Obamacare on the Ropes

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Dr. Brenda Quinn, shown with her husband James Sparks, says that if she can’t get health insurance after the ACA is repealed, she will have to close up shop and look for a job with health benefits. Photo by Chris Saunders

By Peter White

NASHVILLE, TN – Republicans are playing politics with healthcare.

“They’ve been saying they are going to repeal and replace for seven years,” says Michele Johnson, executive director of the Tennessee Justice Center.

Johnson said the GOP is going to repeal the Affordable Care Act but we haven’t seen a replacement.

“They need a plan that takes into account that this is nearly 20 percent of the GDP,” she said.

Meanwhile, a bill to repeal and replace the Affordable Care Act (ACA) will be marked up in Washington this week. The Hill reported the House Energy and Commerce Committee plans to introduce the legislation on March 8.

The draft bill, dated February 10, was leaked to NBC News and while the Congressional Budget Office has not yet analyzed how much the Republican plan would cost, it takes a much different approach to healthcare reform. The biggest part of the plan would be paid for by a tax on the most expensive employer-provided health insurance plans.

The measure repeals taxes opposed by the business community and healthcare providers, including the medical device tax and the tax on health insurance, the so-called HIT tax, that provided funds to pay for the ACA.

The legislation cuts funding to Planned Parenthood, removes insurance subsidies to the working poor and replaces them with tax credits worth $2000 if you are under 30 and $4,000 if you are older than 60.

The plan would greatly expand Health Savings Accounts to pay for healthcare to 20 million people who are now covered by Obamacare. The bill would also stop expansion of Medicaid and impose state caps that would cut off some of the 72 million Americans who currently use it.  How many is not known at this time.

The proposal creates state-based high-risk pools for people who don’t have access to insurance. The federal government would provide $15 billion to fund the pools and the funding would drop to $10 billion in three years.

The bill effectively gets rid of the mandate to buy individual insurance or provide health coverage if you are an employer by removing the penalty if you don’t.

Ron Pollack, head of the Families USA, said the draft bill “buys less care — or no coverage at all.” He is not alone in his dislike of the Republican healthcare plan.

Johnson, of the Tennessee Justice Center, which advocates for healthcare consumers, said the Republicans are not dealing with the real issues.

“We have these amazing videos on our Facebook page.  They are really compelling stories of rural Tennesseans who are following the rules and doing everything right and this is going to devastate them,” Johnson said.  You can view those stories here:

https://www.facebook.com/tnjustice/

Johnson says the Republican bill doesn’t have lifetime caps on out of pocket expenses for those with chronic illnesses. There is no provision that allows children up to 26 years old to use their parents’ plan that the ACA allows.

“You can’t have protections for premium annual caps and pre-existing conditions without getting healthy people into the plan,” says Johnson.

Republicans voted down those ACA provisions last December in a vote-a-rama.  A vote-a-rama is peculiar to the U.S. Senate where members propose a series of amendments after debate has ended on a reconciliation bill. The process can last up to 20 hours before a final vote on a bill is taken.

Johnson says the Republican plan will deliver less healthcare and fail financially because it will not limit premiums and relies too heavily on taxing employer-provided health plans.

“It’s a shrinking pool of people,” says Johnson. She says the number of people covered with employer group health plans gets smaller every year.

Republicans say their plan will stabilize the collapsing health insurance market. Companies like Humana, Blue Cross Blue Shield, and United Healthcare have all decided to pull out of Tennessee. Unless things change you won’t be able to buy a plan from those companies at any price.

That is what worries Brenda Quinn. Both she and her husband have pre-existing health conditions and both have health insurance they bought on one of the exchanges created by the ACA.  They make too much money to get a subsidy and pay about $900 a month.  Quinn isn’t complaining because she is covered.

Quinn, 56, lives in Smyrna and has her own psychology practice in Murfreesboro. She holds a PhD in social psychology and one in clinical psychology.

“Because I’m a provider and I get paid by health insurance I get to see the other side and I have clients who wouldn’t be able to see me without the ACA,” she said.

Quinn says that if she can’t get health insurance after the ACA is repealed, she will have to close up shop and look for a job with health benefits.

“I hope I don’t have to lose my practice but I’m absolutely afraid I might,” she said.

“I love what I do and I’m really good at it and I don’t want to give it up. That would be a little tragedy to me but there are people who are going to die if the the ACA goes away.”

The first priority of the Republican plan is to shore up the health insurance markets. Johnson says what it won’t have is the focus on preventative care the ACA provides for millions of Americans. Johnson said things like pap smears, breast exams, mammograms, colonoscopies, and free wellness visits will no longer be covered.

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