One of the many promises Donald J. Trump made throughout the course of his campaign, was to repeal Obamacare and replace it with “something so much better.” The republicans have tried on more than five dozen occasions, to repeal obamacare, but met roadblocks such as the democrats fillibuster, and the president’s veto. However, with a republican in the white house, and s republican majority in both the senate and house, the rebublicans are most likely to succeed in repealing the healthcare law. But how are they going to go about it, and what challenges will they most likely face?
Well first of all, an outright repeal will be both dangerous, and unproductive. The republicans need a super majority of about 60 republican senators to pass such legislation, in order to avoid a filibuster by the democrats, who will most likely try to prevent the republicans from repealing the healthcare law. However if by some stretch they manage to pull it off, it will lead to catastrophic consequences. Millions of people will lose their health coverage, premiums could shoot up, hospitals could suffer billions of dollars in losses. It is not a feasible plan. What republicans will try to do is introduce a budget reconciliation plan, to remove key elements of the ACA. This strategy will avoid a filibuster from the democrats, since it knly requires a simple majority of the senate, and it is unlikely President Trump will veto it. This strategy will be taken in steps:
Firstly, they will try to get rid of Employer Mandates and Individual mandates. Employer mandates require that companies with 50 or more staff, cover their staff and dependents under 26. Individual mandates require that everyone have health coverage or pay a tax penalty . The individual mandates are a measure to enable insurance companies to cover people with pre-existing conditions, while keeping the premiums low. The common argument among liberals and democrats, is that if that mandate is taken away, insurance premiums will shoot up higher that it is currently, since there are no healthy people paying for insurance, that will help to subsidize the costs of sicker people. However, studies show that despite the mandate, millions of Americans still prefer to pay the tax penalty than to buy health insurance, and as a result premiums go up anyway. Trump has indicated, he want to.keep the pre-existing conditions claus and a way to do that without the individual mandates would be to provide direct premium assistance to such people in the form of tax credits; a plan which many pundits and analysist have been skeptical about.Republican house members on the other hand, want to remove the pre-existing conditions clause altogether and introduce continous coverage plan. A measure that would ensure individuals do not jump in and out of health insurance when their health status changes. GOP house members led by house speaker Paul Ryan will also try to insert and delete certain methods including gutting medicaid grants, privatizing medicare.
Unfortunately, these small gradual changes the GOP plan on implementing will take at least two years. Trump and the GOP have not fully formulated a plan that will replace obamacare. One of their strategies would be to repeal and delay. This will involve repealing obamacare, then delaying the effective date for about two or three years which will allow time for them to come up with a new plan to replace it. What is interesting about this is that, the waiting period will spill into the presidential elections for 2020. And depending on which side wins the presidency; democrats or republicans , they will deal with the fallout, whatever it may be. However it seems more and more likely that obamacare -or at least parts of it- will continue to remain in the system, as Donald Trump seems reluctant to dismantle the entire thing as he promised to do in his campaign, and has indicated he wants to keep certain “good” parts of it, and add provisions that will make it better and bring down premium costs. One should remember however that this was Hillary Clinton’s plan for obamacare. While it is not uncommon for opponents to ‘steal’ certain policies from each other; and it is in fact encouraged, it seems a bit hypocritical of Donald Trump to do something he spent months criticizing Clinton about.
Then we have the replacement. What exactly does the Republican want to use to replace obamacare? Well they want to provide a refundable tax credit to those who don’t have employer provided insurance. While this is similar to Obamacare subsidies, this wont have an income limit, and individuals could purchase a wide variety of plans.They also plan to expand Health Saving Accounts or HSAs which will be tax free. They also want insurance companies to charge old people less and younger people more. Another plan is to provide billions of dollars to high-risk patients, in order to subsidize the cost of their insurance. Also they want to restructure Medicare and Medicaid so consumers will have a variety of options, and not be limited to their current choices, therby choosing a more suitably priced plan. However, these measure will add billions of dollars to the already large deficit, and it does nothing to tackle the issue of people not buying health insurance. If anything, this plan will cause millions of people to stop buying health jnsurance, and the only people who will possess insurance will be sick, and older people, causing a drop in the market, and could eventually lead to higher premium costs.
Repealing obamacare is a long and ardous effort, and one may suspect that it was designed to be that way by the democrats. Unless Trump and the GOP can find a more feasible way to restructure obamacare, and health reform, the health industry is looking at long years ahead of them