Originally published on Virginians for Quality Healthcare website on March 15, 2017
Reposted with permission of the author
Virginians for Quality Healthcare Opposes the American Health Care Act (AHCA)
Virginians for Quality Healthcare (VQH) has long objected to government intrusion into healthcare. “Obamacare”(1) represents the near epitome of government meddling, second only to a single-payer healthcare system. Americans were heartened by election campaign promises to repeal and replace Obamacare “on day one” of the Trump presidency. Donald Trump promised that the new plan would be “greater than ever before.”
That fervor was doused by the roll-out of the House repeal and replace bill, the American Health Care Act (AHCA), 46 days into President Trump’s term. The AHCA has been characterized as Obamacare-lite, and many critics are offended not only by the content of the bill, but by the secrecy imposed during its drafting, as well as the arrogant claim that supporting the bill “is a binary choice.” This is not the way to achieve consensus, much less do what is right for healthcare freedom.
VQH contends that political expediency is driving this bill, rather than sound, principled healthcare reform. In the words of health policy expert and innovator Twila Brase:
The only thing the American people actually asked for in the last three elections is a repeal. This bill [AHCA] is not written for the American people; it’s written for health insurers … Nothing about the bill is going to speak to the hearts and minds of the American people hurting from impossibly high premiums and dangerously narrow [provider] networks.(2)
VQH opposes the AHCA for three primary reasons. First and foremost, it does not repeal Obamacare; the bill’s language alone demonstrates this fact. The phrase “is amended” appears at least 69 times throughout the document, starting on page 1. The phrase “is repealed” appears only once, on page 47, and treats a very narrow section (1402) of the PPACA, starting in 2020. This Congress and Administration were elected to repeal Obamacare, not amend it.
Secondly, the AHCA does not unleash the free market nor give individuals real choice. Instead it entrenches government control of insurance markets, making health insurance and therefore access to healthcare even LESS affordable than ever, offering NO CHOICE to Americans. It has been well-proven that government subsidies in any sector only drive costs up and ultimately benefit a third party (health insurers in this case), not the individual receiving the subsidy.
Market reforms that would lower costs and provide choice to consumers can only be achieved by repealing all the onerous Obamacare regulations, eliminating tax credits (i.e., subsidies), and promoting innovation and entrepreneurship in healthcare. In addition, tort reform to alleviate exorbitant medical malpractice settlements is often cited as a necessary companion to healthcare reform, as is repeal of the McCarren-Ferguson healthcare anti-trust exemption (3), to open insurance markets to all individuals. Taken together these reforms would substantially drive down the cost of healthcare.
Where is the “Bold Leadership” behind the “Bold Agenda” to repeal Obamacare that GOP leaders promised voters for the last three elections? Instead of a simple and clean repeal, the House has written a bill of complex language retaining insurance mandates, while promising additional changes in future “Phases 2 and 3” which are under the purview of the U.S. Department of Health and Human Services, and the U.S. Senate, respectively. Skeptics doubt that Phase 3 is attainable, for the very reason why Congress is using the budget reconciliation process to pass the AHCA in the first place: Senate Majority Leader McConnell cannot muster 60 Senate votes needed to pass new legislation.
At this juncture, Americans have little confidence that all three phases to completely repeal Obamacare will be accomplished in the 115th Congress. The result of such a failure will be either leaving Obamacare in place, or substituting a GOP version of Obamacare. The problem is that Obamacare is unsustainable, and its collapse will create conditions ripe for a complete government takeover of the country’s healthcare system.
Hence, the third major reason VQH cannot support any bill short of full repeal: the AHCA actually paves the path to socialized medicine. If AHCA were to become law, its subsidies would eventually ensnare the entire middle class into government welfare. Subsidies will drive up the cost of health insurance to unaffordable levels, leading the middle class to choose between having no insurance, or accepting Medicaid. In this scenario even employer sponsored insurance could fall victim to higher costs, reducing consumer choices even further. It would be a short step from there to a single-payer system, especially if control of Congress changes hands in 2018.
Opposition to the AHCA is fierce and comes from multiple directions. How disappointing it is to see battle lines being drawn in Congress—energy that could be directed instead toward uniting the GOP like never before. American families are feeling betrayed that their elected representatives have been less than truthful in pursuing real repeal, and aren’t working together to solve this huge problem which the federal government itself created.
Both the enactment of Obamacare and efforts to replace it illustrate why the federal government is incapable of creating and managing a quality, affordable, patient-centered healthcare system. The government is a poor substitute for the innovation and competition that thrive in the free-market. In short, the healthcare debate comes down to preserving the liberties and progress which free-market capitalism has fostered, or accepting the limiting, downward spiral of socialism: that is the true binary choice.
Virginians for Quality Healthcare
March 15, 2017
2. “Press Release: Heartland Institute Experts React to GOP Obamacare Reform Bill”, Mar 7, 2017. www.heartland.org/news-opinion/news/press-release-heartland-institute-experts-react-to-gop-obamacare-reform-bill
3. McCarren-Ferguson Healthcare Antitrust Exemption Must Go, Jan. 19, 2017. http://thebullelephant.com/mccarren-ferguson-healthcare-antitrust-exemption-must-go/