Last night was a good night for people who are working to protect health care. Two more Republican Senators came out against the cruel Better Care Reconciliation Act (BCRA). That was enough to force Republican leadership to halt their efforts to pass it and start over on a health plan.
When the election results came in many people thought that the new Congress would quickly repeal the ACA and dismantle Medicaid, something that has been part of the far-right platform for years. Last night demonstrated the importance of people power. People who knew those proposals were wrong called, showed up at their representatives’ offices, and took to the streets to protest. And once again it worked! When we get loud enough the opponents of the ACA and Medicaid cannot simply take away programs that so many of us like and depend on, even when they control the House, Senate, and Executive Branch.
They will continue trying. President Trump said today that his strategy is to “let Obamacare fail.” The Secretary of the federal Department of Health and Human Services is Tom Price, a person who is virulently against the ACA. As he pointed out at his confirmation hearing, the ACA says “the secretary may” and “the secretary shall” 1,442 times. That gives Secretary Price a lot of chances to rewrite the rules in a way that destabilizes the ACA’s marketplaces. (We’ve written before about the powers the Executive Branch has to diminish the ACA through regulations and by eliminating the cost-sharing reductions that help people manage high deductibles.)
The President’s proposed budget includes the same devastating Medicaid cuts that were in the Republican bills. It adds billions of dollars in cuts to the Children’s Health Insurance Program (called Child Health Plus in New York). CHIP faces another threat – it must be reauthorized every five years, and the deadline is this year. It is unclear whether Congress will reauthorize CHIP without a fight, or what they will expect us to give up in exchange for reauthorizing CHIP.
A House budget proposal released today by Republican leaders includes $1.5 trillion in Medicaid cuts and $487 billion in cuts to Medicare, cuts that are much larger than those proposed in the health bill that failed. The House justifies those cuts to Medicare with a myth that the program is heading towards bankruptcy. Medicare is not heading towards bankruptcy – those claims are meant to scare people into accepting unnecessary cuts to a vital program.
We cannot even count out more legislative battles to repeal the ACA. Earlier in the year, Republicans planned on doing a straight repeal and figuring out the details afterwards. The danger was that they would never work out the details, and the repeal and replace would become simply a repeal. Congress passed something like that in 2015, but it was vetoed by President Obama. The Congressional Budget Office assessed the 2015 bill and found that repealing the ACA without replacing it would cause premiums to skyrocket and cause 27 million people to become uninsured. Senator McConnell is talking about using that strategy again. Several Republican Senators have already said they will not support that effort, but we’ve all seen how fast things can change over the past few months.
So it is a day to celebrate – but don’t forget that we have a lot of work still to do. The good thing is that we can feel confident about our work. We know how to do this! We just have to keep doing what we’re doing.