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    Tuesday, January 17, 2017

    GOP-Created "Uncertainty" Will Kill Obamacare Even Without Repeal

    Remember those days back during Obama's first term when Republicans blamed Obama for creating "uncertainty" that was destroying jobs and preventing businesses from hiring new workers. Eric Cantor blamed "job-destroying regulations” for creating “a cloud of uncertainty hanging over small and large employers." Mitt Romney claimed Obama's policies "have done the one thing employers can’t deal with ... created more uncertainty." Those were the days. Now, of course, Republicans are proposing to take away health insurance from over 30 million Americans, creating a tsunami of uncertainty for millions of Americans. In addition, Republicans seem intent on repealing some parts of Obamacare without any real plan to replace them, causing enormous uncertainty for the health insurance market. But there's no talk of the negative effects of real "uncertainty" now.

    J.B. Silvers, a former health insurance executive, is out today with another piece, this time on the NY Times op-ed page, describing how many millions of Americans will lose health insurance under any repeal and delay plan while also describing the already debilitating effects of the uncertainty about the future of Obamacare on the health insurance markets. According to Silvers, unless Republicans can come up with a real replacement plan, "[b]y April, when filings from insurance company plans and premiums for 2018 are due, there will be a sizable exit — of insurers running away from the greatly increased and unpredictable risk and of individuals not able to afford insurance without the subsidies." In other words, Obamacare will effectively be destroyed for 2018 and beyond by April, even if Republicans back off their insanely unpopular plan to repeal and replace or repeal and delay. Since Republicans can only ram through changes to the funding of Obamacare under budget reconciliation, it seems inconceivable that they will be able to craft a replacement plan that can pass both the House and the Senate by April, nearly two short months away.

    All this leads me to my biggest fear - that Republicans will not repeal Obamacare but won't do it in time to prevent a mass exodus from the exchanges by health insurers. That really would create a death spiral in 2018 and that the GOP would then capitalize on the collapse of Obamacare just in time for the 2018 elections. It seems preposterous that they could get away with that, but, after this year, we should never underestimate the Republican propaganda machine.

    Meanwhile, the Congressional Budget Office (CBO) has come out with its independent analysis of the costs of repealing Obamacare and the numbers are staggering. According to the CBO, "The number of people who are uninsured would increase by 18 million in the first new plan year following enactment of the bill. Later, after the elimination of the ACA’s expansion of Medicaid eligibility and of subsidies for insurance purchased through the ACA marketplaces, that number would increase to 27 million, and then to 32 million in 2026. Premiums in the nongroup market (for individual policies purchased through the marketplaces or directly from insurers) would increase by 20 percent to 25 percent—relative to projections under current law—in the first new plan year following enactment. The increase would reach about 50 percent in the year following the elimination of the Medicaid expansion and the marketplace subsidies, and premiums would about double by 2026."

    Just take a moment to let those numbers sink in. Up to 32 million Americans will lose their health insurance and premiums in the individual market will double. Have the Republicans ever given a real rationale for why they would like to do this and think this is a good outcome? Of course not. Because the real answer is they just want to give massive tax cuts to the rich and couldn't give a damn about the rest of America.

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