Writing Off a Healthier America

Remember their names, remember their faces, remember what they did – and beginning in 2018 vote them out.

By Tommy Hough

It's only been 100 days or so since competent, humane leadership left the White House. Seems like a long time ago now, doesn't it?

Since Donald Trump's inauguration and the swearing in of the 115th Congress, we have rapidly arrived at a point in our nation's history where our federal government is now actively working against us. That "us" includes Americans who work for a living, Americans who don't have access to golden parachutes, and Americans who are trying their best to spend time with their children in between night school and two or three jobs to make ends meet.

From the environment to immigration to labor to health care, not only are we are not represented, but the American Experiment is becoming an experiment in Social Darwinism at the hands of Trump and the GOP Congress. Go ahead and complain – they'll be happy to raise a beer to your misery and say they're helping. In 2017 Washington, congressional representatives and the president have written off anyone who doesn't respond to conservative AM talk radio paeans, and have crafted an un-reality snow job built upon the imaginary transgressions and rudderless resentments of the modern GOP.

The vote this week in the House of Representatives certainly left no doubt as to the state of America's idiocracy-fueled oligarchy. A bill to repeal the Affordable Care Act (ACA), colloquially known as Obamacare, was passed on a close vote – but without any kind of public discussion, determination on the reality of its figures from the Congressional Budget Office (CBO), or without even most of those who voted on it having read the legislation in the first place.

Those who claim to have read the American Health Care Act (AHCA) and still voted for it should run and hide, not only for shame, but for fear of retaliation for being unable to empathize with anyone outside of their own circle of friends or family who may be dying a slow death that bankrupts their entire family for lack of health insurance.

Back in 2009 and 2010, the vast number of Republicans in Congress and right-wing, conservative talking heads complained that the ACA was being "shoved down" their throats by the Democratic majority in Congress. Except that the bill that became Obamacare was, in reality, worked on throughout 2009 and 2010, and was in and out of congressional committees for well over a year. The public could access the bill on-line, and it was thoroughly debated in both houses of Congress. There was nothing secret or unknown about it. Such are the burdens of good government.

When the ACA was at last passed and signed into law, it had a number of moving parts, like many pieces of legislation – but it had been thoroughly, publicly vetted.

People knew it may have been imperfect, but they also knew what they were getting – and it was a real change for the better. As President Obama said as he signed the ACA into law on March 23, 2010, "All of the overheated rhetoric over reform will finally confront the reality of reform." Obamacare was intended to be a document that could be improved upon by future generations. Future generations, that is, who choose to be answerable to the needs of actual people, instead of special interests.

One of the things we do know about the just-passed Republican AHCA is that it undoes the provision that enables tens of thousands of uninsured Americans with pre-existing conditions  to purchase the coverage they need. It also undoes the provision that enables the parents of children who have a pre-existing condition to purchase the insurance their kids need.

To celebrate the eradication of this pesky consideration in the AHCA, House Republicans and President Trump drank beer in the Rose Garden as the president gloated, "Hey, I'm president." Quite a change from the steady hands and legislative competence of 2009 and 2010, and more along the lines of "let them eat cake."

But the AHCA didn't pass the House because it was a good bill, or a humane bill, or a better bill than Obamacare. It passed because conservatives (or what passes for conservatism these days) and House Republicans despise Obamacare. They hate that it was passed by Democrats, and they hate it because it was signed into law by a Democratic president named Obama. Most of all, conservatives and the GOP hate Obamacare because it requires them to be taxed, and requires those who make more to give more, just as it might for tanks and aircraft carriers and jet fighters.

The other reason why conservatives and the GOP hate the ACA is because it works. Ask your friends who benefit from it. Ask your family. Ask my sister, who serves as a caretaker for my father who has dementia. Ask my friend and former colleague who had life-saving quadruple bypass surgery and under Obamacare can't be turned down for insurance because of his pre-existing condition. But under the Republican AHCA, my friend would be left virtually insuranceless due to his now pre-exisiting condition as he stares down a lifetime of check-ups and medical care.

• According to Avalere Health, only five percent of Americans with pre-existing conditions who currently have individual coverage will continue to have coverage under the AHCA. That affects Americans with cancer, cerebral palsy, diabetes, lupus, all forms of mental illness, epilepsy, kidney disease, my friend's heart condition, you name it.
• House leadership (i.e., Paul Ryan) pushed for a vote on the bill before it could be assessed by the non-partisan Congressional Budget Office (CBO), which estimated that an earlier version of the AHCA would've increased the number of uninsured Americans by 24 million over the next 10 years.
• Under the AHCA, Medicaid will go back to being a program for a fraction of low-income Americans. This is how House Republicans will brag that they "cut government spending" while rolling back multiple taxes – the only thing that seems to matter to them.
• The AHCA will enable older Americans to be charged more than they currently are for insurance, at up to five times the rate that younger enrollees pay. That would increase costs for people who earn too much to get subsidies, or who buy insurance plans outside of marketplaces established by Obamacare.
• But hold on a moment – House Republicans wrote an exemption for themselves so they and their families and staff can continue to utilize Obamacare, but YOU can't. After railing against Obamacare for the last seven years, House Republicans have decided they're the only ones who should have it.
• Circling back to pre-existing conditions, the AHCA actually describes sexual assault and domestic violence as pre-existing conditions, which will make it either impossible or incredibly expensive for sexual assault and domestic violence survivors to get health care.

Obamacare may not be perfect in all its facets, but it works – and if there's one thing that's anathema to conservatives, it's a government program that improves the lives of citizens. That pops their entire philosophic belief that government makes things worse, like Interstate highways and the Navy and the space program and the U.S. Postal Service. It's a self-fulfilling prophecy Republicans seek out to prove every time they get elected to office.

The AHCA really will make the lives of hundreds of thousands of Americans worse, where Obamacare made them better. That it's being done in such a willfully cruel manner is simply mystifying, and indeed, quite cruel.

Republicans tried to keep the ACA from passing and then going into effect because they knew it could evolve, grow and become more effective. They still dread that Americans will come to that realization, and they will try harder than ever now to find a way to undo Obamacare with something even as awful as the AHCA when not a single medical professional, patient advocate, economist, or literally anyone familiar with health insurance supports it.

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