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The Ongoing Sabotage Of Obama Care By The GOP

The Republicans have been sabotaging Obama Care (and hurting their fellow Americans) since 2010. The GOP sabotage of the Affordable Care Act (ACA) began during the debate over the law itself. This was part and parcel of the GOP’s effort to undermine the Obama Presidency and make him a one term president.

Even before Obama was inaugurated on January 20, 2009, the GOP began to plan their strategy of all out obstruction. During the transition in 2008–09, Republican Senators told Joe Biden that they had been instructed by Mitch McConnell to refuse to cooperate with the incoming Administration. As Biden said: “I spoke to seven different Republican Senators who said, ‘Joe, I’m not going to be able to help you on anything,’ ” he recalled. His informants said McConnell had demanded unified resistance. “The way it was characterized to me was, ‘For the next two years, we can’t let you succeed in anything. That’s our ticket to coming back.”

Over on the House side, the GOP leadership held a meeting at an upscale Washington restaurant on the night that Obama was inaugurated and settled on a scheme to destroy the Obama Presidency during the deepest economic crisis the country had faced since the Great Depression. At this meeting, Representative Kevin McCarthy said: “We gotta challenge them on every single bill. Show united and unyielding opposition to the president’s policies.”

The Republicans followed through on this strategy and refused to participate in the debate over the ACA even though the individual mandate was a Republican idea hatched in the right wing Heritage Foundation and successfully implemented by Mitt Romney in Massachusetts. As a result, the Democrats had no choice but to pass the ACA with Democratic votes only.

The GOP’s refusal to even allow an up or down vote in the Senate forced the Democrats to cobble up 60 votes to pass the ACA. This caused the inability to pass a government or public option. The lack of a public or government option in the ACA has resulted in less competition in the exchanges and higher premiums for millions of Americans.

The passage of the ACA on a straight party line vote has allowed the GOP (and many in the mainstream press) to question the legitimacy of the ACA. This is a deeply disingenuous argument since the GOP refused to participate in the debate and passage of the ACA. This dishonest questioning of the legitimacy of the ACA has also been used as an excuse by the GOP to sabotage this health care law and harm millions of Americans.

An ongoing act of sabotage at the state level has been the refusal of 18 red states to adopt the Medicaid expansion. This refusal to cooperate with the implementation of the ACA was enabled by the Supreme Court’s 2012 decision to uphold the individual mandate. John Robert’s price for his crucial vote was to make the Medicaid expansion optional for the states.

The refusal of 18 red states to pass the Medicaid expansion has left an additional 5 million Americans without insurance coverage. In addition, the refusal of Ricketts and the right wing Republicans in the Unicameral to adopt the Medicaid expansion has caused 97,000 Nebraskans to go without insurance. Moreover, studies show that the residents of states that reject the Medicaid expansion have higher insurance premiums.

Another Republican attack on the ACA caused 113,000 Nebraskans and Iowans in 2015 to lose health insurance coverage through CoOpportunity Health Insurance Company. This company was liquidated that year because the Congress voted in December 2014 to to cut special risk-adjusting payments that CoOportunity was counting on receiving in 2015.

This cut in funding for CoOpportunity (and other health co-ops) occurred when House Republicans — at the eleventh hour — inserted an amendment aimed at cutting government funding for health co-ops into the must pass CRomnibus bill. (Passage of the CRomnibus prevented another government shutdown.) Senator Deb Fischer, and Representatives Jeff Fortenberry and Adrian Smith voted for the December 2014 CRomnibus bill that killed CoOpportunity and canceled insurance policies for thousands of their constituents.

The passage of the Cromnibus bill in 2014 also cut funding for the so-called “risk corridors” program. This program provides subsidies to insurance companies so that they can hold down premiums. The cut in this funding has cost Americans thousands of dollars in additional premiums over the last two years.

There should have been no controversy over the risk corridors program. These subsidies to the insurance industry were an integral part of the Medicare Part D program that passed in 2003. While the Democrats opposed the final version of that bill because it was a huge give away to the pharmaceutical industry, they fully funded the risk corridors program in 2007 and 2008 during a time of divided government.

The incoming Trump Administration is a big threat to the health insurance of millions of Americans because it is committed to the repeal and replacement of the ACA. HHS Secretary Tom Price was a fierce opponent of the ACA when he served in the House of Representatives. As Trump said after the failure of the Trump Care bill: “The best thing politically is to let Obamacare explode.”

Despite these years of GOP attempts to destroy the landmark health care law, the ACA is still in good shape. According to recent reports from the Congressional Budget Office and Standard & Poore’s, the ACA is stable and would only be upended by disruptive actions from the Administration and the Republicans in Congress. According to these reports, the ACA isn’t in a death spiral and S&P stated that: “We expect 2018, or Year 5 of the ACA individual market, to be one of gradual improvement with more insurers reporting positive (albeit low single-digit) margins.”

The fundamental stability of the ACA hasn’t deterred the GOP from further attempts to wreck the program. The Trump Administration has signaled that it will no longer be enforcing the individual mandate. A failure to enforce the individual mandate could cause insurance premiums to sky rocket.

Trump himself escalated the GOP war on Obama Care by threatening to cut off subsidies to insurance companies that help offset the costs of deductibles and copayments for low-income people. Failure to fund these subsidies could set off the death spiral the GOP is falsely predicting.

Democrats in the Congress reacted (justifiably) with fury to Trump’s blackmail threat. Schumer and Pelosi have said they won’t negotiate with Trump if he cuts off the subsidies and are demanding that funding for these payments be included in a must pass bill to fund the government which would prevent a government shutdown by April 28.

The Chamber of Commerce and the health insurance industry joined the Democrats in opposition to Trump’s threat to hold millions of Americans hostage. In addition, Trump’s threat is causing uncertainty in the insurance markets. The insurance industry must soon make decisions about their participation in the exchanges for 2018 and Trump’s threats are making them reluctant to participate.

If the ACA collapses, the American people will blame Trump and the Republicans. According to a recent Kaiser Foundation poll, 61% of the voters would blame the GOP if the ACA falls apart and only 30% would blame the Democrats.

It’s time for Trump and the Republicans to wake up to the reality that it will take a bi-partisan effort to reform the ACA. As Chuck Schumer said: “Our position remains unchanged: drop repeal, stop undermining our healthcare system and we will certainly sit down and talk about ways to improve the Affordable Care Act.”

As activists, we must continue to engage our members of Congress on the ACA. So far, the resistance is working. Trump Care was defeated and health care was saved for 24 million people. Please call your member of Congress and urge them to work together on a bi-partisan basis to insure more Americans and lower health care costs. Thank you for all that you do!

I’m a trial lawyer, a Democratic activist and a sports fan.

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