Repeal and Replace – With What?
On Wednesday, after hours of debate, the U.S. House of Representatives voted for the thirty-somethingth time to repeal all or part of “Obamacare.” It was a belligerent but futile gesture to exhibit once again their contempt for that Black man that sits in the White House, whom they feel can do absolutely nothing right or praiseworthy.
Many Republicans really believed the assurances from “the bubble” of Faux News and the Limboids that the Affordable Care Act was unconstitutional, and they were really surprised when the chief justice appointed by George Bush, Jr. himself was the swing vote.
(When I was a kid, there were billboards around for years demanding, “Impeach Earl Warren,” the former Republican governor of California appointed chief justice by President Eisenhower. I wonder if we’ll soon see “Impeach John Roberts” versions.)
“Repeal and Replace” has been the recent mantra of the GOP. One wonders what they hope to replace the ACA with.
I’m a C-SPAN junkie. More precisely, I have C-SPAN2, which covers the Senate, droning on in the background much of the time. The grammar, rhetoric, and logic of the Senate are of a higher quality than those found in the House, although sometimes not by much. Nonetheless, I can only take so much of Louie Gohmert and Michelle Bachmann.
Anyway, for almost a year I watched and listened as many congressional committee sessions and interminable floor debates led up to the moment when the Democrats “sneaked” the ACA through Congress. I well remember the Republican talking points, because there were so few of them and they repeated them endlessly.
One of the only substantial proposals that I can recall was to permit interstate sales of health insurance. This was a “lowest common denominator” approach, which would allow a person in one state to buy an approved health insurance policy from any other state. No federal regulation was included, just the chance to find the state with the least restrictive insurance commissioner.
As I recall, there was also a proposal to allow corporations to join with each other to create more stable pools, and, of course, a call for some sort of individual medical savings accounts. The latter would certainly be appreciated by the banking industry, which contributes substantially to candidates and incumbents. But, I have to admit, there was some substance there.
Everything else was what used to be called a “red herring.” If the hounds are after you, drag a dead fish across your trail and throw it in the bushes, and maybe they’ll get sidetracked. That was the GOP strategy.
They spoke at great length about abortion and illegal immigration, two of their favorite topics that are always a hit with their base. The ACA didn’t give new rights to undocumented residents or expand abortion rights, but they endlessly warned that it would.
And then there was their spirited defense of the Medicare Part C program. This was a big giveaway to the insurance companies to entice them to offer policies that “wrapped around” Medicare and covered co-pays and provided extra health services. Under the ACA, this program would be cut by about half a billion dollars. That it was a bloated and inefficient program that they had all probably voted against was not mentioned.
I don’t recall them calling the “individual mandate” unconstitutional at the time, but of course that became the new mantra as soon as the measure was passed. It wasn’t mentioned that the concept had originated at the Heritage Foundation, a right-wing “think tank.” (Boy, there’s an oxymoron.)
And then there was the “death panel” issue, which had no basis in fact, and the dire warning that “the government will come between you and your doctor.” And that was it. If I’ve missed something substantive, please let me know.
There was nothing that dealt directly with the real problems of health care in our for-profit system. It wasn’t mentioned that the insurance companies routinely came between patients and their doctors and made decisions without any regulation. There was no mention of pre-existing conditions and lifetime limits and all the other excesses of the industry. It wasn’t brought up that the federal government runs its Medicare and Medicaid programs for one or two percent of the cost while insurance companies were raking in ten and even twenty percent. There was no solution proposed for the rampant use of emergency room services, at public expense, by the millions of people who couldn’t afford health insurance. There was nothing to stop the health care industry from gobbling a bigger and bigger proportion of our resources. And they didn’t have a fix for the “doughnut hole” in Medicare Part D, the prescription drug benefit, that they had created during Bush-Jr. and didn’t pay for.
So now they want to “repeal and replace” the ACA. From what the Republicans say, I take that to mean a return to the status quo ante. That would be a disaster.
Let’s face it, the Republicans don’t want a federal health insurance program. They didn’t want Medicaid either, or Medicare, or Social Security, for that matter. They really hated Brown vs. Board of Education, which is why they wanted to impeach Earl Warren, and, of course, Roe vs. Wade. If given their way, they would dismantle them all and replace them, if at all, with programs that benefit the banks and corporations, and the bigots and xenophobes, that they represent.
But, unless they can keep their majority in the House, get a filibuster-proof supermajority in the Senate, and replace the president in November, we will have this new program, long overdue, to deal with one of the major problems in our society. Is it perfect? No. Is it a step in the right direction? Yes. Is it the right thing to do? It is.
So, my suggestion is: Don’t repeal and replace the ACA. Reject and replace the Republicans.