If Republicans repeal Obamacare, 
they have to own the consequences

Colorado Republicans gleefully joined their colleagues in the House and Senate to celebrate the imminent demise of the Affordable Care Act (Obamacare) when they convened in January. But to their surprise, they, like their leader President Donald Trump, have come to discover that health care insurance is not simple.

Surely the Republicans should know that. They have voted at least 62 times to repeal all or part of the Affordable Care Act. Of course, they never had to face the reality of what they would replace it with, because they could be sure, even if they got a bill through Congress, President Obama would veto any repeal they passed.

Things changed almost immediately after the election. Trump promised to repeal and replace the Affordable Care Act “simultaneously.”  Even if that is feasible, the immediate problem for Trump and the Republicans is that they have no plan for the “replace” part of the program.

Nevertheless, two Republican-dominated House committees with little consideration or debate quickly moved forward with repeal votes along party lines two weeks ago. On Thursday, the entire House will vote on the Republican plan to repeal the ACA.

It would be simple enough for the Republican majority to push through a repeal of Obamacare, but they face the problem of replacing Obamacare with, as President Trump would say, “something better.”

So far they are not doing so well on that score. With the bill to repeal Obamacare scheduled for a vote on Thursday, Republicans appear divided among themselves, especially on the “replace” part of the proposal.

Failure to replace the benefits of Obamacare will deny health care to up to 24 million Americans over the next decade — beginning with 14 million losing their health care in the first year. This disruption is too much of a jolt to the system for moderate, or even some far right, Republicans.

According to a report by the Colorado Health Institute, nearly 600.000 Coloradans are likely to lose Medicaid coverage and become uninsured by 2030 under the most recent Republican proposal to repeal and replace the Affordable Care Act.

And that is the moderate Republican version. The right-wing Freedom Caucus would make the cuts to Medicaid even more radical, and more painful to the poor by entirely terminating the subsidies Obamacare provided to help low-income people purchase insurance,

Under the Republican plan, the Congressional Budget Office calculated that a 65-year-old with an income of $26,500, who would pay $1,700 in annual premiums under Obamacare, would see premiums rise to $14,600 under Trumpcare — more than half of the total income of that person.

The push to cut more people from the Medicaid rolls is beginning to worry some Republicans, including Colorado Sen. Cory Gardner. Gardner joined with three of his colleagues in the Senate to express concern with the House plan in a letter to Senate Majority Leader Mitch McConnell, R-Kentucky.

“While we support efforts to repeal and replace the Affordable Care Act and make structural reforms to the Medicaid program, we are concerned that the Feb. 10 draft proposal from the House of Representatives does not provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states,” the letter states.

“We believe Medicaid needs to be reformed, but reform should not come at the cost of disruption in access to health care for our country’s most vulnerable and sickest individuals.”

The letter concludes, “We will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states.”

With Republicans in the House planning a vote on Thursday, the fate of the bill is still uncertain. House supporters are still working to assure they have the 218 votes necessary to pass the bill. Even if it passes the House, its future in the Senate is very uncertain.

“Repeal Obamacare!” was a good slogan for Republicans during the last election, but if they foolishly reject the Affordable Care Act simply to fulfill a campaign promise, they will own the consequences as thousands of Coloradans lose their health care coverage.

We will see the consequence of that decision in 2018.

Bill Grant lives in Grand Junction. He can be reached at .(JavaScript must be enabled to view this email address).


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