At a press briefing this week, White House Press Secretary Sean Spicer used the word ‘prong’ 16 different times while referring to the healthcare act that was to repeal and replace Obamacare. He was doing what he and other Republicans are currently working around the clock to do – deflect criticism on Senator Paul Ryan’s Affordable Healthcare Act. Members of the GOP have continually done this by showing that the tabling of the act is just but one part of the process in steps for Obamacare’s overhaul.
Spicer explained to the press that the AHCA was far more complicated than drafting its bill. “It’s a major, complicated piece of legislation that’s got three prongs to it,” he said. As explanations continued, Spicer elaborated the Republican strategy to replace Obamacare strategy “in three prongs.” He stated that there were “significant reforms in prongs two and three” and went on to say “The sooner that we can get all those prongs out there, the better.”
However, despite promises of a better healthcare system, there are some reasons to be skeptical as to the overhaul. Senator Ryan’s Act as compared to what Republicans are promising seems extensively flawed and breaks some of the party’s promises. Discussed below is the GOP’s strategy, one prong at a time.
1. Pass the Affordable Healthcare Act
Having the Act passed in Congress is the first milestone required for Republicans to change the healthcare system. To an extent, the AHCA would change some of the things Republicans consistently criticized the Affordable Care Act on. The AHCA would review tax credits and have them based on age instead of an individual’s income as well as stop the expansion of Medicaid within the country. Additionally, the act would seek to reduce the government’s expenditure on changes in the healthcare system by an estimated $1.2 trillion.
Despite the positivity, the Act has undergone a lot of criticism. This is as a result of the Congressional Budget Office forecasting that the implementation of this act would deprive over 24 million Americans of their health insurance. Further, more than 50 Republicans in Congress have expressed a dislike for the bill and have promised that they would vote against it. As such, the White House should get into working on gathering enough political support to pass the act.
Gathering this support, however, seems to be a daunting task. This is because members of Congress that would come out to endorse the bill would suffer many political liabilities, including lack of support from their constituents. This could lead to decreased popularity and could consequently lead to the supporters having this as their last term in office.
On realization of this setback, the White House is asking everyone, the CBO inclusive, to look at the other parts of their strategy to overhaul the healthcare system and how the bill will fit into the bigger picture. During his Tuesday briefing, Spicer said, “When you look at the additional phases or prongs of this whole comprehensive approach; that actually changes the equation a lot.”
- Changes in Regulation and Administration
The AHCA seeks to be passed through budget reconciliation. As such, the bill needs only 51 votes in the Republican Senate for it to be approved. However, this method of changing policies has a disadvantage in that the Trump administration would only repeal parts of Obamacare that directly affect the country’s budget deficit. Passing the bill without using the budget reconciliation method would have it tabled under legislative process. The latter would require 60 votes from the Senate for approval – a significantly higher number.
Passing the bill through budget reconciliation means that the AHCA can remove citizens’ additional expenses on buying healthcare. However, the bill would not be able to repeal Obamacare regulations that require insurance providers to give enough coverage to clients because such laws do not directly affect the budget deficit. In hindsight, this means that the government would cut down its funding towards healthcare while at the same time do nothing to make the services insurance companies provide to be cheaper. This leaves a reduced amount of money for the same-priced insurance to Americans.
To stop this from happening is where phase 2 of the strategy kicks in. Members of the GOP have stated that HHS Secretary Tom Price has the authority to repeal Obamacare regulations. This will in turn result to lower premiums and consequently lead to cheaper healthcare. Lower-priced healthcare will then lead to an increased number of Americans being covered by the new act. As such, the forecasted number of people who would lose their health insurance on the implementation of the bill alone would be able to retain it.
However, it should be noted that Mr. Price has not specified the Obamacare regulations he would remove. The vagueness thus causes the sector to be unsure of other possible effects of repealing these laws. Some of the rules, if done away with, could result in more Americans becoming uninsured.
Additionally, Mr. Price does not have unlimited capabilities on his authority over Obamacare regulations. Benefits under the Obamacare plan still have to be almost the same as an employer would offer. If the advantages of the scheme are feeble, then the overhaul of the healthcare strategy could lead to legal implications which would inhibit its implementation.
- Bipartisan Reforms in the Healthcare Sector
To support their efforts in repealing Obamacare regulations, Republicans have said that they plan on releasing three major pieces of legislation in a bid to gain Democrats’ support in the Senate. The three initiatives of this part of the strategy would include
- Insurers selling across state lines
- Medical malpractice reform
- Associated health plans, which would separate healthy people from patients with severe medical conditions
Notably, reforms on medical malpractice would be a significant step towards improving the health sector. However, it would do nothing to increase the number of people who can access healthcare. At best, it would simply slow the growth of premium prices.
The associated health plans would ensure that healthier Americans suffer subsidized costs on their health care packages since they are not contributing towards the healthcare of others to a large extent. However, separating the unhealthiest individuals into their pool leaves these patients suffering from catastrophic bills all on their own. Democrats are severely against this initiative.
Currently, the biggest issue Republicans face is how they are going to get those eight votes to pass the bill and worse off, the looming impossibility of delivering what they promised to Americans.
