Why TrumpCare failed twice…and won’t pass the Senate.
Back when Obamacare was introduced in 2013…the Republicans saw an opportunity. They were already against anything Obama tried to do as part of Mitch McConnell and the Republican’s grand plan to block everything Obama tried to do in an effort to make him a “one term President.”
For 7 years, the Republicans made a big show of trying to “Repeal & Replace” Obamacare. They voted over 60 times to repeal and replace it and they did everything in their power sabotage it. They even called it “socialism” even though 60% of the healthcare providers in Medicaid are Private healthcare providers.
The proof of Republican sabotage is the fact that the majority of Republican states — 19 of them — refused to expand Medicaid which resulted in higher premiums and less coverage for millions of americans including the majority of Republican’s own constituents — all for political points.
Of course, they didn’t stop there. They also withheld agreed upon funding for support for “high risk corridors” or essentially rural areas. Ironically, Paul Rubio originally came up with this idea as a way to help those areas where there simply wasn’t enough people to make insurance plans affordable or profitable for the insurance companies.
The extra government funding incentivized Insurance Companies to serve these underserved areas…areas who are, ironically, majority Trump voters.
By withholding funding to these areas, Insurance Companies began to see their costs rise and many of them were and are being forced to pull out. Insidiously, these are the areas that Republicans now hold up as examples of Obamacare failing or “imploding”.
The CBO, on the other hand, says, on the whole, Obamacare isn’t failing especially in states that weren’t the victim of Republican sabotage. Premiums nationwide only went up an average of 3% and in some states premiums actually went down. Imagine what would have happened without Republican sabotage.
Think about it. You have to see how insurance works in your own life. If you work for yourself, you are going to pay more than if you work for a large company. When more people are grouped together like when they work for larger companies, the risk gets spread out which ultimately lowers premiums for everyone.
That is the only reason Obamacare had a mandate. (News Flash: The GOP healthcare plan also has a mandate. Only they don’t call it a mandate. It’s a 30% penalty for insurance lapses. A harsher penalty than the Obamacare tax penalties for not getting insurance.)
Why would that be? Well it’s the same reason why car insurance in “mandated”. If you only made people who were bad drivers get insurance…their rates would be unaffordable….since they would be getting in accidents all the time…and, as a result, their premiums would be sky high. This is called a “High Risk Pool.”
So states “mandate” that everyone who drives a car get insurance so that ultimately good drivers pay for the people who are bad drivers. That way everyone gets covered, premiums are affordable and the insurance companies still make money. Win-win for everyone.
Healthcare works the exact same way. No one can help getting old and sick. If you go to an entirely “free market” healthcare system without a mandate the only people who would get insurance would be the old and sick.
That means that those people would be in a “High Risk Pool”….which means their premiums would be astronomical since there is a higher likelihood that they are going to get sick. As a result, everyone else who eventually decided to get covered would see their premiums based off that high risk pool — which is actually how our partially “free market” system works today and why we all pay so much for healthcare.
You see, insurance isn’t a “free market” product like the Republicans would have you believe. Insurance is a “spread the risk” product. The more people “in” the lower the premiums. For example, if we were all in ; if everyone in the US were grouped into one big pool premiums would be as cheap as they could be. Healthy people pay would pay for the older, sicker people and we would all be covered at the lowest rates possible.…in the same way good drivers pay for the bad drivers. Win-win for everyone.
The reason premiums were still going up today wasn’t BECAUSE of Obamacare…it was because Obamacare didn’t go FAR ENOUGH.
Obamacare was a compromise — a hybrid system. Democrats have always wanted a single payer plan because that’s how insurance works best and becomes most affordable.
Republicans have always wanted a “free market” system since clearly they are bought and sold by the insurance lobby. (The dirty secret is Obamacare was actually the Republican plan for 20 years — it was called RomneyCare. Obama took it to troll Republicans and as a compromise to get it passed.)
So Obamacare split the difference. It had a single payer market…by expanding Medicaid….and left the “free market” system alone. Obamacare became just another affordable option since our “free market” insurance system was causing rates to continue to rise.
So contrary to what many people believe, if you didn’t buy your insurance on the exchanges, guess what, you didn’t have Obamacare. You had “free market”” insurance. Obamacare was simply designed to be a more affordable option for people priced out of the “free market” healthcare system by introducing competition into the healthcare marketplace in an effort to help bend costs lower. Obamacare included government subsidies for poor and lower middle class people who couldn’t afford insurance in the “free market.”
That’s because, based on how insurance works, the free market only makes healthcare more expensive. In a true free market, businesses compete for the consumers business so they are incentivized to improve service and quality to get the consumer’s dollar.
Getting old and sick, on the other hand, isn’t a “choice.” Getting old and sick isn’t a “voluntary” decision.
People are always going to get old and sick. Without insurance, they are going to show up in an emergency rooms..any emergency room…taking services regardless of who is offering them. This fact pushes premiums up for people who do pay for insurance which ultimately leads to less people able to afford healthcare. Which, in turn, means more people showing up in emergency rooms which, in turn, means higher premiums for people who do pay for insurance…and so on and so on until the system death spirals.
That’s why it pays to insure everyone.
The free market just creates a bunch of “High Risk Pools” since people wait until they get old and sick to get coverage or get no coverage at all.
For pennies on the dollar..a small tax…we could insure everyone since healthcare is a “spread the risk and cost product” and no one has a choice of getting old and sick.
So Obamacare was an effort to impact the costs of our “free market” healthcare system with competition from a single payer system.
Obamacare introduced affordable competition into the marketplace and by every measure it was working to bring costs down.
Before Obamacare premiums were going up 22% a year..every year and expected to increase. Since they introduced Obamacare…premiums are 30% to 50% lower than what they would be without Obamacare saving the country 2.6 Trillion in healthcare costs.
This year, healthcare costs only went up an average of 12%…so Obamacare was bending the curve lower. 20 million more people had healthcare. And, just think, if it wasn’t for Republican sabotage (which would have covered millions more people) Obamacare would be doing even better.
But no. Thanks to Republican sabotage, people in 19 Republicans states would go on the Obamacare exchanges and not see any savings thinking it was Obamacare’s fault when it was actually because Republicans who refused to expand Medicare in their states.
It created a lot of anger and confusion. People blamed Obamacare every time their premiums went up even though in many cases they didn’t even have Obamacare.
This helped flip Congress in favor of Republicans…just like they planned all along.
Then Trump won which, by all accounts, was totally unexpected. Suddenly and Republicans actually had to deliver on their promise to “repeal and replace” Obamacare — a promise they had banked on and been vocal about for 7 long years.
Trump promised a plan to repeal and replace Obamacare the first week. But in reality Republicans actually had no plan to “repeal and replace” Obamacare. Not only was it originally their plan in the first place they were caught off guard when Trump won. So what did they do?
They came up with TrumpCare. Was it an attempt to actually fix what they perceived as wrong with Obamacare? Was it an actual attempt to help the American people?
No. TrumpCare is nothing less than a dressed up fancy tax cut for the top 2%. It does almost nothing to help people or fix the issues related to Obamacare. It actually makes everything worse for everyone except the wealthy and insurance companies.
In fact, it maintains the same basic structure as Obamacare — swapping subsidies for tax credits and a mandate for a 30% penalty on coverage lapses — with less funding, more cost and a roll back of the medicaid expansion.
Republicans don’t want to “fix” Obamacare…they want to “pretend” they are fixing it to help give tax breaks to Insurance companies and their donors.
Rand Paul calls it Obamacare-lite. And he is right.
Extreme right-wingers like Rand Paul and the “Freedom Caucus” think Healthcare is just another “entitlement”. The fact that TrumpCare doesn’t crush the poor, old and sick enough bothers them. 24 Million losing coverage isn’t enough.
Moderate Republicans thought the different versions of the bill went too far… and they would get crushed in upcoming elections since it hurts everyone….including Trump voters.
And Democrats continue to be simply horrified at the greed, cruelty and immorality of the whole process.
The first version raised premiums on seniors 750% to give the super rich a tax break.
So Republicans were stuck….they couldn’t go right because they needed Moderate Republican votes to get the bill passed……..they couldn’t go left because they needed extreme right wing Republicans votes to get the bill passed.
And they couldn’t stay with what they had because it’s a disastrous nightmare for everyone including their own voting base — all to give huge tax breaks to the top 2%. They knew they will get crushed in upcoming elections.
They were trapped by their own lies. They had to do something…after all…they PROMISED they would “repeal and replace” Obamacare but they have no new ideas and struggled to come up with ANYTHING that had any chance of being passed.
They were stuck letting their own voters down by doing nothing and, as a result, were still risking getting crushed in upcoming elections since they were in danger of coming off as weak and ineffective.
So they kept at it.
First time around, the Republican plan was to cause millions of old and poor to lose coverage to give a tax cut to the top 2% which pissed off the moderate Repos for being too harsh and the extreme right Freedom Caucus for not being harsh enough — while causing 24 Million to lose their insurance.
The Second time around, they were going to cause millions to lose coverage to give tax breaks to the top 2% by removing “essential benefits”…things like prescription drug coverage, maternity care, and mental health…which pissed off the moderate Repos for being too harsh…and the extreme right Freedom Caucus for not being harsh enough — while causing 24 Million to lose their insurance.
This third time around….they are going to cause millions to lose coverage to give tax breaks to the top 2% by allowing states to opt out of EVERY SINGLE Obamacare regulation if they wanted. TrumpCare would once again allow insurance companies to basically rob us blind essentially killing people for money by capping coverage limits and denying coverage for pre-existing conditions. This made the extreme right Freedom Caucus absolutely giddy with excitement but concerned Moderate Repos for being too harsh…since they know they will get killed in upcoming elections…all while causing 24 Million to lose their insurance.
Enter the amendments. To bring along Moderate Republicans, they added an amendment that would give Moderates some “Political Cover.” They added 8 Billion dollars to “help” states cover “pre-existing” conditions. 8 billion dollars spread out over 5 years.
If you know anything about healthcare costs, 8 Billion is a pittance compared to what the actual costs increases would be if this bill ever became law — especially spread out over 5 years. But Moderate Republicans apparently didn’t care. They could at least say they heard their constituent’s concerns. And since the bill is now moving on to the Senate…Moderate Republicans figured they could now pass the buck of responsibility onto Republicans in the senate. Win-win. They could tell voters that voted for Trump that they did something — voted to R&R Obamacare — and they could tell their more moderate constitutes that they heard their concerns on pre-existing conditions.
This third version, with amendments, passed by one vote.
All of this still doesn’t change the fact that GOP plan is designed to transparently rob from the poor and middle class and give to the wealthy — That’s why it will probably never pass the Senate.
If it somehow does pass the Senate, it will undoubtedly explode the deficit and death spiral from day one — ironically hurting Trump voters most of all.
Again, Republicans simply can’t escape the fact that there isn’t a country in the world that has a successful “free market” healthcare system. Most modern industrialized countries have pretty much have ALL gone single payer.
But that doesn’t matter to Republicans. They know it’s bad. That’s why they rushed it through two House Committees and voted on the 3rd version of the bill without a final CBO score — without knowing how much it will cost or who it will affect.
They don’t even want to do ANY hearings on it in the Senate. What’s that tell you?
The first CBO score from the first round of the bill told the story — 14 million would lose coverage the first year; 24 Million by 2020.
And do you know how they got 10% premiums savings in year six on version one of the bill? Premiums would rise so much on seniors…up 750%…that the old and sick would be forced to drop their coverage leaving only young people with coverage…saving the insurance companies billions.
All this death and destruction to give the top 2% a tax break. The top 2%. People with so much money..they probably don’t even work. They most likely live off monthly dividend payments.
Meanwhile, Trump has no clue what was even going on and was walking around this past week saying things like “Pre-existing conditions are in the bill. And I mandate it. I said, ‘Has to be’” which isn’t true at all and only added confusion to the Republican efforts to sacrifice American people to give a tax break to their corporate and political donors.
The longer we as a country keep deluding ourselves…and Republicans keep lying to us trying to convince us that a “free market” insurance strategy works…the more we will pay for healthcare. For what? To keep insurance CEO’s and the Super Rich…rich?
We as a country already spend 18% of our GDP on healthcare. DOUBLE the rest of the world. Everywhere else in the world…they pay no more than 9% of GDP on healthcare because they ALL realized that the only way to keep healthcare costs under control is a single payer plan. Grouping all of us together spreads risk out and give us all leverage against the insurance companies covering everyone in the cheapest way possible. It isn’t hyperbole to say that healthcare will bankrupt the country if they go through with this bill.
Again, you can see how insurance works in your own life through car insurance…through working for a larger company…as opposed to working for yourself…so I know most people can get the concept.
Single payer isn’t “socialism” as the Republicans would have you believe. It’s simply the way insurance works best.
The sooner the American people wake up and understand that Republicans aren’t interested in “fixing” Obamacare. They aren’t interested in helping the American people. They are interested in saving their cushy jobs by rewarding their donors with tax breaks at the expense of this country’s most vulnerable and desperate.
The fact that Trump and Republicans even considered TrumpCare as a legitimate healthcare option should give everyone in this country pause.
At the very least, TrumpCare should show everyone exactly what the Republican Party’s TRUE priorities are. The fact that they would throw american families under the healthcare bus, explode the deficit and harm the economy for power and money should concern everyone.
Now don’t even get me started on the Trump tax plan.
None of this bodes well for our democracy or our future as a country.
Pray the Senate can rightfully kill this dangerous, immoral and greedy plan to steal from the poor in favor of the wealthy. Our future could depend on it.