EXTRA: The American Health Care Act

EXTRA: The American Health Care Act


Leonard Zwelling


For a quick summary, these are pretty good.

The bottom line is rather simple.

First, why do this at all?

Answer, the uncertainty plaguing the insurance markets due to all of the talk about the Republican repeal of the ACA during the campaign and the fact that Mr. Obama is not in the White House to block congressional action, has created great instability in the insurance markets—both individual and ObamaCare-based. Premiums are rising and many players are actually abandoning markets leaving many without access to insurance. In other words this was a self-fulfilling prophecy on the part of the GOP. Partly ObamaCare was not working because it was a flawed solution to the American health care problem. But partly the uncertainty sown by the GOP destabilized the markets making ObamaCare even more untenable.

There’s another reason the GOP is doing this.

The GOP promised repeal and replace if it won. It won. They really have no choice if they are not to be voted out of House leadership in 2018.

Second, isn’t this really mean, cutting the Medicaid coverage of the poor and disabled, not to mention support for the millions in nursing homes, while giving a tax break to the wealthy? Yes, it is. Next..

Third, without the mandate to buy (individuals) or provide (businesses) insurance, won’t only the sick want health insurance and thus drive prices up even more? Absolutely.

Fourth, what’s wrong with tax relief? Nothing, except it is going to the people who need it least.

We shall see by next week if the Republican Senate can line up enough votes (51) to pass this bill. I actually doubt it. I think that senators from red states that successfully expanded Medicaid (e.g., Ohio) won’t go for taking the insurance away from those who newly gained it. There are abortion provisions in the bill that Senator Murkowski from Alaska won’t like. Rand Paul thinks this doesn’t go far enough and so may block it as well. He calls it ObamaCare Light. Even if it does get through the Senate, will it do so before the Fourth of July? I actually think that most senators will want to go home and feel the pulse of their constituents before laying down on the railroad track’s third rail for Mitch McConnell.

Then, even if the Senate version passes, it is not identical to the House version so either the House will have to pass the Senate version or a conference committee will need to be formed. I doubt the latter as these guys didn’t even have hearings on this bill which was probably written by lobbyists, I suspect, although I cannot imagine who. The usual suspects—insurers, providers, large medical groups—all hate this bill.

I recently told my publisher that I thought it was crazy on the Hill when I was there (2009). It’s crazier now. The GOP will in effect cut off its nose despite its face. I also want to see how President Trump blames the Congress when people begin to complain to him about having lost their insurance.

Finally, let me state that I am for this legislation.

What? How can that be?

Because the bill is so bad, it will force the Congress to visit health reform yet again and soon. And when they do, the consensus is growing for a single payer system—Medicare for all.

I leave you with Winston Churchill:

“You can always count on Americans to do the right thing—after they have tried everything else.”

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