Republican leaders are pushing Congress to rapidly replace the Affordable Care Act. That legislation would leave the Indian Health Care Improvement Act as is. But there are other proposed changes that you need to know about.
This is Trahant Reports.
The American Health Care Act uses the Affordable Care Act as a framework. It reworks the provisions that Republicans most object to … including taxes, individual and employer mandates, and Medicaid reform.
This idea is important. I like the way Jim Roberts described the process on his Facebook page: Quote: Take the ACA, tear out the pages that have been repealed, and see what’s left on the table. It’s pretty easy to figure out. It’s like cutting the face of an ex-spouse out of the family photos! The entire family photo is still intact and everyone knows who that cutout is. It’s Obamacare … Jim Roberts is a senior executive with the Alaska Native Tribal Health Consortium and a long time expert on how health care policy impacts Indian Country.
Congress is moving fast to get this legislation through committees and to the House floor. The final vote could be in a week or two. Then, if the House has enough yes votes, the bill moves to the Senate for consideration.
The Republican Party is divided by serious differences about health care reform and the nature of government. Conservatives do not see health care as a right. They see it as an individual responsibility.
And let’s be clear: This legislation would result in millions of people losing insurance coverage. And to top it off, the plan would cost older Americans more. A lot more. Insurance companies would be allowed to charge older people five times as much as a policy as young people. (And to make that more odd: Older people are reliable GOP voters.)
On the other side of the political ledger are Republicans who represent states that have insured millions of people through Medicaid reform. The House plan would keep Medicaid running as is between now and 2020 and then turn it into a block grant for the states.
Alaska Sen. Lisa Murkowski recently told the state legislature that Alaska should have the option of keeping its Medicaid. And she has other reasons to vote no: The House plan uses a tax credit of $4,000 instead of a subsidy and that would cost Alaskans more than people who live in any other state, a whopping $10,243 per person.
The Senate vote will be close. There are 52 Republicans; it will only take three votes to stop the legislation.
President Donald J. Trump is trying to make his first deal. And he is working it hard. He’s trying to win conservative support despite philosophical misgivings. But if the president gives too much ground, then it’s the moderates who might vote no.
We will soon see if there is a deal to be made.
I am Mark Trahant.
