In my commentary this past Sunday, I broadly explained why there is no before the Unaffordable Care Act to go back to. Maybe it was too broad, because some Senators and House Republicans are still saying the American Health Care Act does not go far enough on delivering what was promised to the American people.
Republicans promised to repeal the UCA, but they did not say how. The House Republicans came up with a three-phase approach to get as much of the UCA repealed as possible, as fast as they can, while avoiding legislative procedural delays.
If the Republicans do a “clean repeal” with no replacement included in the bill, they subsequently run into the famous Senate filibuster to avoid replacing it with anything, which the Democrats will use to keep the disastrous UCA. Many Democrat voices have said so, because they do not believe the UCA is a disaster.
So I will try to explain this situation a different way!
We started with a building (health care and health insurance) with leaks in the roof. We needed to fix the leaks, but the UCA blew up the building and left it in a pile of splinters:
The health insurance plan you were supposed to be able to keep is gone. The UCA defined it out of existence. Yes, you were lied to!
Many doctors some people were supposed to keep are gone. Those doctors can't afford to see some patients because they were forced onto Medicaid, which pays doctors on the cheap in order to try to save the program money. Yes, you were lied to again!
Competing insurance companies in over a third of the counties in this country are gone. Those counties are down to one insurer. There is no competition so prices will surge.
Some people's jobs are gone. The mandate to provide health insurance, if you had 50 employees are more, forced some employers to reduce their number of employees, because they could not afford to provide the health insurance mandated by the UCA.
Many of the so-called health insurance exchanges are gone. They went bankrupt, and some never even got off the ground. The exchanges were supposed to provide affordable health insurance for people who lost what they already had. It didn't happen, because many people could not afford what the exchanges offered if they could navigate through the bureaucratic forms.
These are the main reasons Secretary of Health and Human Services Tom Price said last week that we can’t just repeal without replacing. People will get hurt and left with no options. That’s because the UCA laid waste to the parts of the old system that were good. Many of them don’t even exist anymore.
So if the Republicans were to do a direct repeal law first, we would be left with a pile of splinters. We have no building to repair! It's gone!
That's why the AHCA is a good start. Some of the favorite features are no mandates, no penalties, repeal of taxes hidden in the UCA, allowing the states to manage Medicaid, and most recently, allowing states that opted for Medicaid expansion to keep it. These features are the exact opposite of what's in the UCA, which has failed miserably.
No one gets hurt with the AHCA, except maybe the insurance and prescription drug companies, who will have to retool their business models again. Building their models around the UCA didn't work.
The American Health Care Act is a great start!
