Republicans have attempted to repeal the Patient Protection and Affordable Care Act – Obamacare – more than 60 times since it was passed into law in 2010. Obamacare was one of the most popular punching bags for Donald Trump’s presidential campaign. And with the election now over, the Republican President-elect is poised to make good on his threats to roll back President Obama’s landmark legislation when he takes the Oval Office next year.
Senate Majority Leader Mitch McConnell (R-Ky.) has already signaled his enthusiasm for the repeal process. At a press conference Wednesday, McConnell said:
“Every single Republican thought Obamacare was a mistake. It’s a pretty high item on our agenda and I would be shocked if we didn’t move forward and keep our commitment to the American people. It was the single worst piece of legislation among many bad pieces of legislation passed in the first two years of the Obama presidency. The sooner we can go in a different direction, the better.”
Bad News for America’s Health
But the repeal would do more than just hurt the already insured. Over the past six years, the healthcare industry has gained some 2 million new jobs. Capitol Street – a healthcare policy consulting firm – expressed concerns that a repeal could harm the healthcare industry as a whole. Managing director Ipsita Smolinski told Politico prior to the election that:
“If Trump wins, it is very likely that most health care stocks will sell off significantly. Because he has pledged to repeal the ACA, it almost doesn’t matter if he can do it or not.”
A repeal would be bad news for the healthcare industry, which comprises one-fifth of the U.S. economy.
Trump has been unclear about exactly what his new healthcare plan will entail. In some interviews, he suggests replacing Obamacare with something akin to universal healthcare coverage. In others, he flatly rejects the idea of a universal or single-payer system.
On his website, Trump promises to replace Obamacare with Health Savings Accounts (HSAs). HSAs are special savings accounts that allow people with high-deductible healthcare plans to pay for medical costs.
Critics say that HSAs will leave economically vulnerable Americans without adequate health coverage because they will be too poor to add much to their HSAs. Another concern is that people with prolonged illnesses or chronic medical conditions will quickly exhaust their savings.
Trump also proposes opening health insurance to competition across state lines. In his view, interstate competition would give people more coverage options. While this is theoretically true, evidence suggests that enabling people to buy health insurance across state lines actually does little to improve their coverage.
Several states have already experimented with out-of-state insurance sales, but few out-of-state insurers have demonstrated an interest in selling across state lines. Selling insurance in other states requires new licensing and – most importantly – a guarantee for buyers in the out-of-state market that they will be able to find a network of doctors who provide coverage under the other state’s plan. But negotiating new contracts with doctors and hospitals to accept the out-of-state insurance is difficult.
A Terminal Case?
With both Congress and the Presidency in Republican hands, it will be hard to oppose an Obamacare repeal. Senate Democrats could use a filibuster to block a full repeal, but the GOP might still be able to use a budget tool called reconciliation in order to defang Obamacare.
A reconciliation measure doing just that passed the House and Senate last year, but President Obama vetoed it.
Check out this video clip on how realistic Trump’s alternative to Obamacare would be:
Featured image via YouTube video.