Today, the House of Representatives is scheduled to vote on the American Health Care Act, the Republican leadership’s first step to repeal and replace the Affordable Care Act, more commonly known as Obamacare. The AHCA has been harshly criticized by many on the left and right, and has become a target for op-ed writers at publications across the country, including The Cavalier Daily. In order to fairly evaluate the AHCA, we need to recognize the current problems with Obamacare, as well as view this legislation in the proper context — as a first step to fixing the health care system in the United States.
First, let’s examine the Affordable Care Act. As a gargantuan, 906-page document written in Harry Reid’s office on Christmas Eve was jammed through Congress in a “pass it so you can read it” fashion, Obamacare promised a health care system with lower premiums and more choice. Furthermore, President Obama calmly reassured voters on 37 separate occasions that “if you like your plan, you can keep your plan.” This performance by the president was worthy of an Oscar, but instead won Politifact’s “Lie of the Year” for his blatant deception of the American people. Premiums across the country soared by 69 percent between 2013 and 2015, and a study from the well respected Brookings Institute found that 24.4 percent of this spike was directly attributable to Obamacare. Choices have contracted to the point where one in five consumers have only one healthcare provider to buy plans from. With no alteration to the current law, premiums are expected rise an additional 25 percent on average in 2017.
Obamacare’s main claim of success is that more people than ever are “covered” by health insurance, but the way in which this was done is immoral, arrogant and unacceptable. By using an individual mandate, government penalizes or fines those who do not choose to buy health insurance. Let’s examine the implications of government being allowed to use this power. The current law calls for everyone to buy into these great Obamacare plans, so much so they’re going to force you to, and if you disagree you pay a fine. By deeming this constitutional — which by any rational calculation it is not — the Supreme Court in a 5-4 decision created a precedent where Government can fine people who don’t buy electric cars because they’re better for the environment, gym memberships because exercising is healthy and Kale because it’s better for you. So when Democrats say Obamacare “covers” more people than ever, what they are really saying is Obamacare immorally coerces more people into buying health insurance plans which are more expensive, cover less and have less choice.
Riddled with problems, it is clear Obamacare needs to be repealed and replaced with a better system. This is where the AHCA comes in, and why it is important to put this specific legislation into the context of the larger repeal-and-replace plan. The AHCA is special in the fact that it is being done as a Reconciliation Amendment to the Budget, and therefore can not be filibustered in the Senate. Because of this rule, it only needs the support of 51 — or 50 plus Vice President Mike Pence — Senators instead of the 60 needed on most legislation to prevent a filibuster. At the same time, reconciliation limits what can be put into this bill, so the AHCA is only the first step towards fixing our healthcare system.
The AHCA repeals the immoral individual mandate, as well as many of Obamacare’s flawed subsidies and taxes. At the same time, it would start re-distributing federal Medicaid money to the states on a per-capita basis so it can be more effectively used.
The AHCA would also create a refundable tax credit which families can use in order to purchase health care. This tax credit has been heavily criticized as a windfall for the wealthy, as it only takes family size and age into consideration when deciding the size of the tax credit. Another problem with many of Obamacare’s subsidies is they often don’t incentivize work. As lower income individuals find higher paying jobs and promotions, they out-grow their subsidy under Obamacare. They then have to choose whether they want a better job or decline to take a higher paying job so they could keep their subsidy and health insurance. The new tax credit doesn’t force those attempting to live the American Dream to compromise, and is capped for very high incomes, so we aren’t subsidizing millionaires buying healthcare. In addition, the AHCA gives $100 billion to the states in order to help provide healthcare to those with lower incomes, and creates healthcare savings accounts to further aid individuals in buying health insurance.
When the Congressional Budget Office released there scores of the AHCA, the results stated that while the AHCA would save government $337 billion over 10 years and lower premiums by 10 percent by 2026, it would result in 24 million more people being uninsured as well. Again, it is incredibly important to remember that this CBO report is measuring only one-third of the Republican repeal-and-replace plan. Important provisions, such as the ability for insurance companies to compete across state lines, can be passed in future legislation. This provision would dramatically increase choice and competition of health care plans for customers, drawing millions of people back into the healthcare market. Furthermore, the CBO cites the repealing of the individual mandate as the primary reason for the spike in the uninsured. Part of the reason more people are not buying insurance is because government will no longer immorally force people to buy health insurance. Putting the CBO report into the appropriate context is essential to understanding the AHCA.
In short, Republicans can all agree Obamacare needs to be repealed and replaced, and they all ran and were elected on the promise to do so. While we may have different ideas on how to properly implement some aspects of healthcare reform, we can all agree something needs to be done now. The AHCA and reconciliation represents the best and perhaps only chance for these legislators to keep their promise. If Republicans have any alternative plans which can pass on reconciliation, the country would be glad to hear them. If Democrats have any practical ideas on how to fix their health care mess, they should let us know. While the AHCA may not be perfect or complete, it remains the most viable option to improve our healthcare system at this time.
Adam Kimelman is the incoming Chair of the College Republicans.
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