On the campaign trail, Donald Trump repeatedly said that if he was elected president, one of his first orders of business would be to “repeal and replace Obamacare” which he has described as a “disaster” for the American people as evidenced by skyrocketing premiums, unpopular individual and corporate mandates and health insurance companies abandoning the exchanges in droves. The end result was that consumers were left with fewer and fewer affordable healthcare options. The 2010 “Affordable Care Act” which promised that “if you liked your doctor, you could keep your doctor”, turned out to be one of the biggest failures of the President Barack Obama’s presidency. On Monday March 6, 2017, seven years after Obamacare was introduced and just six weeks into President Trump’s administration, the long awaited Republican replacement The American Healthcare Act was unveiled by House Representatives Kevin Brady (R-Texas), chairman of the House Ways and Means Committee who coined the term “Obamacare Gone” and Greg Walden (R-Oregon), chairman of the House Energy Committee.
Secretary of Health and Human Services Tom Price has described the new plan as “patient-centered healthcare”. During a March 7 press briefing with Press Secretary Sean Spicer, Price displayed the new plan against the Affordable Care Act so that those assembled could see that significantly fewer trees had been sacrificed to generate the 123 page plan versus its 2700 page predecessor. Spicer, for his part, made a point of telling the reporters that 57 of the 123 pages were dedicated to repealing Obamacare.
I actually decided to sit down and read The American Healthcare Act (AHCA). Obviously I have read and watched the media coverage and consequently am aware of the bill’s key tenets including the elimination of the individual and the corporate mandates, the replacement of subsidies with tax credits, and the establishment of health savings accounts. I am also aware that AHCA maintains a few key provisions of ACA including coverage for pre-existing conditions and the ability for young adults to remain on their parents’ plans until age 26. The plan also calls for the defunding of abortion service providers including Planned Parenthood.
All of that being said, I am really glad that I took the time to read the plan for myself. I actually enjoyed seeing key parts of Obamacare “repealed” such as $695 individual mandate marked to $0. I also found it extremely helpful to thoroughly read all of the components of the new plan so that I could get better idea as to why the Democrats and some Republicans most notably Senator Rand Paul (Kentucky), Senator Mike Lee (Utah) are already coming out saying that they will be reticent to support it, describing the new bill as “Obamacare Lite” and “Obamacare 2.0”. Several conservative organizations are opposed to the bill including The Freedom Caucus, the Club for Growth and Heritage Action. The liberal media have jumped all over this lukewarm reception. For example, CNN published an article titled “The GOP’s Obamacare Replacement: Dead on Arrival?”
Apparently, the Republicans opposing the AHCA have two primary objections. They are opposed to the tax credits as they perceive them as being extremely similar to the subsidies under Obamacare. The tax credits are based on age whereas the subsidies are based on income. Under the ACA, individuals receive subsidies which are calculated based on their income level in proportion to the cost of the healthcare plans within their state of residence. Individuals who make more than $48,000 do not qualify for any subsidies against their healthcare expenses. Under the new plan, individuals receive tax credits to use against the cost of healthcare with the tax credits increasing with each age band. For instance, an individual under 30, receives an annual tax credit of $2,000 but an individual who is 60, receives an annual tax credit of $4,000. The AHCA caps tax credits to individuals earning up to $75,000 and couples earning up to $150,000. The AHCA offers annual tax credits between $2000-$14,000 for low to middle income individuals. According to the Kaiser Foundation, older low income individuals who live in states with higher premiums like Arizona would receive a greater subsidy under the ACA than the AHCA. Ironically, in 2017 the state of Arizona experienced one of Obamacare’s highest annual premium increases of 116% over 2016. Younger individuals with higher incomes who reside in states with lower premiums such as Massachusetts will receive higher tax credits under the AHCA versus the ACA, which may serve as an incentive for these individuals to sign up for healthcare.
Some Republicans also maintain that the plan is not in keeping with conservative principles in that it temporarily actually expands entitlement programs. For instance, Senator Rand Paul described the plan’s intention to continue the ACA’s Medicaid expansion until 2020 while also adding tax subsidies will be financially “untenable”. Paul also maintains that while the new plan will not directly penalize consumers for not carrying insurance, insurance companies will by charging a 30% premium on insurance to anyone who has been without health insurance for over two months. (Conservatives-balk-at-obamacare-replacement-bill.html) Vice President Mike Pence tried to win over the plan’s detractors within the Republican ranks of congress on March 7 during a closed door meeting. “If you like your Obamacare you can keep it,” Pence told Republicans. “But the American people want change.”
Of course the big issue is that the plan has not yet been scored yet by the Congressional Budget Office or said another way, we don’t know how much it is going to cost. The plan also does not allow for the purchase of insurance across state lines nor does it allow for a reduction in drug costs. President Donald Trump has already sent multiple tweets to address any holes in the AHCA. “Don’t worry, getting rid of state lines, which will promote competition, will be in phase 2& 3 of healthcare rollout”, he tweeted. He also told the American people “I am working on a new system where there will be competition in the Drug Industry. Pricing for the American people will come way down.” But he directed his last tweet on this topic to Senator Rand Paul. “I feel sure that my friend @RandPaul will come along with the new and great health care program because he knows Obamacare is a disaster”
Leonora Cravotta is the Program & Talent Director for Red State Talk Radio, the Co-Host for the Scott Adams Show, a political radio talk show, and a syndicated writer for conservative publications