Long-frustrated Republicans in Congress are on the verge of achieving their most cherished goal: depriving Barack Obama of the signature achievement of his presidency.
How else to describe their breathless zeal to repeal the Affordable Care Act — with no credible replacement in sight, despite relentlessly attacking it for seven years? How else to explain their willingness to risk the health and finances of millions who now have insurance thanks to the ACA, also known as Obamacare?
This isn’t policymaking. This is hyper-partisanship taken to its logical conclusion: Declare a victory for your team with no thought to the real-world impact on the American people.
In Florida, a flat-out repeal of Obamacare would leave an estimated 1.37 million people without insurance, according to ACAsignups.net, a website that tracks ACA enrollments. These poor and working-class people receive subsidies enabling them to buy insurance on a federally backed exchange, subsidies which would instantly disappear.
That number includes nearly 117,000 in Palm Beach County, and another 29,000 in St. Lucie and Martin counties.
In all, more than 25 million Americans could lose their coverage if Obamacare were repealed in full, according to Charles Gaba, founder of ACAsignups.net.
Perhaps luckily, the health care law’s detractors have begun talking about declaring the bill repealed when Trump takes office, but delaying the effective date to some later point, probably — conveniently — past the 2018 elections, and coming up with a replacement, oh, whenever.
Even a delay could do plenty of harm, however. Merely announcing that government support will be ending for the ACA’s insurance markets will shoot jitters through those markets. The “riskiness” of those markets “will have been ramped up to such a level that continuing makes no sense,” says former health-insurance executive J.B. Silvers.
It’s not just poor people who will get hurt if Obamacare were repealed in full. Millions more could have trouble finding health insurance if companies are again allowed to deny you coverage because they say you have a pre-existing condition, be it cancer or acne.
Older Americans, especially those nearing retirement, are especially susceptible. Most of the ideas that Republicans have suggested in lieu of Obamacare — such as a tax credit to help people pay for premiums — would shift costs to enrollees.
People on Medicare would likely face higher deductibles and higher premiums, because Obamacare’s full repeal would cause Medicare spending to jump by $802 billion over 10 years, according to the Congressional Budget Office. Seniors would pay more for prescription drugs, too, because the ACA is now helping close the Medicare “doughnut hole” that raises the cost for medications after a certain level of spending. Florida Sen. Bill Nelson filed a bill last week to prevent Congress from repealing that ACA provision.
To whip up enthusiasm for this destruction, Republicans from Trump on down have railed relentlessly against the “catastrophe” the ACA has supposedly wreaked on the economy. Come again? During the Obama years, unemployment fell to 4.7 percent from 7.9 percent, the Dow climbing close to a record 20,000 points.
Vice President-elect Mike Pence claims the recent election was a mandate to call in the wrecking ball on the ACA. Really? The latest Kaiser Health Tracking poll finds that three-quarters of Americans either oppose repealing Obamacare altogether (47 percent) or want to wait to repeal it until the details of its replacement are known (28 percent). Only 20 percent support repeal alone.
As we’ve said previously, Obamacare has its faults. Too many people are still scrambling to find good insurance they can afford. Premiums are spiking, mainly because too few young and healthy people are signing up. Out-of-pocket expenses are rising. The regulations are tough on some small-business employers.
These flaws could be fixed if lawmakers put their minds to it, and worked across the aisle to make it happen. But it appears that the new Congress and incoming president, after years of demonizing Obamacare, would rather the satisfaction of symbolically smashing it.
While they applaud themselves, millions of Americans will have to deal with the wreckage and hope they don’t get too sick.
In Florida, a flat-out repeal of Obamacare would leave an estimated 1.37 million people without insurance,