Faces and Figures
The time? Around 1:30 in the morning. Do you know where your senators were?
Voting, apparently. Over the course of a marathon session that began Wednesday evening and went right into the wee hours of Thursday morning, Republicans in the U.S. Senate took the first steps to repealing a law they have detested from the moment President Obama put his pen to it.
Naturally, the first stage repeal of the Affordable Care Act, alternatively known as Obamacare (yes, good people, they are one and the same, despite all the insinuations a great many less educated people seem to believe), passed along party lines: a strict 51-48. What does that mean? It’s time for budget reconciliation, supposing the House jumps on the same bandwagon.
“The Senate just took an important step toward repealing and replacing Obamacare by passing the resolution that provides the legislative tools necessary to actually repeal this failed law while we move ahead with smarter health care policies,” Senate Majority Leader Mitch McConnell said of the action in a statement.
Which is really strange, because there are a lot of actions being taken to repeal, but despite the use of those terms—Replace and Repeal—no one ever has an answer for what replace would entail. Frankly, they don’t seem to care.
Democrats naturally staged a protest of the vote, of course. They even broke the mold by dedicating their votes to those they said would be harmed by the ACA’s repeal.
This seems like a good point to interject something. A lot of people don’t seem to understand the faces attached to this, so let me give you one: Mine. I would be affected if the ACA is repealed. I am a freelance contractor in my journalism work and a writer to boot. There is no one lining up to give me employer-based healthcare. My depression is a pre-existing condition. The ACA helps me get the medication I need to keep that in check.
But then again, I’m just some liberal scribbler, so what do I know?
I know that I’m not the only one who would be affected. My father would be affected. He is retired, and due to crippling physical and internal conditions, he takes a lot of pills and sees a lot of doctors. A lot. If the ACA is destroyed, it would ruin him. Part of my time is spent caretaking for him. I do not want to have to watch him wither any faster than time has already decreed because someone in a building halfway across the country doesn’t see his face, nor recognize that he could be one of many they would condemn to death.
Would you like more examples? I have friends. I have acquaintances. I could bring pictures and files and all sorts of numbers games to this, but of course, the numbers and reports are already out there. We have those figures. The problem is that politicians don’t look at them.
Our institutions can’t protect us unless we’re willing to stand up and protect them, enforce them, make them anything more than paper tigers. Republicans seem determined to repeal and delay, bludgeoning provisions of Obamacare into the ground and then shrugging their way through to a solution years down the line, but people will die in the meantime. They won’t protect us. Democrats can’t protect us. We have to protect ourselves, with phone calls, with protests, with organization. Otherwise, institutions like the ACA, whatever we want to hope, can in fact die. So can democracy, for that matter.
Reconciliation and the Death of Individual Insurance
Now do you remember that little word I mentioned before: reconciliation? It’s an important word. That refers to a procedure which allows the Senate to operate against anything related to the budget—taxes and subsidies, for example—as long as they have 51 votes. Yes, Democrats can filibuster anything else they want, but a lot of damage can still be done under the reconciliation umbrella.
Supposing they begin to gut the various provisions of the ACA—which Republicans are salivating to do—their hope is that they can then say, “We have the numbers. We have already begun. The rest of you can jump on the bandwagon and find something different, something we like, or the market collapses, and that will be on you.” Because that’s how they’ll frame it: despite all their power here—control of all three branches of government here, mind you—they’ll say that they were repealing what they saw as a bad law, and those fighting them were letting people die through inaction. Of course, the idea of letting Obamacare stay until they actually have something they could replace it with wouldn’t set well with their own side, so that wouldn’t happen either.
In theory, it should be easy for the Democrats to turn this around on Republicans, but in recent years, they have caved on a lot of topics. They raise loud voices, but they don’t stick with it terribly well, and don’t maintain media spin so well as the Republican side of the aisle, disturbingly.
All they need to do is make this line stick: the death of Obamacare, of the ACA, is the death of the entire individual market.
This isn’t overdramatization; it’s fact: if the ACA is stripped away, every insurance company in America would yank individual policies, because to do anything but would lead to monumental losses on their end. Currently, it’s believed up to 22.5 million people could lose insurance through repeal of Medicaid expansion and loss of protections and subsidies in the individual market. Lose all those people, you’ve none of the healthy and profitable chaps that insurers are counting on to give them money and not require much from them in turn. Bye bye individual mandate and subsidies? Bye bye individual insurance.
Even those benefiting presently from employer-sponsored health plans, rather than out on the free market like myself, would not escape unscathed, though.
It’s the ACA that guaranteed employers couldn’t demand waiting periods before coverage for pre-existing conditions would kick in. Previously, that little caveat could take up to a year to resolve. Lose your job in the meantime? Tough luck.
Of course, the ACA also made mandate caps on individual costs for health plans—both those hosted by companies and on the individual market. Remove that, and even a good job might not defend against medical costs, which can cripple the most business savvy of us. Likewise, the ACA said that capping benefits was a no-no. Healthy young fellow? Great. Suffer from MS? Removing the no-limits policy would see you exceeding your cost support in no time, and leave you up the creek.
Hello Fellow Hostages
Naturally, no discussion of these repeal efforts would be complete without mentioning our incoming president, currently in the midst of his own “trickledown” problems.
In a heated press conference on Wednesday, Trump said that his administration was dedicated to the repeal and replace platform.
“It will be repeal and replace. It will be essentially simultaneously,” Trump said. “It will be various segments, you understand, but will most likely be on the same day or the same week, but probably the same day, could be the same hour.”
However, he also couldn’t resist using the opportunity to blackmail the legislative branch by insinuating that the replace portion wouldn’t be offered until his pick for secretary of the Health and Human Services Department—Rep. Tom Price—was confirmed in that role.
“The easiest thing would be to let Obamacare implode in 2017, and believe me, we’d get pretty much whatever we wanted, but it’d take a long time,” Trump said. “We are going to be submitting, as soon as our secretary is approved, almost simultaneously, shortly thereafter, a plan.”
No hints as to what that plan would be, of course, or any genuine proof there would be one—just the hope that if he got his way, the rest of the country might get something like theirs.
This whole situation should be at once terrifying, infuriating, and downright maddening. The only way forward? To fight tooth and nail for those you know who will—not may—suffer from these systemic actions. Access to high-quality, affordable health care is at stake, and no one can afford to bury their heads in the sand on this issue.