Repealing ObamaCare with TrumpCare

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The big news in D.C., other than Michael Flynn, Jeff Sessions, wire-tapping allegations, and just general ineptitude, is the American Health Care Act which was recently revealed by the Republicans. It is their answer to Obamacare, which many are lovingly referring to as TrumpCare. Needless to say, it has not been received kindly by the press. In fact, it is fair to say that it is worse than most people, insiders include, had expected.

What are the Key Points of what this Act?

Planned Parenthood. Under TrumpCare, Planned Parenthood loses all its federal funding because it is an organization that provides abortions. Notably, Planned Parenthood does not use federal funds for abortions, because that is illegal. Essentially, Planned Parenthood is losing federal funding for essential services for women like prenatal care, HIV testing, pap smears, and breast exams. Also, lest one think that Planned Parenthood is only for women, it also provides services for men including prostate, colon, and testicular cancer screenings, vasectomies, and STD testing.

Private health insurance coverage for abortion. TrumpCare, according to a House Ways and Means Committee digest, would not allow health plans that rely on federal tax subsidies to offer coverage of abortion.  In essence, this will decrease the average American’s access to insurance that covers abortion. An even more likely scenario is that this will lead most insurers who rely on federal tax subsidies to drop abortion from their plans altogether. Without any such coverage, what would happen? Likely, insurers would be able to offer separate policies to specifically cover abortions, but would be able to charge high premiums since there would be little competition.

Essential health benefit rules are repealed. Under TrumpCare, there would no longer be a federal requirement that health plans offer, among other benefits, hospitalization, maternity care, or mental health services. Such regulation would be delegated to States to decide whether coverage is mandated. Much like private insurance coverage for abortions, this has the potential to create a small market where certain benefits, like maternity coverage, would be extremely expensive, if available at all.

Income-based premium subsidies would be replaced with age-based subsidies. Under ObamaCare, premiums, deductibles, and co-pays were based on average household income. Under TrumpCare, such costs would be based on the buyer’s age. Older buyers would receive more subsidy than younger buyers. What would be the effect of this change? Essentially, lower-income buyers would be at a disadvantage and it would likely discourage the younger population from getting health insurance that might be cost prohibitive.

Medicaid.  Under TrumpCare, as of Dec. 31, 2019, Medicaid will be block-granted. What does that mean, practically speaking? Less federal funding, resulting in the sickest and most destitute with reduced aid. As states get less federal funding, there is less money to dedicate to medical care.

All of Obamacare’s taxes are repealed.  Under Obamacare, there were taxes placed on certain medical costs and providers. There was also a surcharge to high-income taxpayers.  Under TrumpCare, these taxes will be eliminated. Notably, high-income tax payers will benefit greatly. According to the LATimes, this tax cut for the high-income population would be about $346 billion over a 10-year span.  This would apply to taxpayers earning more than $200,000 (or couples earning $250,000).

These are just some of the keystones of TrumpCare. Unfortunately, the bill is quite voluminous and many of its proposals are still being analyzed. Nonetheless, it is clear why the media has not been kind their reception of the Act.  But what about other politicians? What has been their reaction?

Political Responses

It should be noted that Paul Rand’s criticism of TrumpCare is that it is too similar to ObamaCare. Notably, it still allows for some government subsidies for low income families, and in general, Mr. Rand has criticized it as not conservative enough.

Notwithstanding Mr. Rand, other Republicans have publicly criticized it, namely for its lack of protection for those who are entit Medicaid.  Republican Sens. Rob Portman (Ohio), Shelley Moore Capito (West Virginia), Cory Gardner (Colorado), and Lisa Murkowski (Alaska) expressed these concerns in a letter to Senate Majority Leader Mitch McConnell stating: “While we support efforts to repeal and replace the Affordable Care Act and make structural reforms to the Medicaid program,” the letter says, “we are concerned that the February 10th draft proposal from the House of Representatives does not provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states.”

Of course, the best responses were those from non-politicians on Twitter:

And this author’s personal favorites:

Laura Bilotta
Laura Bilotta

NYU Law Grad. Public Defender in NJ for 10 years and counting. Vegan for 3 years and counting. Runner and cyclist in spare time.

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