To repeal or not to repeal

Republicans look to fix flawed Affordable Care Act, need new strategy

The promise to repeal the Affordable Care Act (ACA), better known as Obamacare, was a constant topic in an otherwise chaotic election season.

While then-presidential candidate Donald Trump promised to have the act repealed in his first 100 days, after a month in office, President Trump has been forced to adjust his timeline with the hope to repeal Obamacare by the end of the year.

The delay has been caused by members of the House of Representatives and the Senate fighting over creating a replacement plan, debating what portions of the law should be repealed and which ones should stay.

Meanwhile, democrats have promised to block all attempts at a repeal as many, including the outspoken Senator Bernie Sanders, believe the ACA needs to be expanded not decreased.

In CNN’s Feb. 7 town hall debate between Senators Ted Cruz and Sanders the many benefits and downsides to the ACA  along with possible measures to fix what was recognized as a severely flawed system were discussed.

Senator Sanders was quick to tell stories of constituents who have benefited from the ACA as either the government subsidies allowed them to afford insurance for the first time or they were no longer rejected on the basis of a preexisting condition.

Meanwhile Senator Cruz talked about Texans who have seen their premiums increase from $400 a month to more than $1,000 a month since the law’s enactment.

Skyrocketing premiums are the result of expanded coverage requirements and a decreasing number of insurance providers.

Aetna Health Care CEO Mark Bertolini described the Obamacare market as being in a “death spiral” when discussing Humana’s announcement that it would withdraw from all public exchanges starting in 2018, according to Politico.

Repealing the ACA would allow market competition to stabilize prices while individuals and families are able to purchase the coverage they need, not what the government tells them they need.

However, the fear among many Americans is that they will suddenly be dropped by their insurer or lose their subsidies, leaving them to pay their insurance premiums entirely on their own.

It is because of these fears that the Republican Party is now promising to repeal and replace the ACA.

Currently there are two replacement bills that have been presented on the Senate side that take differing approaches to solving the problems of the ACA.

The first bill, Senator Bill Cassidy’s “Patient Freedom Act,” focuses on returning authority over healthcare to the states by allowing them to choose either to keep the ACA or to become what he calls “Patient-Grant Electing States.”

The second bill, introduced by Senator Rand Paul, is known simply as the “Obamacare Replacement Act” and focuses on repealing private market rules and regulations on the sale and purchase of insurance.

While these two proposed acts differ on how much of the Affordable Care Act to repeal, they both keep many of the more popular elements.

The Kaiser Family Foundation, a health policy think tank, published a comparison tool to illustrate the similarities and differences between the proposed plans and the ACA.

Similarities include the requirements that 26 year-olds be allowed to remain under their parents’ insurance and the prohibition of annual or lifetime limits on coverage.

These plans also keep the rule that insurers cannot reject an individual for pre-existing conditions with the slight adjustment this rule only applies during open enrollment
periods.

In the hope of keeping individuals enrolled and stabilizing prices, both plans offer rewards for continuous coverage with Senator Paul’s plan even offering portability protection, allowing an individual to take their insurance with them from his or her job or from state to state.

The use of Health Savings accounts is also promoted by both plans as money from employers and federal subsidies would automatically be deposited for individuals to use toward premiums, deductibles  and other medical expenses.

Currently the proposed replacement plans do not contain any so called poison pills.

However, there have been calls to include the defunding of Planned Parenthood in a replacement plan.

This amendment and others would not only increase the resistance among members of the Democratic Party, it could also lead to some middle ground republicans jumping ship.

lapp is an opinion writer.