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The US House of Representatives recently passed a bill to repeal and replace ObamaCare, known as the American Health Care Act (AHCA), by narrow margins. The 217 to 213 vote followed intense lobbying on the part of Speaker Paul Ryan and vice president Mike Pence.
The bill includes major changes on pre-existing conditions, overturning the individual mandate, shifts some of the financial burden from the young to the elderly, converts Medicaid funding to a block-grant system for the states, and slashes Medicaid funding and some subsidies.
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Children would still be allowed to remain on their parents’ plans until the age of 26, and states will be allowed to add a work requirement to Medicaid.
The bill was opposed by two distinct coalitions of Republicans. On one side, a group of libertarian-minded representatives who felt the bill did not go far enough, and was a mere regurgitation of the failed ideas that were the basis of ObamaCare. Thomas Massie (R-KY), for example, claimed the legislation is “replacing mandates, subsidies and penalties with mandates, subsidies and penalties.”
On the other hand a number of moderate Republicans were concerned by funding cuts in Medicaid. Prominent Florida representative Ileana Ros-Lehtinen released the strongest statement in opposition, suggesting, “the proposed changes to this bill would leave too many of my constituents with pre-existing conditions paying more for health insurance coverage and too many of them will even be left without any coverage at all.”
A last minute change under the auspices of the so-called Patient and State Stability Fund was key to win over the support of moderate holdouts. The fund provides $100 billion to help states manage the costs of providing care to their most expensive patients.
As PJ O’Rourke once noted, “If you think healthcare is expensive now, wait until you see what it costs when it’s free.” During ObamaCare’s tenure, costs have skyrocketed, while private insurance industry profits have doubled, as noted by both Ted Cruz and Bernie Sanders in a CNN-sponsored healthcare debate.
The real key to driving down costs is to get the government out of healthcare entirely. The 80% to 90% of Americans who are capable of paying for their own health insurance should do so, while private charity is a far more efficient and effective institution to provide healthcare to those who truly are incapable of taking care of themselves.
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