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Obamacare not in 'death spiral' because people value it

  • 22 July 2017


President Trump and the Republican Party are stymied in their efforts to repeal and replace Obamacare; they are learning the difficulties of taking away government benefits that people value. The task is made harder because Congressional Republicans have never gone beyond their ‘repeal and replace’ mantra and undertaken the hard policy work required to do this—and they have been unable to unite around a common approach.

Conflicting rhetoric and promises from Trump, who clearly has no idea about the substance or consequences of congressional proposals and the processes upon which their enactment depends, have not helped. The man who once said: ‘You're going to have such great health care at a tiny fraction of the cost and it's going to be so easy’ is now reduced to issuing veiled threats aimed at wringing a healthcare bill—the substance of which hardly seems to matter—out of an increasingly divided Republican caucus.

The only issues that unite Republicans is their antipathy to Barack Obama and their hostility towards his key legacy, healthcare reform. There was not a single Republican vote for Obamacare in 2010 and Republican rhetoric quickly poisoned public opinion about its provisions.

Yet the bill, although imperfect, was soundly constructed and thoughtfully implemented. It has withstood constitutional challenges and survived endless Congressional votes to repeal and amend it. Republicans talk only about its problems and the Trump Administration has worked hard to sabotage it further, but the fact is that Obamacare is not in a 'death spiral'. It is working surprisingly well and delivering real change to peoples’ healthcare.

The Republican leadership does not grasp the national need for government to have a role in providing affordable health insurance and better access to care. There is an underlying theme of the undeserving poor and personal responsibility in their approach.

They ignore the evidence for Obamacare’s success and belittle its public support. Yet poll after poll shows growing support for Obamacare, which is now considerably more popular than the politicians who oppose it. There is also increased public recognition of how many Americans depend on Medicaid.

Americans are increasingly aware that proposed Republican changes will ensure that 20 to 30 million people lose health insurance and increase the cost of insurance for all but the wealthiest and healthiest. It will allow insurers to revert to discriminating against those with pre-existing conditions, and make sharp cuts to Medicaid that will affect the poor, the disabled, the elderly, hospitals and residential facilities that provide their care. That is reason enough for their anger; that these changes are done to ensure big tax cuts for the wealthiest few adds to