President Trump has been trying to repeal and replace Obamacare since he took office, and he’s not alone. Republicans in office have been working towards this repeal for years, even while Obama was still President. Naturally, Obama wasn’t excited about repealing his own plan, and neither were the democrats in office. Now, Republican President Trump and Republican Speaker of The House Paul Ryan have broken through Congress. The bill to repeal and replace Obamacare passed in the House Of Representatives today. Next stop, Senate.
Speaker Paul Ryan did a great job laying the plan out in his house address this morning. He starts by introducing the three prong approach:
Options for coverage are disappearing. Competition is dying, and insurers are completely leaving the marketplace. This year, over 1,000 American counties are left with only one plan to choose from. Some, like Knoxville, TN, are left with literally zero options for coverage because insurers are only losing money by offering coverage there.
People have less options for coverage, and then the coverage they do have access to is increasingly expensive. Premiums have been skyrocketing over the past few years, and consumers can’t switch to a cheaper plan because there isn’t one available. In just one year, average state premiums have risen by as much as 69% in Oklahoma and 63% in Tennessee.
Paul Ryan describes Obamacare and its effects as a death spiral. The worse it gets, the harder it’s going to be to change things – which is why a change needs to happen now.
The American Health Care Act, or AHCA, has four major components:
Naturally, people are incredibly skeptical about the lowering costs portion of the plan, but not everybody realizes all the expenses that Obamacare entails. The AHCA will repeal Obamacare taxes, eliminate major spending, and remove mandates which include the government telling people exactly what to buy and that they have to buy it.
Aside from these legal provisions, Republicans also hope to make the entire system more efficient and consumer-friendly.
The current system doesn’t do anyone any favors by outlining costs. Paul Ryan, in his address, tells the story of all three of his kids having the same procedure within three years of each other. Ryan says he was unable to get a clear answer either from the hospital or his insurance carrier about what it would cost him. It wasn’t until months later that he started receiving bills, all for different parts of the procedure. Ryan received separate charges for the anesthesiologist, the surgery, etc. He even admitted to a $1400 charge just for his son to sit in a room and watch TV all day while he recovered. Not only is that expensive, but he didn’t know what to expect until much later.
Part of the plan is to expand health savings accounts for moments like that, so that consumers aren’t dipping into their personal savings or having to make cuts in other important places to pay for medically necessary procedures.
Paul Ryan says that Medicaid is growing so much that it doesn’t make sense anymore – it needs to be “modernized.” His goal is to follow in the footsteps of his home state of Wisconsin (before Obamacare forced the state to change). The AHCA will give Medicaid control back to states, because states have a better idea of what their patients in low income areas need.
Ryan stated his Medicaid goals as:
A major provision that the house was excited about was the stable transition. No one will lose coverage in the switch from Obamacare to The American Health Care Act. The AHCA will keep a few Obamacare provisions, like the one that keeps young adults on their parent’s plans until they are 26.
Obamacare had healthy and stable people paying for sick people’s coverage. With the AHCA, states will have federally-funded risk pools.
The goal here is to prevent carriers from having to shell out tons of coverage for those with preexisting health conditions, which will help them keep premiums lower for everyone else – but those with preexisting conditions will be covered directly by the government.
Not as long as everything goes according to plan. In fact, Ryan talked about adding a portable monthly tax credit. The current system penalizes those who do not have a health care plan through their employer. Right now, those who do receive health care from work receive a tax benefit. Those who don’t end up paying more in taxes, making it even harder to pay for a health care plan.
Towards the end of Ryan’s speech, he says, “The patient is the nucleus of the health care system.” That belief has been central in Republican efforts to repeal and replace Obamacare. Ryan is optimistic that the Republican-leaning senate will pass the bill all the way through for next year. Watch Paul Ryan’s speech here.