aside Conservative Republicans First Major Action Will Be The Repeal Of Obamacare

Image result for photo of republicans voting to repeal obamacareOkay, the repeal of Obamacare is the second step after the U.S house republicans attempted to unsuccessfully eliminate the House Ethics Bill and the House’s independent ethics office.

There are conservative republicans who are pushing to repeal Obamacare with a delayed termination, so that republicans can come up with a replacement. This bait and switch con should not be considered acceptable.

While on the campaign trail, the republican President Trump did frequently promise his supporters the following: “I will get rid of Obamacare and replace it with something “terrific” that is “so much better, so much better, so much better.”

On 1/4/2017, Senator Rand Paul stated on the MSNBC TV show “Morning Joe,” that the repeal of Obamacare without a substitute, while retaining the popular parts, would cost American Taxpayers, $20 billion dollars. The senator continued to explain that the insurance companies are already having profits eroded by adverse selection, but this status will become much worse if Obamacare is repealed without immediately being replaced with an alternative.

Vann Newkirk II tells how repealing Obamacare will hurt that segment of rural White Americans who catapulted the republican presidential candidate, Donald  J. Trump into the White House in the 11/22/16 Atlantic article, “Simply Repealing Obamacare Will Hurt the White Working Class:”

“Trump will become president. For the first time in the seven years since  its passage, Republicans will have what they need to repeal the Affordable Care Act.”

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“Trump has made some remarks indicating a full repeal of Obamacare might not be in the cards. But his own repeated campaign promises, the Republican Party platform, and dozens of congressional votes make it fair to expect that most of the law will be repealed or rolled back over the coming months. The three biggest provisions of the ACA—Medicaid expansion to all low-income people, the individual mandate to buy insurance, and the creation of a subsidy-backed private-insurance marketplace—are the most obvious candidates for the axe. Unfortunately for many of the millions of voters who elected a Republican president and Congress, cutting those provisions could place their lives in disarray.”Image result for photo of republicans voting to repeal obamacare

“The full-throated Republican rebellion against Obamacare since its passage was both a rejection of Obama’s policies and a reaction to a dysfunctional health-care system that proved unaffordable to many. Trump has been widely credited for tapping the economic anxiety of many white working-class voters, promising to help them make ends meet and make their lives better.”

But white people who make less than $50,000 annually have derived particular benefit from Obamacare’s provisions, especially in the Rust Belt and in rural, white Republican strongholds. It’s been widely reported that rates of uninsurance dropped more for people of color than for white people in the years since Obamacare was passed, but that’s largely because people of color are generally more likely to fall into lower income brackets, where the Medicaid expansion and tax subsidies had the greatest effect on increasing coverage.”

“When stratified by income, however, it appears that among those whose incomes are less than 200 percent of the federal poverty level—just around $49,000 for a family of four this year —whites actually gained insurance at relatively high rates.”Image result for photo of republicans voting to repeal obamacare

“Data from the 2016 and 2014 current Population Survey Annual Social and Economic Supplement shows that the proportion of uninsured low-income white people dropped by 8.6 percentage points from 2013 to 2015, a reduction that was roughly similar to the decrease among Hispanic people, but which outpaced the national average of 8.1 percentage points, and dwarfed the decrease among black people in the same income groups. Members of the white working class, in other words, were particularly likely to gain coverage from Obamacare.”

“A closer look at some of the states that Trump captured reveals a much more nuanced picture of Obamacare’s role in the lives of low-income white people than his campaign-trail rhetoric might suggest. In the “coal-miner country” of Appalachia, the Affordable Care Act has been vital in shoring up collapsing rural-health systems that have become overburdened with the mounting health problems of their constituents.”Image result for photo of republicans voting to repeal obamacare

“West Virginia, which has been wracked by public-health problems, pollution, and has the most per-capita drug deaths in the country, has had to embrace Obamacare’s Medicaid expansion and subsidies in order to provide affordable healthcare for all those coal miners, other low-income workers, and their extraordinary rates of disease and disability. While premiums for exchange plans have increased by double digits across the state, that largely reflects the cost of covering such a sick pool of rural enrollees, and most people in the state will never see those increases because of subsidies.”

“One of the benefits that these people have lost the most and that has contributed to family economic woes is the employer-sponsored health care. Public insurance—now bolstered by Obamacare—has taken up much of the slack.”Image result for photo of republicans voting to repeal obamacare

“Extending health-insurance coverage is not, of course, a guarantee of affordable or useful healthcare. But the ACA actually does fund several direct public-health initiatives that attempt to address rural America’s deepening health issues. The president-elect has largely neglected these in his scathing analysis, but the law authorizes funding for hundreds of new community-health centers and for sending physicians to long-neglected communities outside of urban centers.”

” While so far, the law’s implementation has been a severe strain on rural hospitals, clinics, and the healthcare workforce that caters to many low-income white patients, that strain has come because millions of people with lifetimes of unmet medical need now have a way to finally get into the system. If the goal is to help these people, that might be a case for expanding the ACA’s coverage and capacity-building measures, not abandoning the attempt.”Image result for photo of republicans voting to repeal obamacare

“All but one of the plans currently in consideration by the congressional Republican leadership, however, would not only diminish Obamacare’s subsidies, but also restrict Medicaid in historically novel ways. The sudden removal of billions of dollars of Medicaid and subsidized private payments to rural health centers, reducing support below even 2012 levels, could be the final blow for many places that are the last lines of defense for America’s whitest communities.”

“Although tax reductions and lower premiums would likely benefit many of the healthiest and youngest adult residents of white America, they would distinctly harm exactly the kinds of vulnerable people that Republicans have placed at the center of their narrative.” According to an analysis from The Economist, the health of a county was the strongest predictor aside from race and education of the likelihood of its voters to switch from voting for President Obama in 2012 to voting for Trump in 2016.”Image result for photo of republicans voting to repeal obamacare

” There might not be causality there, since on a county level, poor health outcomes are strongly associated with rurality, which is itself associated with whiteness, low-incomes, and less education. But the places that suffer the most and have flipped for Trump by the highest margins stand out as Rustbelt counties that have been hit hard by a number of other issues. While Obamacare has not been enough to solve their problems, the plans so far advanced by Republicans restrict federal funding for health crises and public health, as opposed to extending new avenues of coverage, care, and access.”

“The people who desperately need better health-insurance coverage and a more robust healthcare infrastructure among the stereotypical Republican base are black-lunged ex-coal miners in West Virginia who’ve lost pensions and union protections; children with opioid-addicted parents; hard-scrabble farmers who work 100-hour weeks just to rise above the poverty level; and abandoned auto- and steel-industry employees in polluted towns who now need public benefits just to feed their families. If anything, the years of experimentation with Obamacare have indicated that more investment is necessary to protect them. But it appears America will be going the other way.”


    • Dear Kim,

      As long as they are required to come up with an alternative, republicans will learn that there is no easy answer. Here’s the rub. Just getting rid of Obamacare while keeping the popular parts will cost the American taxpayers about $20 billion dollars.

      Hugs, Gronda

  1. Gronda, Republican Congresspeople, Senators and President-elect may want to pay attention to the Kaiser Health Family Foundation monthly survey. Here are the number results:

    Per the Kaiser Health Tracking Poll, the following survey results are germane.
    – 74% of all Americans want the ACA to continue (with 1/2 of Republicans)
    – Of Republicans, regarding specific features of the ACA:
    — 82% like the ability to include adult kids to age 26
    — 77% like the free preventive services
    — 72% like the exchanges and 67% like the subsidies
    — 67% like Medicaid expansion
    — 63% like guaranteed issue and renewability
    Of Republicans, the only unfavorable results are on the employer mandate (45%) and individual mandate (21%). Again, these individual feature results reveal clearly that Republicans like the ACA except for the mandates. I think this gives GOP lawmakers clear indication of what they should consider, yet they should realize and measure the mandate fees help pay for the subsidies. Eliminating them will increase the cost of the subsidies, but improve its appeal.

    Also, it would be nice if more American were aware of the role Republicans played in strangling the ACA. I have written many times about Congress not fully funding the risk corridors for adverse selection to insurers. J.B. Silvers, a former healthcare CEO and professor of healthcare finance at Case Western University, noted in a MarketWatch article, that Congress only funded 12% of these risk corridor payments in an effort to strangle the ACA. So, insurers bore the brunt of higher usage and some had to exit some unprofitable exchange markets.

    This law is working pretty well, but does need improvements. The above is one. We also have data on the states who expanded Medicaid and those who did not – when you look at those, personal bankruptcies declined and hospital receivables improved in states that expanded.

    It would be nice to see a data driven anaylsis of what to do. To your point, Trump bragged on something terrific. So, I guess he is going to wait awhile to tell us what that is.

    • Dear Keith,

      I appreciate so much your feedback and added data like, “I have written many times about Congress not fully funding the risk corridors for adverse selection to insurers. J.B. Silvers, a former healthcare CEO and professor of healthcare finance at Case Western University, noted in a MarketWatch article, that Congress only funded 12% of these risk corridor payments in an effort to strangle the ACA. So, insurers bore the brunt of higher usage and some had to exit some unprofitable exchange markets.”.

      This is one area that requires fixing. Otherwise, the horse has left the barn. Obamacare is more popular than the figures show. Some folks don’t even know that they are getting Obamacare because in some states, it goes by a different name.

      Ciao, Gronda

      • Gronda, you are right. Kentucky residents rank KyNect ahead of the ACA and both ahead of Obamacare. They are all the same thing.

        • Gronda, I saw another interesting tidbit. VP Elect and Indiana governor Mike Pence is leading the fight to repeal Obamacare. Average premium increase in Indiana exchanges is minus 3%. Tell me again governor how this was horrible for your state?

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