Wrecking crew
by Tom Sullivan
We often build a new stadium beside the old one before we demolish the old one and turn it into a parking lot, my wife observes. Same thing with replacing old bridges. We build the new ones first before we blow up the old so we minimize disruption for commuters. But radicalized congressional Republicans are so hopped up on disruption they may just implode Obmacare before sitting down to design a replacement.
Kentucky Sen. Rand Paul is worried his Republican colleagues may do just that:
“I think it's imperative that Republicans do a replacement simultaneous to repeal,” Paul said Wednesday on MSNBC’s “Morning Joe,” cautioning that disaster in the form of insurance company bankruptcies and a “massive” bailout could follow a move to repeal the law without a new one in its place. “If they don't, Obamacare continues to unravel.”"And your point is?" the GOP caucus dared say aloud.
Some Republicans, determined to repeal Obamacare quickly now that they have one of their own entering the White House, have advocated repealing the law with a delay period in which they would try to come up with some replacement. If they failed to pass a new law in that time, millions of people who depend on Obamacare for their health insurance could lose their coverage.
Surveys show that most enrollees in the Affordable Care Act marketplaces are happy with their plans. The Trump voters in our focus groups were representative of people who had not fared as well. Several described their frustration with being forced to change plans annually to keep premiums down, losing their doctors in the process. But asked about policies found in several Republican plans to replace the Affordable Care Act — including a tax credit to help defray the cost of premiums, a tax-preferred savings account and a large deductible typical of catastrophic coverage — several of these Trump voters recoiled, calling such proposals “not insurance at all.” One of those plans has been proposed by Representative Tom Price, Mr. Trump’s nominee to be secretary of Health and Human Services. These voters said they did not understand health savings accounts and displayed skepticism about the concept.And yet proposals under consideration may indeed demolish what's there before constructing something to replace it. (Republicans had 7 years to design a replacement for what was essentially a Republican plan in the first place.) The Washington Post reports:
When told Mr. Trump might embrace a plan that included these elements, and particularly very high deductibles, they expressed disbelief. They were also worried about what they called “chaos” if there was a gap between repealing and replacing Obamacare. But most did not think that, as one participant put it, “a smart businessman like Trump would let that happen.” Some were uninsured before the Affordable Care Act and said they did not want to be uninsured again. Generally, the Trump voters on Medicaid were much more satisfied with their coverage.
House Republicans tasked with writing the repeal legislation said that no final decisions have been made on what it will include. Rep. Patrick J. Tiberi (R-Ohio) who chairs a House subcommittee that oversees health care, called the incoming administration’s Jan. 27 deadline “a challenging goal.”BOOM!
Among the unanswered questions is whether Republicans will immediately end health-care taxes, such as an additional 0.9 percent Medicare payroll tax and a 3.8 percent investment income tax, that were created to help pay for the Affordable Care Act. Some Republicans have insisted that the taxes should be eliminated immediately, even if lawmakers decide to delay the repeal of other parts of the law. Others worry that repealing the taxes will make it impossible to pay to keep Obamacare afloat while a replacement is finished.
