In his weekly address on Friday, President Donald Trump increased his support for the American Health Care Act, the Obamacare “replacement” plan proposed by congressional Republicans.
“House Republicans have put forward a plan that gets rid of this terrible law, and replaces it with reforms that empower states and consumers,” Trump declared. “The House plan follows the guidelines I laid out in my recent address to Congress: expanding choice, lowering costs, and providing healthcare access for all.”
The president offered this support for the bill only after cataloguing the failures of former President Barack Obama’s healthcare law, the “Patient Protection and Affordable Care Act,” better known as Obamacare.
Seven years ago this month, Obamacare was signed into law over the profound objections of American people. Our citizens were told they would have to pass Obamacare to find out what it was and how bad it was. Now we know that the hundreds of pages were full of broken promises.
Among others, Trump cited the promise that Obama’s health reform “would bring premiums down $2,500 for a typical family,” but noted that those premiums actually shot up “by more than $4,000.”
“Through seven long years of botched rollouts, soaring costs, canceled plans, and bureaucratic mandates, Americans have cried out for relief, and relief is what we are determined to give them,” Trump declared. “I want everyone to know that action on Obamacare is an urgent necessity. The law is collapsing around us, and if we do not act to save Americans from this wreckage, it will take our healthcare system all the way down with it.”
After laying out the flaws of Obamacare, the president defended the House bill branded as “Obamacare-Lite,” “TrumpCare,” “Obamacare 2.0,” and even “RINOcare.” Trump argued that under the new bill, “you will have the choice and the freedom to make the decisions that are right for your family.”
“We will deliver relief to American workers, families, and small businesses who right now are being crushed by Obamacare, by increasing freedom, choice, and opportunity for the American people,” the president declared.
Unfortunately, this particular law arguably does not accomplish that. Edmund Haislmaier, a health care policy expert at the Heritage Foundation, argued that the 25 million Americans who most need relief from Obamacare would receive “no meaningful relief” from this bill.
“Americans with unsubsidized individual-market coverage (10 million people) or small-employer plans (at least another 15 million people) … are the ones who most need relief from Obamacare, and have the strongest motivation to politically support repeal and replace,” Haislmaier argued. “They have been subjected to significant premium increases and coverage dislocations with no offsetting subsidies.”
According to the Heritage Foundation expert, the Republican bill “leaves Obamacare’s costly insurance regulations in place, and attempts to offset those costs with even more subsidies — a variant of the same basic approach in Obamacare.” Those subsidies help the 22 million individuals who benefit from Obamacare. In other words, they maintain the status quo.
Many conservatives have attacked the bill for similar reasons. RedState senior contributing editor Joe Cunningham noted that the bill starts with “amends.” He argued that it is wrong to say this bill “repeals and replaces” Obamacare. If Trump is right when he declares “we must repeal and replace Obamacare,” he cannot be right when he says the House plan “gets rid of this terrible law.”
Indeed, the leaders of Americans for Prosperity (AFP), an enormous conservative grassroots organization, attacked the Republican health law as breaking voters’ promises. “Republicans in the House promised to fully repeal the law, all the mandates and all the taxes, everything. This proposal from last night simply does not do that. It does not do the job,” AFP President Tim Phillips declared.
Trump’s response to these attacks was already embedded in his weekly address, however. As he previously tweeted, the president said “this plan is part of a three-pronged reform process.”
As House Speaker Paul Ryan explained in a press conference Thursday, the House bill is phase one. Phase two consists of administrative reform at the hands of Secretary of Health and Human Services Tom Price, as the HHS secretary is empowered by Obamacare itself. As Trump said, “I have directed Dr. Tom Price … to use his authority to reduce regulations that are driving up costs of care.” Conservatives are likely to attack this idea — any regulations Price reduces would be open to expansion by a later Democrat HHS secretary. This is insufficient.
The final phase consists of additional legislation. As Trump explained, later laws would include “reforms that lower the costs of care, like allowing Americans to purchase health insurance across state lines.” He cited his promises during the Republican presidential debates on this issue.
Finally, Trump encouraged Democrats “to work with us to improve the healthcare system for the American people.” But his problem right now isn’t Democrats. Three senators (Texas’ Ted Cruz, Kentucky’s Rand Paul, and Utah’s Mike Lee) declared that the 2015 Obamacare repeal bill should be “the floor, the bare minimum” of reform.
Speaker Ryan criticized the call, made most prominently by Senator Paul, to pass a “clean” repeal of Obamacare and then to debate on a “replacement” separately. “The last thing we want to do is repeal it, and then have replace being filibustered,” Ryan told Sean Hannity on his radio show. “We want to repeal it, and put the replace in the repeal bill so they can’t filibuster it so we can get House republican conservative health care policy in one place.”
In order to achieve this, Ryan will need to make serious alterations to the health care bill. So long as Cruz, Lee, and Paul stand united in opposition to it, it cannot pass the Senate (without the exceedingly unlikely Democrat votes for it). All the Trump speeches in the world will not push “Obamacare 2.0” across the finish line.