Squandering a Once in Lifetime Opportunity

A demonstrator in support of U.S. President Barack Obama's health-care law, the Affordable Care Act (ACA), holds up a "ACA is Here to Stay" sign after the U.S. Supreme Court ruled 6-3 to save Obamacare tax subsidies outside the Supreme Court in Washington, D.C., U.S., on Thursday, June 25, 2015. The U.S. Supreme Court upheld the nationwide tax subsidies that are a core component of President Barack Obama's health-care law rejecting a challenge that had threatened to gut the measure and undercut his legacy. Photographer: Andrew Harrer/Bloomberg via Getty Images

America is once again dealing with healthcare, but there is so much more going on than just what you see on TV or read about in the newspaper. For the average American, all they know about Obamacare is how expensive healthcare has become, and the promise by President Trump and the GOP to repeal and replace the Affordable Care Act.

They also see the gridlock in Washington continue and not just between Republicans and Democrats, but between factions in the Republican party. People don’t understand the procedural gymnastics that are occurring which has resulted in stagnation. The GOP has been working behind the scenes to find a compromise that would allow the American Health Care Act to get to the House floor for a vote, but this has not been easy. No one is clear what has to be done to get this done nor how imminent this is.

What is obvious to all, is that Obamacare is on shaky ground and ready to implode, taking its toll on the healthcare system. The cost of healthcare insurance is going up for everyone, unless the federal government does something quickly to stabilize the market.

President Trump has authorized HHS to release money to the insurance companies participating in the healthcare exchanges, which will buy some time for the 6 million people who are getting their insurance under the ACA. This, despite the fact that the House Republicans successfully filed a lawsuit to block these payments because they were illegally made by the Executive branch under President Obama. A US district court has denied the Obama administration appeal, siding with the GOP. But this will be a short term fix. For everyone else, the premiums are escalating and the GOP is playing politics and allowing this to happen.

A major sticking point is how to treat the “goodies” that some Americans found desirable with regard to their healthcare. These would include keeping kids on their parents’ insurance until age 26, compelling insurance companies to cover people with pre-existing conditions, and how to treat minimum essential benefits covered by an insurance policy.

The far right Freedom caucus, sticking to their ideology of doing nothing if it does not include repeal now, want these items removed from the American Health Care Act, and to allow states that wish to have them, apply for waivers to implement them. In this way, they fulfill their campaign promise and it creates a national experiment, to see how high insurance premiums go in states that offer these benefits compared to those states that do not.

The more moderate Tuesday group wants to retain these Obamacare benefits and instead allow states that want to opt out to do so. They did not believe that their constituents would tolerate getting rid of these benefits, needing instead to petition for waivers to get them back. In either case, the end result is the same, but the tactics on how to get there differ.

In the midst of this infighting came the news that the plan supported by the Freedom caucus would not apply to members of Congress or their employees. They would be able to keep the pre-existing conditions and essential benefits. When questioned about this, they did not deny it, but said that it was procedural and needed to be retained in order to get the bill through the Senate, but would of course be fixed.

It is no wonder that most Americans give Congress a favorable grade of under 10%. But specifically, in the case of Republicans, they cannot get done the one thing that they have been complaining about for the past 7 years. They have had plenty of time to prepare for this and now have run out of excuses. They are squandering a once in a generation opportunity and are failing millions of Americans who trusted them.



  1. Hal,
    Thank you for the update and summary. The website suggests that I’ll be the first to comment and I wonder why. I wonder if we’re speechless and for ease of conversation, heartbroken.
    Hopefully perseverance will pay.

  2. K Murray Leisure MD

    Many of us hope that personal Health Savings Accounts and less constrictions on a wider variety of health insurance plans would allow market forces to preserve more personal choices for health care plans at much less costs.

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