Ignoring overwhelming opposition from both the health care industry and the public in general to legislation that would destroy the Affordable Care Act (ACA), the US Senate voted this week to begin repealing ACA without having any workable plan to replace it. Essentially, Senators voted “Yes” without even telling the country which of several deeply-flawed bills they intend to pass.
These bills would all devastate Medicaid and leave millions more people without health insurance. They would make medical care unaffordable for many low-income and middle-class families. It seems that “doing something” was the only imperative for those voting for the motion to proceed, so that something could then move to a conference committee with the House, which in May, by the slimmest of margins, forced through its own appalling health care bill.
There are three main proposals in the Senate. One, the Obamacare Repeal Reconciliation Act, would eliminate important parts of the law without a replacement, stripping 32 million Americans of health insurance and cutting $842 billion from Medicaid, according to the Congressional Budget Office. Another plan, the Better Care Reconciliation Act, includes a replacement and would deny a mere 22 million people of coverage and cut $756 billion.
The third option is a “skinny repeal” because while much of the ACA would survive, it would eliminate one of the law’s taxes and the mandates that individuals buy insurance and that employers offer it to their workers. That plan would increase the uninsured population by “only” as much as 15 million while also pushing up insurance premiums by 20 percent.
Legislators supporting this misguided course of action are sending a troubling message not only to voters (who overwhelmingly oppose these proposals), but to hospitals and other health care providers and even insurers, who are unsettled by the complete uncertainty of it all. It is that uncertainty that keeps insurers from committing to markets and rates.
Iowa health care advocates have been staunch in their opposition, knowing that rolling back ACA would deprive thousands of their family, friends and neighbors of coverage. They know real progress in improving the health and well-being of thousands of Iowans, who were previously trying to get by on the edges of the health care system, would be lost.
They know “doing something” will likely lead to doing harm. And that is simply not acceptable.
There are no good options in the proposals now being considered by the Senate. Iowa health care advocates must continue to tell our Senators: Oppose any and all legislation that does not protect existing coverage.