But the GOP replacement plan, titled “The American Health Care Reform Act of 2017,” doesn’t reform any of the most pressing issues regarding health care and will end up hurting more than it helps. The AHCA is evidence of how little Republican leaders understand the problems in the American health care system and how out of touch they are with some of their poorest constituents.
The GOP has opposed the Affordable Care Act since its inception. During the crafting of the bill from 2008 to 2010, then-Senate Minority Leader Mitch McConnell lobbied tirelessly to keep all Republican senators against its passage. In an interview with the New York Times in 2010, he explicitly stated he didn’t want the bill to have the added legitimacy of being “bipartisan.”
Not a single one of the 218 Republicans in Congress at the time voted in favor of the bill, and it only made it through because there were exactly 60 Democratic senators, just enough for the bill to pass. After the passage, Republicans proposed bills to repeal the Affordable Care Act more than 60 times during the Obama presidency without success. And President Trump often spoke about his desire to repeal and replace the Affordable Care Act during the campaign. So now that the Republican Party has its chance to make good on this promise, will their proposition change American health care for the better?
Simply put: no, not at all.
While there are many provisions in the AHCA, two stand out as particularly consequential. The replacement does away with the individual mandate, which requires all Americans to have health insurance or pay a penalty. Also gone is the provision of a Medicaid expansion, which provides extra funding to Medicaid to cover those living 138 percent below the poverty line.
The removal of these two provisions alone will leave fewer Americans insured and more at risk than ever. What legislators fail to see is that even keeping popular provisions — like parts of the ACA that prevent denial of coverage due to pre-existing conditions and allowing children to stay on their parent’s plans until age 26 — you need the individual mandate.
Without healthy people paying into the system to offset the cost of caring for the sick, health care will simply be too expensive for those who need it the most. When there are funds coming from everybody, companies have more resources to dedicate to the sick, forcing their insurance costs down.
The Medicaid expansion is also imperative, as health care costs too much for those living below the poverty line. Without the expansion, the neediest would be forced to forego most medical care. And when they inevitably need care, the cost falls back on the hospitals, who pass it on to insured patients.
The results of the repeal of these provisions specifically is that as many as 24 million currently insured Americans will lose their coverage by 2026, according to the Congressional Budget Office. Trump’s rural, working class voter base, in an unfortunate twist of fate, will be affected most. For those with chronic or aggressive conditions, this bill is the difference between life and death.
And those in the health care industry are painfully aware that people need health care to live. Even moderately conservative groups like AARP, the American Medical Association and the American Hospital Association have come out in opposition to the proposed bill.
The good news in all of this is that the AHCA will almost certainly fail to pass. Four Republican senators have already publicly stated they will not vote in favor of the bill. Meaning multiple Democrats would need to support the bill to prevent it dying in the Senate. But the mere fact that the politicians in power right now don’t understand the issues they’re working to fix is incredibly worrying.
This isn’t to suggest that the Affordable Care Act is a perfect bill — far from it, actually. It fails to address the central problem with American health care: corporate interests. As far as the Affordable Care Act is concerned, insurance companies still run the show, and any company’s main motive is to make money.
There are some things that simply shouldn’t be rooted in that profit motive, and health care is one of the biggest. The fact is a full 63 percent of Americans are unable to handle even an extra $500 in expenses, according to CBS MoneyWatch. No one should be forced to choose between health and financial stability.
If the GOP wanted to improve the health care system in America, its replacement plan would need to address these central problems. This plan fundamentally fails to do that, proving that Republican legislators, including our President, don’t even understand what is wrong with the Affordable Care Act in the first place.
Conspicuously absent from this debate has been the idea of a public option, or government-run health insurance. Since government agencies don’t have to make a profit, they can offer much lower prices for better coverage. This would force private companies to lower their prices to remain competitive — and it’s an idea legislators should consider if they really want to make positive health care changes in the country.
If the GOP wants to craft policies with tangible, positive results, they need to start doing their homework. Otherwise, they’ll have quite the reckoning on their hands come next election.
Nick primarily writes on politics and American culture for The Pitt News.