The Swine Line: The Staff Blog of Citizens Against Government Waste

Senate Delay on Obamacare Repeal is a Pothole in the Road

The Swine Line is the staff blog of Citizens Against Government Waste (CAGW) and the Council for Citizens Against Government Waste (CCAGW). For questions, contact blog@cagw.org.

On June 27, Majority Leader Mitch McConnell (R-Ky.) announced there would be no vote on the Senate’s bill, H.R. 1628, the Better Care Reconciliation Act (BCRA), to repeal and replace the Patient Protection and Affordable Care Act (ACA), or Obamacare, until after the Independence Day recess.  Capitol Hill staffers have said the delay is simply a “pothole in the road.”  In other words, while efforts have slowed down, the legislative process is moving forward.

It is important that the Senate keeps working.  Obamacare is collapsing.  On practically a weekly basis, Americans learn that more insurers are dropping out of the Obamacare exchanges.  Anthem announced on June 7 that it would drop out of the Obamacare’s exchanges in Ohio, leaving 18 counties in the state and 10,500 people facing the possibility of no options for health insurance in the ACA individual market.  A Daily Caller June 19 article points out that UnitedHealth significantly dropped its participation in ACA, from 34 states in 2016 to just three in 2017 and it plans to be out of Virginia by 2018.  Aetna and Humana are planning to be completely out of Obamacare by 2018.  It is expected 47 counties in the US will have no insurer in an Obamacare marketplace in 2018 and as many as 1,200 counties, or 40 percent of all counties nationwide, will only have one insurer to choose from.

Here's a summary of the provisions in the Senate repeal and replace bill:  

  • The bill will repeal the Obamacare individual and employer mandates that force Americans to purchase health insurance they do not want or cannot afford;
  • It provides advanceable and refundable tax credits to help people with incomes between 100 to 350 percent of the federal poverty level pay for their insurance premiums (currently individuals with incomes of $12,060 to $42,210);
  • It repeals the taxes that Obamacare placed on individuals and businesses that have stifled the economy, including the taxes on over-the-counter medicines, Health Savings Accounts (HSAs), prescription drugs, and medical devices;
  • It expands the use of HSAs and Flexible Spending Accounts;
  • It continues to allow Americans with pre-existing conditions to access health insurance and for children to stay on their parents’ insurance plan until age 26;
  • It would allow states to waive the Obamacare insurance mandates that have driven up costs for individuals and makes it simpler for states to apply for such a waiver.  This will allow states to once again write the rules for insurance coverage in their state and for insurers to design the kinds of healthcare plans consumers want to buy, not what Washington, D.C. bureaucrats dictate;
  • It provides funding to help states stabilize the insurance markets in their states as they move away from Obamacare's dictates; and,
  • It reforms Medicaid, which is vitally important because the program has been declared unsustainable and it is rife with waste, fraud, and abuse.  (Medicaid improper payments reached $36 billion in 2016.)  Contrary to some news reports, and ads being run by special interests groups that prefer ACA and federal control of our healthcare, Medicaid continues to grow but the Senate bill puts the program on a budget for the first time since its inception in 1965.  It gradually reduces Obamacare’s Medicaid expansion enhanced funding but continues to protect the disabled, poor pregnant women and children, and low-income elderly.  The bill gives governors greater flexibility in structuring Medicaid for their state, a policy Republicans have advocated for years, and to choose either a Federal block grant or per-capita federal funding for their Medicaid enrollees.

Concerns with the bill have been expressed by both fiscal conservatives and moderates.  Some of the greatest push-back comes from Senators whose states unwisely expanded Medicaid and are now facing huge state budget increases.  These states want federal taxpayers to keep propping them up.  But BCRA provides the mechanisms to reduce their state's reliance on Washington and the ability to develop systems that will help their low-income citizens get the healthcare help they need.

There is a lot more work and compromise to be done but it is important that the Senate moves forward and relieve Americans of Obamacare's onerous mandates and taxes.

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