Obamacare – Page 2 – * Failed Pols

Since before he was elected, Donald Trump has promising a “phenomenal new health plan” that will replace “Obamacare” (the Affordable Care Act, or ACA), and that it will be coming out “very, very soon.” Does anyone still believe that Trump and GOP lawmakers will ever create a health care bill at all, let alone one that would be “better” than the ACA? Does anyone still believe that Trump wants to improve health care for Americans as much as he wants the pleasure of gutting one of Obama’s major domestic accomplishments?

The Affordable Care Act, though far from perfect, has been an important first step toward making health care accessible for more Americans. Not only did it create health insurance “marketplaces” for people who didn’t have health insurance through an employer, it mandates that every insurance plan cover a set of 10 “essential health benefits,” including well exams, pregnancy and childbirth care, and mental health services. It also prohibits insurance companies from denying coverage or raising premiums on the basis of a preexisting condition. Provisions of the Affordable Care Act, including its 10 essential benefits and the preexisting condition mandate, affect all Americans, whether they have insurance through an employer, a private broker, or a state-run health insurance marketplace.

Trump ran on his promise to abolish the Affordable Care Act, and whether or not health care mattered much to his base back in 2016, Trump’s promise to obliterate an Obama accomplishment sounded good to them. For those of his base to whom health insurance mattered, “repeal and replace Obamacare” must have implied to them that they would end up with better coverage and more affordable health care under Donald Trump. Others of Trump’s base saw the ACA as the gateway to socialized medicine, which terrified them.

In 2018, as evidenced by the flipping of the House from Republican to Democrat, it was clear that health care was on the minds of voters, who weren’t impressed with the GOP’s inability to present a replacement for the ACA. Now we’re in the midst of the coronavirus pandemic. Americans have lost jobs, and with jobs, their health care. Access to health care matters to Americans a lot right now.

In August of 2019, White House counselor Kellyanne Conway said that Trump was about to introduce an elaborate redesign of America’s health care system. “We’re working every single day here,” Conway said. “I’ve already been in meetings this morning on the president’s health-care plan. It’s pretty impressive.”

A year later, the world is still waiting for the impressive unveiling.

Just over two weeks ago, Trump told Chris Wallace of Fox News, “We’re signing a health care plan within two weeks, a full and complete health care plan.”

On Friday, July 31, just before the two weeks was up, Trump said, “We’re going to be doing a health care plan. We’re going to be doing a very inclusive health-care plan. I’ll be signing it sometime very soon.”

All Trump or his cronies can offer when asked about their mysterious and so-far elusive health care plan is that people with pre-existing conditions would still be covered, and that people would not lose their coverage if they become sick. They won’t say how much their premiums might increase, however.

As “sometime very soon” gets closer to Election Day, here are some things Americans should remember about how much Donald Trump and his GOP care about Americans’ health care.

In 2017, the GOP Congress spent most of the year trying to repeal portions of the Affordable Care Act, though they ultimately failed, except with the individual mandate. As part of the 2017 tax reform bill, they eliminated the ACA’s penalty for failing to carry health insurance, and this, in turn, neutralized the ACA’s insurance mandate. Some lawmakers contend that this invalidates the entire Affordable Care Act.

Toward the end of 2017, Trump continued his crusade against “Obamacare” by ending the ACA-required payments to insurance companies that made it possible for them to offer discounts to low-income consumers on out-of-pocket costs. This caused many insurance companies to eliminate or reduce their offerings on the health insurance marketplaces, as well as to raise their premiums and deductibles. ACA health insurance plans with reasonable deductibles became more expensive. Yet, Trump and his cronies continue to claim that the health care of Americans is of the utmost importance to them.

The Department of Health and Human Services (HHS) also cut federal funding for outreach and advertising to encourage people to purchase ACA health care plans during the annual enrollment period. Though it was a clear effort of the Trump administration to reduced enrollments in ACA plans, recent enrollment figures show an increase— not a decrease— in enrollments since last year.

During 2018, GOP lawmakers made it easier for states to redefine the 10 “essential health benefits” they were required to offer. They also made it easier for Americans to purchase short-term health plans that are cheaper than marketplace and private plans, while offering minimal coverage and higher deductibles. These plans, meant to be just short-term bridge policies for when someone is, say, between jobs, also don’t offer all of the ACA required benefits or meet consumer protections. Should a policyholder get sick or injured, their out-of-pocket costs could cause financial hardship.

Currently, the Trump administration, hell-bent on destroying a health care plan created by Trump’s nemesis, has a lawsuit before the Supreme Court to declare the entire Affordable Care Act unconstitutional. This would leave tens of millions of Americans without health care coverage. And yet, no replacement plan is forthcoming, even though we’re in the midst of a pandemic.

Nevertheless, White House press secretary Kayleigh McEnany maintains, “President Trump continues to act in delivering better and cheaper health care, protecting Americans with preexisting conditions, lowering prescription drug costs, and defending the right of Americans to keep their doctors and plans of their choice.”

If only a health care plan could cover the damage that occurs from the continued and repeated ingestion of gaslight fumes.

Trump Has No Healthcare Plan | Meidas Touch [2020-08-02]

Trump promises ‘great, great surprise’ health care package | ABC News [2017-06-28]

The attempts by Trump and his ilk to dismantle the Affordable Care Act (ACA, or “Obamacare”) continue, even as they are overshadowed by Congress’ impeachment inquiry. The next imminent threat to the Affordable Care Act may occur at some point in October, as judges in the 5th Circuit Court of Appeals rule on the Texas v. Azar lawsuit, argued in July.

Destroying the ACA was a hallmark and battle cry of Donald Trump’s 2016 campaign. On the day of Trump’s swearing in, he immediately signed an executive order “to waive, defer, grant exemptions from, or delay” portions of the Affordable Care Act.

On December 15, 2018, a Texas federal district court judge found that the 2017 Tax Cuts and Jobs Act (TCJA), which nullified the tax penalties associated with the individual mandate portion of the ACA, rendered the individual mandate unconstitutional. Consequently, since the individual mandate is an “essential” part of the ACA, the entire ACA was unconstitutional, the judge ruled.

The state of Texas, along with the other plaintiffs, argued that with the tax penalty removed, the zero dollar fine now outlined in the ACA is a “naked, penalty-free command to buy insurance,” explains Nicholas Bagley, professor of law at the University of Michigan.

“…Congress doesn’t have the power to adopt a freestanding mandate,” he says. “It just has the power to impose a tax.”

Therefore, plaintiffs argued, “The naked mandate that remains in the Affordable Care Act must be unconstitutional.”

The fact that only two of the three judges in the case (both Republican-appointed) asked any questions when hearing the case in July is thought to bode poorly for the future of the Affordable Care Act.

“I think we should be prepared for the worst — the invalidation of all or a significant part of the Affordable Care Act,” says Bagley.

If this is true, it doesn’t mean that the ACA will be immediately invalid. It is still the law.

However, says Sabrina Corlette, director of the Center on Health Insurance Reforms at Georgetown University, “If that decision comes out before or during open enrollment (November 1 through December 15), it could lead to a lot of consumer confusion about the security of their coverage and may actually discourage people from enrolling, which I think would be a bad thing.”

The case will almost certainly go to the Supreme Court if the 5th Circuit Court declares the Affordable Care Act invalid, however.

Here are some other ways the Trump administration has hacked away at the Affordable Care Act:

Ending cost-sharing reduction subsidies to insurers. These federal payments to insurers were meant to motivate insurers to participate in the ACA insurance exchanges, and help keep premiums down. The Trump administration abruptly stopped paying these in 2017.
Allowing states to add “work requirements” to Medicaid. The ACA expanded Medicaid so that more individuals and families were eligible. Under Trump’s new rules, states may choose to require potential Medicaid beneficiaries to provide documentation that they either go to school or work, in order to receive benefits.
Expanding access to short-term “skinny plans.” Under the ACA, these low-cost, low-coverage plans were meant only as a “bridge” for those between jobs or in school. These plans don’t tend to cover ACA-mandated items such as pre-existing conditions or “essential health benefits.” What’s more, their extremely high deductibles could place their holders in financial difficulty should they become seriously ill.
Reducing funds to facilitate signup for healthcare.gov insurance plans. Under the ACA, Navigator programs and a marketing budget were created to help people figure out how to sign up for health insurance on the exchanges. Trump’s reductions in funding for these services is a passive way to make it more difficult for disadvantaged people to sign up for ACA plans.

Experts have warned that dismantling the Affordable Care Act will cause great damage throughout the U.S. health care system. It is the Affordable Care Act, for example, that protects people with pre-existing conditions from being uninsurable, and mandates that “essential health benefits” such as a basic check-up, maternity care, and prescription drugs, are covered.

“The Affordable Care Act is now part of the plumbing of our nation’s health care system,” says Bagley. “Ripping it out would cause untold damage and would create a whole lot of uncertainty.”

Could Texas v. Azar End the ACA? — Christopher Holt | American Action Forum (AAF) [2019-05-20]

Chairman Scott: Texas v. Azar Decision is “Frivolous” | House Committee on Education and Labor [2019-01-09]

Category: Obamacare

Editorial: Trump’s Promised Health Care Plan: “Very Very Soon” Has Expired

Texas v. Azar: The End of the Affordable Care Act?