Sunday, January 22, 2017
Like a dog chasing a car, the GOP has been barking about repeal of the Affordable Care Act (ACA, or "ObamaCare") for years, but now that the dog has caught the car, the Republicans have no idea what to do. They don't know how to repeal the ACA, and moreover, they don't even really know why they want to repeal the ACA. Do they want to go back to allowing insurance companies to deny coverage for pre-existing conditions? Or do they want to go back to allowing insurance companies to have lifetime caps? ("Sorry you need that life-saving medicine, but you've hit a lifetime cap so we're not going to pay for it anymore.") Maybe it's the part about allowing parents to cover their children up to age 26 that they want to eliminate? Or maybe they want to go back to the Medicare "donut hole", so that seniors might be on the hook for thousands of dollars in medication costs? Do they hate that more than 20 million people who previously couldn't obtain insurance now have coverage? Or that states are saving hundreds of millions of dollars in uncompensated care because fewer uninsured people are using emergency rooms as last resorts? Maybe they don't like the primary care coverage, which helps reduce costs in the long run? Or maybe they don't like the mental health and substance abuse treatment coverage, that allows people to get into rehab programs rather than just showing up at the hospital when they overdose. (And note to the smug morally superior folks who might think substance abuse is a problem for "those other people": google "opioid epidemic".) Pretty much every feature of ObamaCare is popular when people are surveyed about it. When it comes down to it, the only thing people truly hate about ObamaCare is the name. Here's a pro tip for members of Congress: Americans don't really hate ObamaCare, what they really hate is disruption in their health care. If over 20 million people lose their insurance because the ACA is repealed, and if millions more lose benefits they currently have from the ACA, those people are going to blame this Congress. You break it, you own it.