Now that Republicans’ efforts to repeal and replace Obamacare are finally dead -- this time for good -- Congress can actually do what the American people want, which according to a poll, is improving Obamacare -- not repealing it.
The Congressional Budget Office released a preliminary report revealing that the Republicans’ last-ditch effort to repeal and replace Obamacare would result in millions of Americans losing health insurance. The result was Maine’s Republican Senator Susan Collins opposing the bill, which was a third vote Senate Republicans couldn’t afford to lose.
The now bipartisan effort to improve Obamacare, for which Republican Senator of Arizona John McCain has called, began with a health care debate broadcasted on CNN, Monday. It revealed opportunities for Congress to improve upon Obamacare -- if Republicans are willing to work with Democrats to pass legislation.
The four Senators participating in the debate were Democrat Amy Klobuchar of Minnesota, Independent Bernie Sanders of Vermont, and the Republican writers of the latest effort to repeal and replace Obamacare, Lindsey Graham of South Carolina and Bill Cassidy of Louisiana. The debate remained cordial for the most part, with moments of consensus indicating a bipartisan bill is indeed possible.
Graham pointed out that since the passage of Obamacare, the money has continued to flow away from Americans to health insurance and pharmaceutical companies. He cited the profit increases of the major health insurance providers, with all six of the biggest seeing their stock hit all-time highs this summer. This was music to Sanders’s ears, who acknowledged his Medicare-for-All bill introduced in the Senate won’t pass and that a bipartisan effort to improve Obamacare should be the short-term focus of Congress.
Cassidy even seemed to agree that something needs to be done to reign in the prices Americans pay for prescription drugs. Since Congressional Republicans held the longest roll-call vote for the Medicare Modernization Act, or Medicare Part D law, back in 2003, the federal government has been barred from negotiating prices with pharmaceutical companies.
According to a 2016 Reuters report, prices for four of the nation's top 10 drugs increased more than 100 percent since 2011. The report also shows that sales for those 10 drugs went up 44 percent between 2011 and 2014, even though they were prescribed 22 percent less. Prescription drug expenditures account for 20 percent of healthcare costs. But when Sanders asked Cassidy if he would vote for a bill to reverse the Part D law, much like Klobuchar’s Medicare Prescription Drug Price Negotiation Act, Cassidy instead called Sanders a Socialist who wants to commandeer the formulas for medicines to be produced by the State and disincentivize medical innovation.
A 2016 Kaiser Family Foundation poll found that Cassidy is part of a very small minority on the subject, with 93 percent of Democrats and 74 percent of Republicans in favor of the government negotiating Part D prescription drug prices. The problem, though, is that Congressional incumbents rely on pharmaceutical companies to win elections, which will make both Republican and Democratic votes hard for Klobuchar to attain. Senators Richard Burr of North Carolina, Orrin Hatch of Utah, Mitch McConnell of Kentucky and Roy Blunt of Missouri will likely join Cassidy as “no” votes on Klobuchar’s bill, given the donations their campaigns received from the prescription drug industry totalling $4.35 million between 2003 and the middle of last year.
Another obstacle for Klobuchar’s bill is the fact that this time last year, there were 894 pharmaceutical lobbyists to the 535 members of Congress, with more than 60 percent of them having previously served in Congress or worked other government jobs. It seems the prescription drug industry provides nice retirement work for former government officials, which incumbents won’t want to see go away.
So while CNN’s healthcare debate provided opportunities to improve Obamacare, Congressional corruption presents obstacles to overcome in order for Americans to see their healthcare costs decline.
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Republicans are again trying to repeal and replace Obamacare, but what they’re really doing is attempting to alter the Affordable Care Act just enough so they hold onto their jobs and fulfill a promise made by Donald Trump to repeal and replace Obamacare “one Day 1.” We are nearing Day 100, and the House Republicans can’t even agree amongst themselves let alone get enough votes in the Senate to pass their American Health Care Act.
The best thing that could have happened for Republicans with regard to the Affordable Care Act would have been to accomplish the goal announced by House Majority Leader Mitch McConnell just after Barack Obama was elected president. "The single most important thing we want to achieve is for President Obama to be a one-term president,” he said. They failed, and so will their attempt to repeal and replace Obamacare.
The problem for Republicans, and specifically Southern Republicans, is that Obamacare is working for some and would work for most of their constituents. In fact, the South had the highest rate of uninsured people in 2012 at 18.6 percent. And it’s not all Hispanics. Over 68 million of them are white.
Southerners are also the least healthy of all Americans, with 20 percent reporting fair or poor health in 2014. Southerners are also the most impoverished Americans, with 17 percent of Southerners living below the poverty level in 2014. The South also has the highest rates for diabetes, obesity and infant mortality in the nation. The South accounts for nearly as many uninsured people as the rest of America combined, and 17 percent of the uninsured fall into the coverage gap for Medicaid expansion.
Yet Southerners have taken advantage of, or actually, been disadvantaged by the Supreme Court decision to not force Medicaid expansion upon all states. Had all states been required to expand Medicaid, 7 million people would gain coverage, 4.3 million fewer people would be uninsured and states would see between $5 and $10 billion in uncompensated care savings over the next 10 years, which would offset increased state spending by between 13 and 25 percent.
Of the 19 states resisting Medicaid expansion, 14 are in the South. The states with the most people who stand to gain insurance through expansion are Florida (1.253 million), Texas (1.186 million) and Georgia (.682 million). Georgia nearly elected a Democrat to the house just a few days ago, Texas is turning blue, and two Republican incumbents lost House seats to Democrats in Florida last November, while Democratic incumbents retained all six of their seats.
In short, Southerners need Obamacare and the subsidies that come along with it. They’re just starting to realize it. Now, if America adopted a Medicare-for-all system that Bernie Sanders has proposed, maybe we could stop spending nearly $3 quadrillion on health care as a nation.
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