Here's What Republicare Will Look Like

Republican lawmakers are busy rubbing their hands together and waiting for the US Supreme Court to strike down the individual mandate in the Affordable Care Act. They believe this will give them the momentum they need to begin selling their "replacement plan" for Obamacare, after they repeal it, of course. Actually, they're hoping the Supreme Court will repeal it for them by upholding the non-severability clause which allows the entire law to be struck down if one provision is struck down.

Here's what they're planning to replace it with, via The Hill:

The Republican plan will not preserve one of Obama’s most politically popular reforms: the requirement that insurers cover people who have pre-existing conditions. Some Republicans have said in the past that it would be difficult to walk away from that provision. But Pitts said the GOP will instead propose state-based pools in which the government would take over the cost of the sickest, most expensive patients, rather than requiring private insurers to cover them.

The rest of the plan Pitts outlined draws from long-standing GOP priorities. It will include limits on medical malpractice suits and allow the sale of insurance across state lines, Pitts said, while also expanding the use of health savings accounts.

Ask Susie Madrak how those state-based pools are working out for her. Yes, they're better than having nothing. But they don't help with high deductibles in the least. Selling insurance across state lines? Which state will race to the bottom to compete for the business? North Dakota? South Dakota? And health savings accounts? I've told you all about how those work until they don't.

I repeat: The Affordable Care Act was all about pre-existing conditions. Not mandates, not Medicare Advantage, not insurance exchanges, and not private versus public insurance. Pre-existing conditions exclusions have always been and will forever be the barrier to universal health care in this country. Now House Republicans have confirmed that.

But hey, at least they can call those pre-existing conditions plans a public option. I can hardly wait to see how states like Texas and Alabama would implement such a thing, can't you?

The only good idea to come out of Pitts' committee right now is decoupling employment and health insurance so individuals get the tax deduction for insurance rather than companies. Of course, it doesn't work as well with the Republican plan as it does with the Affordable Care Act.

Can we please stop hating on the Affordable Care Act and consider defending it now? Because what Republicans are proposing will do absolutely nothing at all to help people who need access to affordable health care. At least the ACA offers some government help toward that, and yes, it eliminates the pre-existing conditions exclusion, which established a level ground for everyone.

Bernard Avishai has a wonderful article in the February 13, 2012 issue of The Nation discussing Paul Starr's book about the development of health policy and passage of the Affordable Care Act. Of Starr, he writes this:

Starr’s great fear is repeal of the Affordable Care Act, which would not only deny healthcare to more than 30 million people but would cast doubt on whether “Americans will ever be able to hold their fears in check and summon the elementary decency toward the sick that characterizes other democracies.” Obamacare, in short, was healthcare reform’s best—and last—shot, and it would be unconscionable for liberals to remain cavalier about its defense, or Obama’s, for that matter. It’s past time to discard the misguided assumption that in a better economy, or with more of “a fighter” in the White House, something like a Canadian-style single-payer system might have been (or might sometime fairly soon be) enacted.



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