Conservative members of Congress should vote “No” on the American Health Care Act — the House Republican “Obamacare replacement” bill — unless major changes are made. Those who have already pledged to vote against it deserve thanks from the American people.
Thursday marks Obamacare’s seventh birthday, a date that for years Republicans have acknowledged by pointing out the law’s canceled health plans, higher premiums, and countless other broken promises. Thursday is also the day Speaker of the House Paul Ryan has scheduled a vote on legislation that is intended to replace Obamacare, but simply fails to address its biggest problems.
For years, Republicans across the country ran on a promise to repeal Obamacare. They made healthcare issue number one, and voters responded in kind with massive waves that gave Republicans control of the House in 2010, the Senate in 2014 and the White House in 2016.
But now, finally given the opportunity to end Obamacare’s nightmare of canceled plans, higher costs and federal control once and for all, Republican leadership is pushing a bill that maintains its most harmful elements.
While the American Health Care Act makes some productive changes such as repealing the individual and employer mandates and expanding health savings accounts, it also replaces one entitlement with another, preserves Obamacare’s “Cadillac tax” and “essential health benefit” mandates, and keeps the unaffordable Medicaid expansion open for nearly three more years.
The GOP bill’s refundable tax credits are nearly indistinguishable from Obamacare’s subsidies. Like Obamacare, the GOP’s $300 billion entitlement provides a direct payment to mask the cost of premiums. While this helps consumers in the short run, it does nothing to reduce the actual cost of health insurance or healthcare and merely shifts the burden to taxpayers.
The Republican legislation also preserves Obamacare’s Cadillac tax that has been delayed in the past. Republicans have promised to repeal all of Obamacare’s tax increases, but maintained this one simply as a budget gimmick.
While both of these provisions are disappointing, they pale in comparison to AHCA’s lack of action on Medicaid expansion and insurance regulations.
Medicaid expansion is the single most expensive piece of Obamacare. It has deepened the debt, crowded out state budgets, and worsened access to care for the most vulnerable Americans for whom Medicaid was intended. While moving to a block grant is a welcome reform, AHCA keeps the inflated federal match rate for Medicaid expansion open through 2019 for states that have already expanded.
This incentivizes states to grow Medicaid enrollment as much as possible before then to increase federal funding, and punishes states that wisely rejected Medicaid expansion. Medicaid expansion enrollment should be frozen no later than Jan. 1, 2018. Doing so would protect both taxpayers and patients, as states have demonstrated previously and nearly 200 state lawmakers called for last week.
Finally, AHCA leaves in place Obamacare’s “essential health benefit” mandates that every plan must cover, regardless of whether people want them. These regulations essentially made low-cost insurance illegal. They are the reason millions of Americans had their health plans canceled in 2013 despite President Barack Obama’s promises they could keep them, and why millions more have seen massive premium increases year after year.
Many have argued that Congress cannot repeal regulations in the budget reconciliation process. While their claim itself is debatable, they also fail to explain why Congress shouldn’t at least try.
Leaving in place Obamacare’s most harmful provisions — including those most expensive to taxpayers and its primary driver of plan cancellations and premium increases – is why conservatives have dubbed the American Health Care Act “Obamacare 2.0” and why Americans for Prosperity and several other conservative organizations are urging members of Congress to vote “No” on Thursday.
As of Wednesday, roughly two-dozen Republicans had declared opposition, such as Freedom Caucus founder Rep. Jim Jordan, R-Ohio, and Rep. Ted Budd, R-N.C. Lawmakers opposed to the bill deserve thanks, and Americans for Prosperity has pledged to defend and applaud them with digital ads, phone calls and more from its base of more than 3.2 million activists across the country.
Republicans have promised for years to repeal Obamacare. In 2015 after capturing the Senate, they did just that, sending a bill that repealed major portions to Obama’s desk. The only thing that has changed since then is that there’s now a Republican in the White House who would sign it into law.
Conservatives should defeat the American Health Care Act and simply do what they promised: repeal Obamacare. After doing so with a bill they’ve already passed before, they should move forward on free-market healthcare reform proposals that would actually reduce costs, many of which could receive 60 votes in the Senate outside the divisive framework of Obamacare.
After all, the American people elected Republicans to end the Obamacare nightmare, not simply replace it with more of the same.
Akash Chougule (@AkashJC) is a contributor to the Washington Examiner’s Beltway Confidential blog. He is the director of policy at Americans for Prosperity.
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