Democrats, hoping to seize on momentum from the apparent collapse of the Republicans’ health bill, are grappling with a tough question—whether they can do anything to prevent the Trump administration from weakening the Affordable Care Act through administrative actions by the Department of Health and Human Services.
Democrats are trying to mobilize public support to block potential changes. Five Democrats on the Senate health committee sent a letter to President Donald Trump Monday calling on him not to undermine the health law.
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The full dimensions of the GOP’s self-defeat on health care will emerge over time, but one immediate consequence is giving up block grants for Medicaid. This transformation would have put the program on a budget for the first time since it was created in 1965, and the bill’s opponents ought to be held accountable for the rising spending that they could have prevented.
The members of the House Freedom Caucus who killed ObamaCare’s repeal and replacement claim to be fiscal hawks. Most of them support a balanced budget amendment. Yet they gave zero credit to a reform that would have restored Medicaid—a safety net originally intended for poor women, children and the disabled—to its original, more limited purposes.
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President Donald Trump and GOP lawmakers, seeking to regroup following the collapse of the effort to repeal the Affordable Care Act, have an option for gutting the health law relatively quickly: They could halt billions in payments insurers get under the law.
House Republicans were already challenging those payments in court as invalid. Their lawsuit to stop the payments, which they call illegal, was suspended as Republicans pushed to replace the ACA, but it could now resume—or the Trump administration could decline to contest it and simply drop the payments. Mr. Trump could unilaterally end the payments regardless of the lawsuit.
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President Donald Trump blamed Democrats for the defeat of his bid to overturn the 2010 Affordable Care Act and enact Republican policy in its place. In some ways he may have been right.
Supporters of the health law popularly known as Obamacare launched an all-out campaign for its survival, keeping Democrats unified in opposition to its repeal, and identifying and exploiting Republican divisions that ultimately forced GOP leaders to pull the bill at the eleventh hour Friday.
In every corner were top officials from former President Barack Obama’s administration, reeling from an election that put their party out of government and left them with plenty of free time on their hands.
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With the collapse of Republicans’ health plan in the House on Friday, the Trump administration is set to ramp up its efforts to alter the Affordable Care Act in one of the few ways it has left—by making changes to the law through waivers and rule changes.
The initiative now rests with Health and Human Services Secretary Tom Price, who has vowed to review every page of regulation and guidance related to the ACA. The steps he and the administration take next could have sweeping repercussions, accomplishing some of the same types of changes Republicans were unable to push through Congress.
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Business groups were hoping a quick repeal of the Affordable Care Act would give employers more flexibility on health care and create momentum for priorities like a tax overhaul.
Friday’s decision by House GOP leaders and President Donald Trump to abandon a vote on the Republican health plan left them less certain on both fronts.
“This is a dismal failure,” said Juanita Duggan, chief executive of the National Federation of Independent Business, a group representing small businesses. “NFIB is officially unamused, and we’re not going to let them off the hook.”
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What politicians, those hardy folk, don’t understand about health care is how anxious it makes their constituents. Not suspicious, not obstinate, but anxious. Because unlike such policy questions as tax reform, health care can be an immediate life-or-death issue for you. It has to do with whether, when, and where you can get the chemo if you’re sick, and how long they’ll let you stay in the hospital when you have nobody, or nobody reliable and nearby, to care for you. To make it worse, the issue is all hopelessly complicated and complex and pits you as an individual against huge institutions—the insurance company that doesn’t answer the phone, the hospital that says “I’m afraid that’s not covered”—and you have to make the right decisions.
House Republicans pulled their health-care bill shortly before a vote on Friday, and for once the media dirge is right about a GOP defeat. This is a major blow to the Trump Presidency, the GOP majority in Congress, and especially to the cause of reforming and limiting government.
The damage is all the more acute because it was self-inflicted. President Trump was right to say on Friday that Democrats provided no help, but Democrats were never going to vote to repeal President Obama’s most important legislation. And that’s no excuse. Republicans have campaigned for more than seven years on repealing and replacing ObamaCare, and they finally have a President ready to sign it. In the clutch they choked.
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Section 202 of the AHCA contains a transitional schedule of tax credits that would apply only in 2018 and 2019. These tax credits vary by both age and income, and they are set up so that they cap Americans’ exposure to high premiums. Take a childless 40-year-old making $25,000. Under Section 202, he would be expected to pay 6.3% of his income—roughly $1,500—for out-of-pocket premiums. The tax credit covers the rest. So if he buys a policy that costs $5,000 a year, the tax credit would be $3,500. If congressional leaders continue Section 202’s tax credits past 2019, they can kill three birds with one stone: repealing more of ObamaCare, lowering premiums for everyone, and making coverage especially affordable for the working poor.
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The American Health Care Act is all about is the boldest and most conservative health-care legislation to come before Congress in decades. Bold because it dismantles the progressive health-care experiment and replaces it with a dynamic, patient-centered system. Conservative because it applies America’s founding principles—freedom, free enterprise and federalism—to the problems of the day. Repeal of ObamaCare must happen, and urgently—not because of any ideology but because American families are already paying the price of the law’s collapse. The legislation gives control of Medicaid back to the states, equips state insurance markets to take care of people with pre-existing conditions without driving up costs for everyone else, and expands health savings accounts.
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