If you thought the threat to Obamacare ended when Republicans failed to get a repeal bill through the Senate in July, you are sorely mistaken. Unable to get anything else of substance passed, they are back with more legislation that would cripple the Affordable Care Act.
Meanwhile, Democrats are trying to figure out whether to support Sen. Bernie Sanders’ proposal to address the ACA’s shortcomings by expanding Medicare to cover virtually anyone who wants it. Medicare for all could be the best answer to make America’s healthcare system more accessible, but the dramatic changes required make its enactment unlikely anytime soon.
Sanders’ plan would give the federal government primary responsibility for paying every healthcare provider who treats patients. Single-payer systems are criticized as being expensive, but such criticism fails to fairly calculate the higher costs consumers pay now by having profit-driven insurance companies manage their healthcare.
Over a four-year period, Sanders would move Medicaid recipients, veterans, and people enrolled in other government programs into an expanded Medicare system. Instead of getting coverage through their employers, workers also would be enrolled in Medicare. But anyone could opt to buy a basic plan or supplemental coverage from a private insurer.
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Republicans still can’t agree on how to kill Obamacare. Sens. Bill Cassidy, R-Louisiana, and Lindsey Graham, R-South Carolina, have introduced a bill that would turn the ACA into a block-grant program that gives each state funds to devise its own healthcare system. But Republicans who don’t want to see Obamacare survive in any form don’t like the idea.
Recognizing the urgency of fixing Obamacare’s flaws, the governors of Colorado, Massachusetts, Montana, Tennessee, and Utah asked Congress to stabilize the ACA’s insurance markets by allocating federal funds to continue paying subsidies to insurance companies that are losing money by giving discounts to low-income clients.
Sens. Lamar Alexander, R-Tennessee, and Patty Murray, D-Washington, led an effort to provide the subsidies, but it wasn’t generating support. Republican senators want the ACA to give states more flexibility in implementing the law. Democrats say that would lead to diluted versions of the ACA in some states, which might erase consumer protections and impose higher deductibles and out-of-pocket costs.
The Trump administration has quietly continued its war on Obamacare by cutting the advertising budget for the law’s next enrollment period, which begins Nov. 1, from $100 million to $10 million. By reducing the number of participants, Trump hopes to torpedo the ACA markets where consumers can buy insurance and cause Obamacare to “collapse under its own weight,” as he predicted.
It’s sick that a president would engineer the destruction of a program that provides health insurance to millions of Americans who didn’t have it before it existed. Even sicker is Congress’ inability, after all this time and debate, to find common ground on an issue so crucial to their constituents’ well-being.
If they’re not ready for a restructuring as dramatic as Medicare for all, they need to fix Obamacare and stop playing politics with people’s health.
This editorial originally was published in The Philadelphia Inquirer.