Obamacare at a crossroads: No end in sight to the GOP's mission to deprive Americans of health care

Republicans will not end their quest to repeal ACA. If Clinton wins, it'll be one of her first battles with the GOP

Published September 19, 2016 9:59AM (EDT)

  (AP/Carolyn Kaster/Reuters/Stephen Lam/Photo montage by Salon)
(AP/Carolyn Kaster/Reuters/Stephen Lam/Photo montage by Salon)

If Democratic presidential nominee Hillary Clinton wants to add any new groups to her list of deplorables, I would like to suggest the Republicans in Congress who are forcing President Obama to scramble to shore up the Affordable Care Act before he leaves office.

The GOP is not exactly forcing the president’s hand directly. It is more a combination of congressional inaction fed by the desire of senators and representatives to not take responsibility for the party's base that they long ago trained to dial up the frothing madness to 11 anytime anyone anywhere says the word “Obamacare.”

Who would have thought that the president would in his eighth year in office still have to spend time trying to keep the signature policy achievement of his first year from collapsing with zero support from Congress? That he would have to beg and plead with insurers to not throw Americans off their health insurance because the Republican Party has decided it would prefer to let Obamacare die out of spite?

Politico has a story about these efforts, and it might make you grind your teeth into powder if you read it and then think about all the time that could have been spent shoring up the law through legislation instead of wasted on dozens of pointless repeal votes — all so some freshman representative elected in 2014 could go back to his deep red district and brag that he was fighting Obamacare for his people.

Obama and his administration are redoubling their pleas for insurers to shore up the federal health care law and pushing uninsured Americans — especially younger ones — to sign up for coverage. 

The efforts come at the end of a summer of both good and bad headlines for Obamacare. Last week the Census Bureau announced the uninsured rate last year had dropped to 9.1 percent, the lowest ever recorded, and may have dropped another half a percentage point since the beginning of this year. The rate was 15.7 percent before the ACA was signed, so a drop of almost half despite GOP opposition and Republican governors refusing to sign up for the law’s Medicaid expansion out of spite (and yes, no matter what many of them said about fiscal responsibility, spite for the president was the motivating factor) is a notable achievement.

Every bad headline, though, is ammunition for Republicans to argue for full repeal. A few weeks ago Aetna, one of the nation’s largest insurers, announced it would pull out of 11 of the Obamacare exchanges it participates in. The company cited rising costs and the lack of profitability for the move, though there is a chance that pique at federal regulators for holding up its merger with Humana also played a role. Nonetheless, the move means nearly a million Aetna customers will be shopping for new coverage on exchanges with fewer plans, which means higher prices.

Aetna’s move followed Humana's and UnitedHealth Group's pulling out of most exchanges as well, citing big losses. It is possible that in 2017, as many as 20 percent of consumers will have only one option for purchasing insurance on whichever exchange their state participates in.

Could the Republican majority in Congress, working with the president, have come up with legislative fixes to shore up the exchanges? Sure. But instead the GOP went in the other direction. For example, Senator Marco Rubio of Florida led a battle to block the administration from fully implementing risk corridors, a provision of the original law that would have had the Department of Health and Human Services covering some of insurers’ losses with money, designated as “user fees,” that it collected from insurers that were doing well.

Rubio later talked up his killing of risk corridors to help his presidential race, but he still got crushed by the sentient nativist mango named Donald Trump who ultimately won the nomination. Thanks, senator. I hope it was worth it.

I have written before that the troubles with Obamacare make this a good time for Hillary Clinton to push for the public option of a government-run insurance program that Obama had to leave out of the ACA in 2009 to get it past moderates in the Senate. And indeed, 33 Senate Democrats have allegedly now signed on to the idea, which was also a plank of the Democratic platform adopted at this summer’s convention.

The problem is that even if the Democrats win back a Senate majority in November, there are still moderates in the caucus who are opposed to the idea. And that is to say nothing of the fact that no Obamacare fix will get through what is likely to be the still-Republican-controlled House of Representatives. No White House push is likely to change any minds.

Which is why congressional Republicans deserve to be on that “deplorables” list. Refusing to legislate is not doing their job as legislators. It is the exact opposite.


By Gary Legum

MORE FROM Gary Legum


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