out. It’s a serious matter.â€
Kasich is not the only GOP governor who supports keeping the healthcare law. Michigan’s Governor Rick Snyder has also recently been an Obamacare proponent telling the Detroit News, “I hope they carefully look at the success we’ve had in Michigan.â€
Tennessee’s other Republican Senator Bob Corker, who chairs the Senate Foreign Relations Committee, also advised caution as he spoke with reporters Friday morning at a Christian Science Monitor breakfast in Washington.
“[It] would be best for our country to go ahead and replace it with something that works and repeal at the same time,” he said.
Corker also urged Democrats “to come to the table to work on a deal on a replacement, including swapping out the employer and individual mandates with auto-enrollment and giving governors more flexibility on Medicaid.â€
Pulitzer Prize winning journalist Tina Rosenberg, a former editorial writer for The New York Times, wrote in an op-ed piece published last week:
“Most endangered are the insurance provisions that have brought coverage to 20 million people. Among them are Medicaid expansion and the requirement to buy insurance — without which the market would collapse.
“The A.C.A. is more than insurance. As the Times reported Monday, the law is leading a transformation of America’s health care system. It’s a change that nearly everyone, Republicans and Democrats, agrees is desperately needed — and for it to happen, the relevant parts of the A.C.A. must be preserved.
“The transformation moves health care away from a fee-for-service model, which pays doctors and hospitals according to the number of procedures they do, toward value-based care, which pays based on what helps patients get better.”
Rosenberg also noted:
“Fee-for-service care encourages providers to do more and do it more expensively. The result is uncoordinated care that does not attack underlying health problems and comes at an enormous cost. Health care now accounts for around 18 percent of America’s gross domestic product. It is pushing state and local governments into near-bankruptcy and neutralizing workers’ raises. And as the first baby boomers are hitting 70, things will only get worse.â€
A senior White House official told NCRM that one of the other obstacles confronting Republicans is now that repeal is a distinct possibility, people are becoming more aware of “the real world impacts†that losing the healthcare law’s coverage will have on them and their families. Echoing a long held belief by some political pundits as well as Washington policy makers, he stated, “Before the election the press ignored the real consequences of repealing Obamacare and now is going to have to play catch up to properly inform the public.â€
“Let’s look at the largest demographic of the population that will be most adversely affected by repeal – senior citizens,†he said adding, “who voted in large numbers for Donald Trump and the GOP.â€
“For the over 57 million senior citizens and disabled Americans who have been covered under Obamacare, and who are currently paying $700 less in premiums and cost sharing than they would without it, they’re looking at higher premiums, deductibles and cost-sharing. But where it really hits them in their wallet is that “the Donut Hole†will be back. This was a factor after a person had exceeded their ‘specified coverage’ and were 100% responsible for the cost of their medications.â€
Using the examples of expensive medications such as those for cancer, heart disease, etc., he pointed out that nearly 11 million seniors and disabled had saved more that $2100 a person for those drugs under Obamacare. He then added that screenings for breast cancer, colon cancer, heart disease, diabetes, which are currently covered at no cost, will revert to an out-of-pocket expenditure, which in many cases of fixed or lower income persons would be cost prohibitive.
Besides of those “people” factors, GOP lawmakers need to consider the fiscal cost and drain to the federal budget, he added.
“A full repeal of Obamacare will cost approximately $350 billion over the next ten years,†he said. “When the Affordable Care Act was first enacted it didn’t add to the federal deficit instead it actually boosted revenues slightly.â€
The current law affects the federal budget in three ways, as CNN Money reported last week:
“Coverage provisions, which include the individual and employer mandates, subsidies and Medicaid expansion.”
“Taxes and fees levied on high-income Americans, insurers, providers and others, as well as the Cadillac tax on high-cost insurance plans.”Â
Finally, the “Medicare components, such as slowing the growth of provider rates and lowering payments to Medicare Advantage insurers.”
According to the bipartisan Committee for a Responsible Federal Budget, removing all three components would blow a hole in the budget even before the GOP come up with a replacement plan, which would also then need to be funded.
The American Medical Association, one of the most powerful lobbying groups in Washington, has also spoken out in a letter to Republican leaders urging them to take a different approach.
“Policymakers should lay out for the American people, in reasonable detail, what will replace current policies,†the letter reads. “Patients and other stakeholders should be able to clearly compare current policy to new proposals so they can make informed decisions about whether it represents a step forward in the ongoing process of health reform.â€
The person who will ultimately decide how quickly and in what form Obamacare repeal and, possibly, replace, comes, is Senate Majority Leader Mitch McConnell (R-KY) (photo). Sen. McConnell on Sunday said, “There ought not to be a great gap” between repeal and replace, but would not define just how long Americans will be without coverage.
Brody Levesque is the Chief Political Correspondent for The New Civil Rights Movement.
You may contact Brody at Brody.Levesque@thenewcivilrightsmovement.com
You can respond directly to Mitch McConnell by sending your comments to him on Twitter: @SenateMajLdr and @McConnellPress. He is on Facebook, and his office information can be found here and here. You can also call the US Capitol switchboard at (202) 224-3121 and ask for any Senator including Sen. McConnell.
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