The GOP’s Unaffordable WeDon’tCare Act

The GOP’s belated solution to the nation’s health insurance challenges just makes working families pay more.

— by Emily Schwartz Greco

Emily Schwartz Greco

Remember when it looked like the Republican Party could do nothing but stamp its feet and shout about the Affordable Care Act’s shortcomings without coming up with any alternatives?

OK, there was former Sen. Jim DeMint’s suggestion last summer that having the uninsured continue to abuse emergency-room services due to a lack of options would work better than President Barack Obama’s health insurance reform. And conservatives enjoy boasting about how many ideas for overhauling the nation’s health insurance system the GOP has lobbed over the years into what it might call the marketplace of ideas.

The Unaffordable Health Care Act, an OtherWords cartoon by Khalil Bendib

The Unaffordable Health Care Act, an OtherWords cartoon by Khalil Bendib

Since none achieved any traction, the Republicans in Congress are trying again.

Maybe this escaped your attention. After all, Obama signed the Affordable Care Act into law in 2010 and it’s now being implemented regardless of those 47 House repeal votes. Perhaps you heard about its rocky roll-out? Warts and all, major government programs are as easy to revoke as it is to get toothpaste back into the tube.

Plus, four years is a long time, especially when news cycles are so short that blinking means missing out on key developments like Justin Bieber’s latest travails.

The GOP is moving ahead anyway with new plans to replace the Affordable Care Act that are sure to go nowhere in our gridlocked Congress. A trio of Senate Republicans is leading the way with a new approach that upholds the party’s unofficial allegiance to the “WeDon’tCare” creed.

That’s the term Jim Hightower has used to describe Rep. Paul Ryan’s dream of converting Medicare into a privatized voucher scheme.

WeDon’tCare also serves as the Republican approach to many other urgent problems dogging the United States. Intractable unemployment? Rising hunger? Pollution? Climate change? The GOP just doesn’t care.

Maybe you do care and wish Republicans would too. But this policy does have plenty to offer. It’s versatile, consistent, and great for time management.

The GOP’s WeDon’tCare policy is very attractive for lawmakers who might have better things to do with their time than get bogged down in petty problems. Rather than grapple with issues that are making the lives of millions of Americans who can’t afford to make campaign contributions miserable, lawmakers free up time for other activities. Like golf. And taking free trips to France.

The new Republican plan probably won’t save any more tax dollars than the Affordable Care Act and might actually save less. It won’t shock you to hear that it’s structurally very similar to the system often called Obamacare except that its subsidies would be financed more by working families and less by taxes on corporations and the very rich.

Under this new plan, outlined in legislation introduced by Republican Senators Orrin Hatch of Utah, Richard Burr of North Carolina, and Tom Coburn of Oklahoma, insurance companies wouldn’t have to cover preventive care any more. Once again, insurers could charge women more than men. Unlike with the Affordable Care Act, the vast majority of Americans insured through their workplace would start paying more for their coverage. And if that isn’t enough, there are also, plans in motion to set some seriously low caps on amounts for which patients who’ve been harmed can sue the one or ones who did the harming.

I bet there’s a good chance that it will matter to you, personally, should this ever manage to get enacted. You might even get angry.

What about House Republicans? Majority Leader Eric Cantor says they’re on it, with Representatives Dave Camp and Fred Upton — both with Michigan seats — and John Kline of Minnesota taking the lead. If you’d like some specifics, you’ll have to wait a bit longer since apparently they need more time.

Why are they even bothering?

“Pointing and laughing at the failures of Obamacare will not be a sufficient governing vision,” conservative Michael Gerson observed in one of his recent columns.

Something more, in other words, is required to win back the White House. Having a presumed front-runner for the Republican nomination who isn’t embroiled in a career-killing scandal would be helpful.

But if the GOP really wants to fare better in the 2016 presidential election than it did in 2008 and 2012, Republicans will need to ditch their WeDon’tCare platform on health insurance and other issues voters care about.

Emily Schwartz Greco is the managing editor of OtherWords, a non-profit national editorial service run by the Institute for Policy Studies.

Five Years in — GOP Still Has NO Plan

Five years after Obama’s first election, the GOP has absolutely NO comprehensive health care reform plan other than “hurry up and die” or “good luck not going bankrupt over healthcare costs.”  Instead of embracing the Affordable Care Act, they prefer to return to insurance corporation rule over the healthcare options for Americans.

They can talk about “tort reform” and “selling insurance across state lines” … but neither of those concepts will help someone declared by the insurance industry to be defective, in that they have a “pre-existing” condition, making them ineligible for insurance at any price.  A large number of governors have already attempted “tort reform” and have been unable to achieve positive results.  In addition, I doubt those same Governors would want to see Insurers from some other state “cherry-pick” healthy citizens out of their state only to watch health pools become mostly populated with more unhealthy individuals causing healthcare costs to rise dramatically.

The GOP claims tort reform would give more certainty to the healthcare marketplace by curbing liability costs of providers of healthcare.  The only way they can conceivably do that is to dictate flat monetary values for the loss of a foot, arm, life, etc., or flat allowances for the plethora of malpractices that are committed on a regular basis.  In other words, if a doctor or health provider ruins your health or the quality of your life, you’ll get only a pittance for your bad luck.

The GOP’s desire to “sell insurance across state lines” is at cross-directions with their “States Rights” mantra and instead would throw each state under the bus.  Each State has its own Commissioner of Insurance who sets minimum requirements for those who provide Insurance policies to citizens of their particular state.  So, instead of protecting “States” rights, it appears the GOP wants to plow the way for large corporate insurance providers to take out more efficient and less costly smaller sized organizations … DECREASING competition in the marketplace, and thus HIGHER costs and abuses.

But, that’s all they’ve got.  So, before we throw out the baby with the bath water, so to say … maybe it’s time to get behind what was actually passed, upheld by the Supreme Court, and now in the process of being implemented.  The benefits of the Affordable Care Act are pretty straight forward: the law makes it easier to get insurance you can afford, ensures you have the care you need when you get sick, and covers the preventive services you need to stay healthy without additional co-pay:

Oklahoma Woman Tells GOP Lawmakers: Without Obamacare, ‘I Will Be Dead Before My 27th Birthday’


26-year-old Kendall Brown

26-year-old Kendall Brown [CREDIT: COURTESY OF KENDALL BROWN]

As the deadline approached for Congress to pass a continuing resolution to keep the government funded, Republicans refused to strike a deal unless it defunded or delayed Obamacare. Now, a week later, GOP lawmakers still seem unwilling to compromise unless they are able to dismantle some of the health reform law. One Oklahoma resident wants them to understand the human impact of that political position.

On the eve of the looming government shutdown, 26-year-old Kendall Brown published an open letter to the lawmakers who wanted to delay Obamacare for one year before agreeing to pass a funding bill. Brown didn’t mince words. “I am dying, because of the political games you are playing right now,” her op-ed began.

The Oklahoma resident explained that she was born with Crohn’s Disease, an inflammatory bowel disease that has no cure. When Brown was in college, she was removed from her mother’s health care coverage. Since her illness prevented her from being able to take a full course load, she couldn’t meet the credit requirements to qualify as a student to remain on the plan. During that time, she could only afford a limited student health plan, and she accumulated thousands of dollars in medical debt.

Once Obamacare allowed young adults to remain on their parents’ plans regardless of their academic status, Brown was able to return to her mother’s insurance. That provision of the health law was enacted at a crucial time — not long afterward, Brown needed to undergo emergency surgery to remove two feet of her intestine that had swollen shut. She wouldn’t have been able to afford the procedure otherwise.

But Brown is now 26 years old, and no longer qualifies for coverage under that Obamacare provision. Although she’s currently employed full-time at a nonprofit, the small organization can’t offer her any health benefits. She’s tried to apply for insurance plans on her own, but she’s been denied because of her pre-existing condition. She cannot currently afford the lifesaving treatment to manage her illness, a form of chemotherapy that costs $15,000 for each infusion. She is desperate to enroll in the health law’s new marketplaces so she can have the coverage she needs.

“I tell you this because I am tired of being reduced to a number, a statistic or, even worse, being described as a freeloader that wants to live off of the government health care teat,” Brown explains in her open letter. “I tell you this because if you defund Obamacare, or delay it even for one year, as you are debating today, then this will be my last letter to you. I will be dead before my 27th birthday.”

In an interview with ThinkProgress, Brown explained that she had been following the political drama in the lead-up to the current shutdown, and she decided to write her letter “out of incredible hurt and anger.”

“I don’t think that our elected officials are willfully terrible people — I think they are just so caught up in the game, so dead set on doing whatever it takes to get those votes next re-election season, that they forget that they’re talking about actual people,” the Oklahoma resident explained. “That’s what I wanted them to remember from reading my letter.”

Brown believes that Obamacare has already saved her life, because it allowed her to receive surgery while she was covered under her mother’s plan as a young adult. “Without that surgery I would have died a very painful death,” she noted. And with the law’s state-level insurance marketplaces opening to the public, Brown says her life will be saved all over again. She’ll be able to afford her medications and her regular chemotherapy treatments. She’ll hopefully be able to avoid another surgery.

But she’s still disappointed in her lawmakers. Congress ultimately failed to delay Obamacare’s marketplaces from opening for enrollment, but the federal government has still ground to a halt. And in Brown’s home state of Oklahoma, politicians are still resistant to health reform. Some Republicans continue to fight against the health law’s optional Medicaid expansion, which would help extend coverage to the state’s considerable uninsured population. Seventeen percent of Oklahoma adults don’t have health coverage.

“I am a very proud Oklahoman, and I plan to make my career and raise a family here, but I do not feel that our state elected officials are serving our best interests,” Brown told ThinkProgress, saying she’s “baffled and saddened” that her elected officials have dug in their heels against health reform.

“That, to me, is not in the spirit of being an Oklahoman,” she continued. “I grew up in a small western Oklahoma town, where you took sick neighbors casseroles and you offered to watch each other’s children. In short — you helped out your fellow man. And that’s what Obamacare is about, for me.”

This material [the article above] was created by the Center for American Progress Action Fund. It was created for the Progress Report, the daily e-mail publication of the Center for American Progress Action Fund. Click here to subscribe.

How the Health Care Law is Making a Difference for Nevadans

Because of the Affordable Care Act, the 78% of Nevadans who have insurance have more choices and stronger coverage than ever before. And for the 22% of Nevadans who don’t have insurance, or Nevada families and small businesses who buy their coverage but aren’t happy with it, a new day is just around the corner.

Soon, the new online Health Insurance Marketplace will provide families and small businesses who currently don’t have insurance, or are looking for a better deal, a new way to find health coverage that fits their needs and their budgets.

Open enrollment in the Marketplace starts Oct 1, with coverage starting as soon as Jan 1, 2014.  But Nevada families and small business can visit right now to find the information they need prepare for open enrollment.

Key Features of the health care law are already providing better options, better value, better health and a stronger Medicare program for the people of Nevada:

Key Features




Better Options

The Health Insurance Marketplace

Beginning Oct 1, the Health Insurance Marketplace will make it easy for Nevadans to compare qualified health plans, get answers to questions, find out if they are eligible for lower costs for private insurance or health programs like Medicaid and the Children’s Health Insurance Program (CHIP), and enroll in health coverage.

By the Numbers: Uninsured Nevadans who are eligible for coverage through the Marketplace. 

  • 473,971 (22%) are uninsured and eligible
  • 347,244 (73%) have a full-time worker in the family
  • 174,840 (37%) are 18-35 years old
  • 218,730 (46%) are White
  • 44,217 (9%) are African American
  • 157,518 (33%) are Latino/Hispanic
  • 33,012 (7%) are Asian American or Pacific Islander
  • 258,036 (54%) are male

438,826 (93%) of Nevada’s uninsured and eligible population may qualify for lower costs on coverage in the Marketplace, including through Medicaid.

Nevada has received $74,754,285 in grants for research, planning, information technology development, and implementation of its Health Insurance Marketplace.

New coverage options for young adults

Under the health care law, if your plan covers children, you can now add or keep your children on your health insurance policy until they turn 26 years old. Thanks to this provision, over 3 million young people who would otherwise have been uninsured have gained coverage nationwide, including 33,000 young adults in Nevada.

Ending discrimination for pre-existing conditions  

As many as 1,157,045 non-elderly Nevadans have some type of pre-existing health condition, including 162,452 children.  Today, insurers can no longer deny coverage to children because of a pre-existing condition, like asthma or diabetes, under the health care law. And beginning in 2014, health insurers will no longer be able to charge more or deny coverage to anyone because of a pre-existing condition.  The health care law also established a temporary health insurance program for individuals who were denied health insurance coverage because of a pre-existing condition.  1,373 Nevadans with pre-existing conditions have gained coverage through the Pre-Existing Condition Insurance Plan since the program began.

Better Value

Providing better value for your premium dollar through the 80/20 Rule

Health insurance companies now have to spend at least 80 cents of your premium dollar on health care or improvements to care, or provide you a refund.  This means that 88,491 Nevada residents with private insurance coverage will benefit from $3,977,544 in refunds from insurance companies this year, for an average refund of $75 per family covered by a policy.

Scrutinizing unreasonable premium increases 

In every State and for the first time under Federal law, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. Nevada has received $4,959,972 under the new law to help fight unreasonable premium increases.

Removing lifetime limits on health benefits 

The law bans insurance companies from imposing lifetime dollar limits on health benefits – freeing cancer patients and individuals suffering from other chronic diseases from having to worry about going without treatment because of their lifetime limits. Already, 937,000 people in Nevada, including 329,000 women and 269,000 children, are free from worrying about lifetime limits on coverage. The law also restricts the use of annual limits and bans them completely in 2014.

Better Health

Covering preventive services with no deductible or co-pay

The health care law requires many insurance plans to provide coverage without cost sharing to enrollees for a variety of preventive health services, such as colonoscopy screening for colon cancer, Pap smears and mammograms for women, well-child visits, and flu shots for all children and adults.

In 2011 and 2012, 71 million Americans with private health insurance gained preventive service coverage with no cost-sharing, including 615,000 in Nevada. And for policies renewing on or after August 1, 2012, women can now get coverage without cost-sharing of even more preventive services they need.  Approximately 47 million women, including 391,181 in Nevada will now have guaranteed access to additional preventive services without cost-sharing.

Increasing support for community health centers

The health care law increases the funding available to community health centers nationwide. In Nevada, 2 health centers operate 30 sites, providing preventive and primary health care services to 57,987 people.  Health Center grantees in Nevada have received $8,264,743 under the health care law to support ongoing health center operations and to establish new health center sites, expand services, and/or support major capital improvement projects.

Community Health Centers in all 50 states have also received a total of $150 million in federal grants to help enroll uninsured Americans in the Health Insurance Marketplace, including $451,674 awarded to Nevada health centers.   With these funds, Nevada health centers expect to hire 9 additional workers, who will assist 10,600 Nevadans with enrollment into affordable health insurance coverage.

Investing in the primary care workforce

As a result of historic investments through the health care law and the Recovery Act, the numbers of clinicians in the National Health Service Corps are at all-time highs with nearly 10,000 Corps clinicians providing care to more than 10.4 million people who live in rural, urban, and frontier communities.  The National Health Service Corps repays educational loans and provides scholarships to primary care physicians, dentists, nurse practitioners, physician assistants, behavioral health providers, and other primary care providers who practice in areas of the country that have too few health care professionals to serve the people who live there.  As of September 30, 2012, there were 36 Corps clinicians providing primary care services in Nevada, compared to 12 in 2008.

Preventing illness and promoting health

As of March 2012, Nevada had received $7,500,000 in grants from the Prevention and Public Health Fund created by the health care law. This new fund was created to support effective policies in Nevada, its communities, and nationwide so that all Americans can lead longer, more productive lives.

A Stronger Medicare Program

Making prescription drugs affordable for seniors 

In Nevada, people with Medicare saved nearly $41 million on prescription drugs because of the Affordable Care Act.  In 2012 alone, 22,122 individuals in Nevada saved over $14 million, or an average of $611 per beneficiary.  In 2012, people with Medicare in the “donut hole” received a 50 percent discount on covered brand name drugs and 14 percent discount on generic drugs.  And thanks to the health care law, coverage for both brand name and generic drugs will continue to increase over time until the coverage gap is closed.  Nationally, over 6.6 million people with Medicare have saved over $7 billion on drugs since the law’s enactment.

Covering preventive services with no deductible or co-pay

With no deductibles or co-pays, cost is no longer a barrier for seniors and people with disabilities who want to stay healthy by detecting and treating health problems early. In 2012 alone, an estimated 34.1 million people benefited from Medicare’s coverage of preventive services with no cost-sharing.  In Nevada, 166,815 individuals with traditional Medicare used one or more free preventive service in 2012.

Protecting Medicare’s solvency

The health care law extends the life of the Medicare Trust Fund by ten years.  From 2010 to 2012, Medicare spending per beneficiary grew at 1.7 percent annually, substantially more slowly than the per capita rate of growth in the economy.  And the health care law helps stop fraud with tougher screening procedures, stronger penalties, and new technology. Over the last four years, the administration’s fraud enforcement efforts have recovered $14.9 billion from fraudsters.  For every dollar spent on health care-related fraud and abuse activities in the last three years the administration has returned $7.90.

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The Truth about Obamacare

Don Rogers, Jack Rabbit Ranch blog

DonRogersWell, I can see it’s going to be a bad six weeks. I just heard a paid TV advertisement for people to call their Congressman and urge him to oppose funding Obamacare, because the President is exempt. I expect to see a lot more of these misleading ads, and if past is any indication there won’t be much response from Democrats. They are not nearly as loud and insistent as Republicans and I’ve never understood why.

Is the President exempt? I guess so, depending on how you define exempt. Anybody who already has medical insurance is exempt. I’m with Aetna, so I’m exempt. If you are over 65 and are on Medicare, you are exempt. If you are in the military, you are exempt. If you are a veteran with VA coverage, you’re exempt. If you are a member of a Native American tribe, you are exempt.

However, some changes will affect everybody. For example, if your medical insurance had a lifetime limit, it’s gone. If your plan had an exclusion for pre-existing conditions, that’s gone. If you have a child under 26 they can stay on your plan.  If you’re a woman, gone are the days when you could be charged higher premiums merely because of your gender.  Plus, all plans now must include preventive screenings, such as mammograms, and routine medical checkups at least once a year.  But most of all, your insurance company can use no more than 20% of what it collects from the pool you participate in for its administrative expenses and profit.  If they collect more than 20% from folks in your pool, they must return the overage they charged those pool participants.

Obamacare, or the Affordable Care Act, is for people who don’t have or cannot afford medical insurance. Up until now, when an uninsured person got sick, their only option in most areas of the country was to go to the emergency room, where the hospital was required to treat them. That is a very expensive way to provide medical care. Many hospitals and doctors, to keep from going under, then raise the costs for their services to the rest of us who do pay for insurance.  If folks had the opportunity to purchase affordable insurance, those critical conditions they ended up being treated in the ER could have been treated much earlier much cheaper.  But instead of being treated early, hospitals see them much later in the disease process when treatment becomes much more intensive and expensive … and even with help from the taxpayers, many hospitals have found it next to impossible make ends meet without passing on costs to those who can pay.

Healthcare costs in the USA were double the costs in every other country, and some method had to be found to cut the cost of heath care, as well as provide coverage to those who had no insurance coverage. The cost of medical insurance was skyrocketing, and we were reaching the point where almost nobody would have been able to afford coverage.  In essence, those purchasing insurance are paying for insurance for themselves and indirectly subsidizing those who choose to not purchase, or who don’t make enough money to purchase their own insurance.

So the object of a national health care plan was threefold:

  1. To cut the cost of health care by providing more competition between insurance providers.
  2. To cut the cost of health care by encouraging more preventive care, and enabling visits to the doctor rather than the hospital.
  3.  To increase the number of people covered by insurance to include as many as possible, especially young families and children.

Several different options were available to achieve these goals. The first would have been Socialized Medicine. This was never even considered by the administration. Under socialized health care, the government would take over all hospitals and clinics. All doctors and nurses would get a salary from the government. There would be no charge for the patients. No one would be allowed to make a profit from anybody’s pain or injury. I had this coverage in the US Army. All the military and VA hospital coverage was socialized when I was on active duty in the US Army in 1965. As I understand it now any service member on Tri-Care Prime and getting health care at a Military Treatment Facility is still receiving socialized medicine. Anyone who contends that Obamacare is socialism is displaying his ignorance or his duplicity.

Another option would have been a Single Payer plan. The hospitals remain private, for profit  institutions and the doctors are independent, for profit providers. But all insurance would be handled by the government on a non profit basis. Medicare is such a plan. Premium payments come out of payroll taxes, and the patient chooses among doctors and hospitals who accept the insurance coverage. President Obama never even brought it to the table, probably because he saw the insurance company lobbyists loading for bear. Some Liberals and Progressives felt betrayed, because Barack Obama spoke of this as he campaigned for the presidency.

A third plan was called the Public Option. This would involve for profit hospitals, doctors, and insurance companies, but would include a federal government run non profit insurance option competing with the insurance companies to force their premiums lower. Bill Clinton proposed a similar plan in 1993, but due to a concerted effort by insurance companies and conservative organizations, he and Hillary could not get it through Congress.This idea didn’t last very long during the negotiations for the Affordable Care Act, either.

So the Affordable Care Act became a collage of compromises to get all the health care actors on board so they would call off their lobbyists. Insurance companies don’t have to compete with a federal insurance plan, because Obamacare agreed to just subsidize the states to increase their state run Medicaid programs with expanded coverage for poor people.

Insurance companies agreed to provide coverage nationwide instead of statewide as long as the law made coverage mandatory, so they get more customers. Most states will get more companies competing for their business, so prices should come down.

Big Pharmaceutical companies agreed to go along if the law prohibited the government from negotiating for lower drug prices. So we still have to go to Canada or Mexico if we want drugs for 1/10th the cost. But the gap in Medicare Part D coverage for drugs (The Donut Hole) will be reduced each year until it disappears in 2020.

Doctors got changes to their billing practices, including being paid by the patient rather than the procedure. That’s supposed to reduce the number of unnecessary and redundant procedures and save costs. Eventually they are supposed to go to standardized medical records on computer, for easier access, reduction of errors and lower costs.

Since Obamacare is expected to greatly increase the number of people receiving health care, hospitals immediately got money to expand and renovate. If your local hospital has a new wing or even a new hospital in the last two years, it’s probably funded by Obamacare.

By co-opting every group who had opposed universal health care in the past, Democrats were barely able to get the bill passed by one vote. By not having all the changes happen in the first year, they gave themselves time to get it implemented. And as snags have come up they have made revisions and postponed some of the deadlines.

This is a big and complicated bill, to deal with a large and complicated problem. The writers knew it would not be perfect, and so there is flexibility written into it to allow for fixing problems as they arise.

Already some people are noticing the elimination of their lifetime limits and their pre-existing condition clauses going away. Some have been able to keep their kids on the policy longer, which is a lot cheaper than having to buy a second policy. Some people have gotten rebate checks back. because insurance companies are now required to give money back if 80% of the premiums are not spent on health care, but on overhead or salaries.

As more and more people start to experience the benefits of having affordable health care, they may begin to understand and appreciate what they have received. For the first time they do not have to live in fear and dread of a medical condition devastating their lifetime savings.

Republicans know this and some have said as much. They are desperate to find some way–any way–to stop the Affordable Care Act from being fully funded and implemented. They fear that voters will remember who helped them when they needed help, much as people remembered for two generations which party got them Social Security, and which party fought it tooth and nail.

Some states with Republican governors and legislatures have decided to refuse the federal funds intended to set up the insurance exchanges and expand their Medicaid coverage, hoping to somehow stymie Obamacare. It will be interesting to see when they figure out that they are handing control over to the federal government to set up the exchanges and provide low cost federal insurance instead of locally controlled Medicaid programs. They are enabling the public option some of us preferred in the first place.

After decades of people losing their savings and their homes, being forced into bankruptcy when struck by cancer or some other medical disaster, finally we are catching up to the rest of the civilized world!

And today I just heard a TV ad for Obamacare with a number to call for information and application forms! Maybe they are going to start selling this thing after all!