Nate Beeler's cartoon ‘Past Prologue?’ captures the heart of the Republic dilemma. Looking at a tome called Obamacare in 2010, the Democrat says, "We need to pass it to find out what's in it." Looking at the same tome in 2017, the Republicans say, "We need to repeal it to find out what to replace it with."
Having promised to repeal the Affordable Care Act, the Republicans had better come up with something that, if not better, at least won't be worse. Here are links to some thoughtful pieces that might help them think things through:
• The Health Care Plan Trump Voters Really Want (Drew Altman, New York Times, 1-5-17) Altman draws on observations from focus groups in rust belt states of people in the Affordable Care Act (ACA) marketplaces who voted for President-elect Trump and say they may not like their coverage under the ACA but could like Republican replacement plans even less. “The Washington debate is disconnected from the concerns of working people,” he says.
• The Latest from the Kaiser Family Foundation. A roundup of key points to consider, and documents to study.
• Major Considerations for Repealing and Replacing the Affordable Care Act (Kaiser Family Foundation, or KFF.org, and the Committee for a Responsible Federal Budget). Video of a public forum to discuss the process and implications of repealing and replacing the Affordable Care Act. The discussion covered the implications of using the budget reconciliation process to repeal the ACA, and what an ACA replacement could mean for health insurance coverage and costs.
• The Complex Mess of Health Insurance (David Leonhardt, OpEd, NY Times, 1-5-17) "A lot of Americans are deeply frustrated by the logistical headaches built into our health care system. Strikingly, some of the Trump voters told Kaiser that they resented lower-income people who were enrolled in Medicaid, which they viewed as a better deal. Medicaid has its own complexities (and its own problems), but government-run programs do tend to be simpler than private ones. It’s true of Medicare, and it’s true of single-payer systems in other countries....Wouldn’t that be ironic? The Republican passion for getting rid of Obamacare could ultimately lead to a bigger dose of Big Government."
• A Better Way: Our Vision For a Confident America (House Speaker Paul Ryan, 6-22-16). KFF's summary of “A Better Way,” a policy paper offered by Speaker Paul Ryan as a framework for repealing and replacing the Affordable Care Act (ACA). It is not a legislative proposal and, as such, lacks some of the details and specificity of legislative text.
• Hospitals Worry Repeal Of Obamacare Would Jeopardize Innovations In Care (Kristin Espeland Gourlay, Repeal and Replace Watch, Rhode Island Public Radio, NPR and Kaiser Health News, 2-1-17)
• Demand For Popular Short-Term Insurance Plans Could Surge If Health Law Is Relaxed (Michelle Andrews, Repeal and Replace Watch, Kaiser Health News, 1-31-17) 'As Republicans look for ways to weaken the health law’s coverage requirements and explore the possibility of not enforcing the requirement that people have health insurance, short-term plans may be poised to grow even more. If that happens, consumer advocates warn it could be bad for consumers....“To many consumers it looks like health insurance, except it’s cheaper,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation. But the plans don’t protect people when unforeseen events occur such as a car accident or a cancer diagnosis."'
• Getting Patients Hooked On An Opioid Overdose Antidote, Then Raising The Price (Shefali Luthra, Kaiser Health News, ) First came Martin Shkreli, the brash young pharmaceutical entrepreneur who raised the price for an AIDS treatment by 5,000 percent. Then, Heather Bresch, the CEO of Mylan, who oversaw the price hike for its signature Epi-Pen to more than $600 for a twin-pack, though its active ingredient costs pennies by comparison. Now comes Evzio, a device that administers just enough naloxone to stabilize someone who has overdosed on drugs. Its manufacturer, Kaleo, may be positioning itself to find profits in a dire health care crisis. (Will Republicans, who are heavily supported by the pharmaceutical industry, be willing to limit price-gouging on life-saving medicine and devices? Not likely.)