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Repealing Obamacare

Thursday, 9 March 2017

by Erin McAllister, Paralegal

House Republicans introduced a bill that would scrap Obamacare's individual mandate, a major pillar of the law, replacing it with refundable tax credits for individuals to purchase health insurance. It would also restructure Medicaid and defund Planned Parenthood. The American Health Care Act (“AHCA”) is not the complete repeal of Obamacare that was promised to voters; hence the new name - Obamacare Lite.

The AHCA would repeal the unpopular fines on people who don't carry health insurance. However, it includes an inducement to stay insured in the form of a 30% surcharge on a year’s premium for anyone who drops their coverage or allows it to lapse, then seeks to re-enter the market. The AHCA would have a refundable tax credit to help pay for the insurance and some see this as just another entitlement or government program. Those on the other side of the aisle see it as a way to keep the most marginalized individuals in the program. The AHCA would replace income-based subsidies the current law provides to help millions of Americans pay premiums with age-based tax credits that may not provide the same advantage to people with low incomes. Those payments would phase out for higher-earning people.

The AHCA keeps the extremely popular provisions barring insurance companies from discriminating against people because of their preexisting conditions and forces them to continue allowing young adults to stay on their parents’ plans until they’re 26.

The AHCA would restructure the country's Medicaid program so that states receive a set amount of money from the federal government every year -- experts warn this change could result in millions of people losing access to insurance they received under Obamacare.

Others argue that universal healthcare belongs in the bailiwick of individual states. Since the make-up of residents of individual states varies in size, age, and wealth, to name just a few, it is argued that individual states and their legislatures would be in the best position to create insurance programs that would meet the needs of their constituents.

If human behavior under Obamacare is any indication, many people will wait to purchase insurance because they “aren’t sick.” They are young and invincible, the exception to the rule. Taking a chance and remaining uninsured has always been potentially dangerous, but the new healthcare act could make it more appealing to do so because there is no incentive for them to start paying premiums. Having such people remain outside the insurance pool would raise costs for everyone else. When people remain outside the health-care system until they are older and sicker, the practice of medicine changes from preventive to reactive. It becomes more difficult for doctors to keep people healthy and raises costs across the board.

At least four Republican senators have voiced concerns with the new healthcare bill. Republicans have just a 52-48 majority in the Senate, so the loss of four votes would doom any legislation. GOP leaders can find a narrow path to passage if enough of their members simultaneously accept legislation that falls short of full repeal while embracing the argument that more consumer choices, lower taxes, and less government involvement is worth the tradeoff of covering fewer people. If the initial reactions are any indication, however, that middle ground may be shaky.

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