Obamacare on the block; the big question now, what’s next?

IBJ Staff Report
    One of the first items out of the gate for the newly seated Congress is finding a cure for Obamacare.
    The expected vote to repeal and replace the Patient Protection and Affordable Care Act is less a question that the specifics of what congressmen come up with, how long it will take before it goes into effect and how many people will be lost along the way as a result of shifts in national health-care coverage.
    The Republican majority is united on repeal, but not on the fix for President Barack Obama’s signature legislation.
    Some Republicans would revise and rebrand Obamacare by jettisoning unpopular provisions like its requirement that most Americans carry health insurance, while preserving popular provisions like allowing young people through age 26 to remain on their parents’ coverage. Others would rip up the Affordable Care Act and not replace it.
    U.S. Rep. Rodney Davis, R-Taylorville, who represents the 13th Congressional District, said the health-care law has got to go, but be replaced.
    “It’s been pretty clear that it’s been a disaster,” he told the Illinois Business Journal. “We will again vote to repeal it, and this time we have a president that will take our repeal and replace (bill) and make some major changes. I think the American people demanded it. I think one of the major reasons Donald Trump was elected president was the outlandish premium increases we saw under the Affordable Care Act.”
    Davis, who represents much of Southwestern Illinois, used a local example to illustrate the problem.
    “In my hometown alone, one of my friends who is an independent insurance agent said his clients had a minimum 67 percent increase in premiums, up to 80-something percent. This is with deductibles of up to $6,000 a year. You can have insurance but it’s unaffordable to use and that’s unacceptable to the American people — and to me.”
    Monica Bristow, president of the Godfrey-based RiverBend Growth Association, has heard the rumblings among the economic development agency’s membership — as well as among her own staff.
    “The big thing I’m hearing is health-care relief. It’s huge. One of my own employees, their rate went up 61 percent and the hospitals aren’t even within the network. It really is sad that they are paying so much money and not getting anything for it,” she said. “But they have to have insurance. It’s almost criminal what they’re paying. It’s not affordable.”
    Bristow — like most in Congress — doubts that the revamp can be done within a year. Some experts have wondered whether the changes could actually be enacted in Trump’s four-year term.
    Republicans have “a really narrow path,” Grace-Marie Turner of the Galen Institute, a free-market health-care research organization, told the Associated Press. “They’ve got to deal with the politics of this, they’ve got to make sure they come up with good policy, and they also have process challenges.”
    House Ways and Means Chairman Kevin Brady, R-Texas, compared the challenge to tax reform — another of Trump’s priorities. “Unlike Obamacare, which ripped up the individual market, this will be done deliberately, in an appropriate timetable.”
    Republicans say they will move quickly to repeal the ACA, while suspending the effective date to allow them to craft a replacement.
    Many Republicans quietly favor stripping out the ACA’s taxes and requirements. The unpopular “individual mandate”’ to carry health insurance or risk fines could be replaced with other persuasion short of a government dictate. Rules on insurers would be loosened.
    But popular provisions such as protecting those with pre-existing health conditions would be retained in some form, as well as financial assistance for low- and moderate-income people.
    The health-care industry itself, including hospitals, insurers and pharmaceutical companies, largely favors changes.
    While a rebranded version of Obama’s law may well cover fewer people, the goal of “universal access” instead of universal coverage underwritten by government may be more politically acceptable.
    Republicans are riding a wave into the next Congress but they might not be so fortunate in the 2018 elections, by which time the Obamacare votes will have been tallied.
    MoveOn.org, the largest independent, progressive, organizing group in the United States and a prime supporter of Obamacare, is drawing ranks for a fight.
    “The conventional wisdom in Washington, D.C., is that come January, Republicans will be able to abolish the Affordable Care Act, torpedoing health insurance coverage for 30 million people and that nobody will make a peep about it. …we showed that the conventional wisdom is dead wrong,” the organization said in a statement, referring to a gathering on Dec. 20 of organization members and allies gathered outside 82 Republican House and Senate offices in 26 states across the country. Thousands more people supposedly flooded state GOP offices with phone calls.
    “Our message: “Don’t take away our health care.” And if you try, you’ve got a fight on your hands,” the MoveOn statement said.

Associated Press contributed some information for this report