Republicans Have No Choice But to Repeal Obamacare -- No Matter the Cost

[babylonsister]

http://prospect.org/article/republicans-have-no-choice-repeal-obamacare-no-matter-cost

Republicans Have No Choice But to Repeal Obamacare -- No Matter the Cost
Paul Waldman
January 2, 2017

After feeding their base's anger for so long, the new Congress has to deliver.

snip//


Now let's get serious for a moment, as we consider what repeal will actually bring—and what Republicans will be wrestling with. First, repealing the ACA would immediately toss well over 20 million people off their health coverage, most particularly the 12 million who are covered thanks to the law's expansion of Medicaid and the nine million who are receiving substantial subsidies to buy private insurance on the exchanges (figures are from Charles Gaba, who tracks these data more comprehensively than anyone). That's not to mention the 52 million Americans under 65 who have pre-existing conditions and would be made vulnerable if the ACA's rule that prevents insurance companies from denying them coverage is repealed. And that's just part of what would happen, from increasing the deficit, to undoing Medicare payment reforms, to removing subsidies small businesses get to insure their workers.

Of course, Republicans say that with their terrific free-market plan (whatever it turns out to be), everyone will do better in the end. That idea happens to be ludicrous if you look at what they're considering, though that's a topic for another day. But even if you accept it, what can't be denied is that their changes will take time, perhaps lots of time, to produce the outcomes Republicans hope for. The idea is that while you and your family might get kicked off Medicaid now, once the Republican reforms work their free-market magic, insurance will become cheaper and cheaper, to the point where you'll be able to afford it even on your $20,000 salary.

So even in the best of circumstances, there would a positively gargantuan amount of short-term suffering and eventually, perhaps, things would work out for the best. That suffering will play out in very visible ways, with horrifying stories reported in the media of families losing their coverage. Just wait until we hear about people dying—and make no mistake, people will die—when they can no longer access health care.

And the Democrats who have had such trouble defending the ACA in all its complexity will find themselves with a new political and rhetorical focus as they attack Republicans' plan to unleash chaos on the American health-care system. The political dynamic of health care in the last few years, in which the president's party gets the blame for anything that goes wrong in the system, whether it was their doing or not, will now work against Republicans. They'll probably try to say it's really Barack Obama's fault, but with complete control of government, and with years of promises of how great things would be once they got their paws on the health-care system, no one will believe them. And as Republicans know well, it's a lot easier to attack something than it is to propose your own complicated solution.

I have no idea what Republicans in Congress are saying to each other in private as they contemplate the catastrophe they're about to initiate. Perhaps they genuinely believe that with some health savings accounts and high-risk pools, they really can create a health-care paradise and Americans will reward them for their benevolent genius. Or perhaps they think they can win the spin war, no matter how many Americans suffer once repeal takes effect—though their own actions suggest they don't think so, given that they seem to be leaning toward a "repeal and delay" plan, where they repeal it now but delay the irepeal's mplementation until after the 2018 midterms—or even the 2020 presidential election.

Or perhaps—and this is what's most likely—McConnell and Ryan are fully aware of the repeal's political danger and the ghastly toll it will take on people's lives, but they feel they have no choice. After saying since 2010, when the law passed, that it's the most vile tool of statist oppression since Stalin's gulag, and after holding 60 votes to repeal it, and after saying again and again to their base that they'd set it aflame and stomp on the ashes the instant they could, they can't possibly avoid repeal. Keep in mind that these leaders have spent that entire time terrified of their base and the Tea Party extremists in their own caucus. When that base called them cowards and appeasers, their response was "We're right with you, but what can we do? Until we get a Republican president and a Republican Congress, we can't kill Obamacare. But make sure you keep hating it with all your might until that glorious day arrives."

Well now that day is here, and they have to deliver. And they can no longer blame anyone else for the harm they do.

[Mika]

1. The republican electorate's response ...

... let them die.

[SharonAnn]

3. A Health Savings account is of no use to someone with very little income.

[CousinIT]

4. Not really. Most Americans (even stupid Trump voters) don't want ACA repealed

Or cut in any way. Most want it tweaked - biggest complaint is high deductibles & copays.

[zipplewrath]

5. They'll make it easy on themselves

I predict that they'll "repeal" it, but that the repeal won't kick in until some time in the future. That will leave them years to actually change anything but they can always claim that they repealed it.

And quite honestly, I suspect the "early" changes will be fairly mild. They'll probably keep the most popular features, but get rid of the mandate. They'll probably ultimately fund the exchanges through block grants to the states. The one problem they'll ignore is that currently the ACA is saving the Federal Government a lot of money. Hard to see how they'll sustain that aspect since it involves some taxes, that they'll surely want to eliminate.

[lark]

7. It's going to immediately crumble if they do this, as planned by Repugs.

Insurance companies only played ball because of the requirement for everyone to have coverage. With this bastardized product, and no individual mandates, they will bail immediately and there will be few - no choices left within a year or two. That's what the Repugs plan to do, say the plans were a failure (because they deliberately destroyed them during the "phase-out" period). Then they will allow tax deductible unlimited medical savings which will be a great help to the already wealthy but do nothing for the working poor, and allow insurance sales across state lines with no guidelines for actually providing coverage and the working poor will be paying for nothing that would really help them, then people will start dying and they will blame Obamacare, because, well they think they can lie with impunity, like their fuhrer.

Of course, they will also destroy Medicare and SS along with ACA.

Our only hope - rise up and make a huge noise, and even that's a thin hope when Repugs care nothing about us.

[uponit7771]

8. If they kick any of the three legs from the stool o -care falls

[csziggy]

11. One of the discussions over the weekend said if they repeal it immediately

Nothing will change until 2018, maybe the end of 2018. The budget for this year is already in effect, and insurance companies and people are already committed to contracts that rely on the subsidies for payment.

Not sure which channel or what show that was on - mostly I've been avoiding the cable news channels and I wasn't really paying much attention.

ETA - Just now one of the guests on MSNBC said the current budget runs out in March 2017 so I was wrong about that. One thing that would absolutely enrage people is if the Republican Congress repeals the subsidies and people are still contractually obligated to their policies with no means to pay them. But the insurance companies will be pissed if they lose millions of customers at the whim of Congress - of course they also don't want customers that are unable to pay the premiums.

[Historic NY]

6. The 61st time will be the charmer.............VICTORY

over Obummercare..... They will all be high fiving and chest bumping.

[Girard442]

9. How much will people dying from lost healthcare hurt the Republicans...

...if the press doesn't cover it?

They'll be too busy breathlessly reporting the latest battle in Lower Shitholistan.

[MineralMan]

10. They'll probably punt until 2018.

Leave the subsidies in place and much of the rest until after the 2018 election. They can "repeal" the ACA formally, while leaving whatever they want to leave in place to avoid widespread alarm that might cost them votes in the mid-term elections.

That's what I expect.

[Yo_Mama_Been_Loggin]

12. K&R