So we are getting details on the Senate version of the AHCA and it's pretty clear that it is pretty much the same as the House bill except the Medicaid phase-out period will probably be extended until 2023 or 2026. On the other hand, those Medicaid cuts may actually be deeper than the House plan. The Senate plan actually increases subsidies over what the House has and links them to income rather than age. The Senate also removes the House language on restricting abortion coverage because it would not pass parliamentary muster and would require 60 votes.
This isn't even AHCA-lite. It is just the same old AHCA with a few things moved around. But we knew this was what Republicans would do back in November after the election when it was clear they controlled Congress and the White House. What has been especially disappointing in this whole health care debate has been the reaction, or lack of one, from the health care industry.
Despite having enormous input into the crafting of Obamacare, the health care lobby has been remarkably silent as Republicans plan to destroy it. As Dylan Scott writes, "Health industry groups generally don’t love Obamacare enough to jeopardize their ability to shape the rest of the Republican agenda — including big corporate tax cuts. They also fear incurring White House retaliation."
In fact, for certain segments of the health care industry, the tax cuts the Republicans are promising not only in the repeal of the ACA but also in the proposed cut in the corporate tax rate is far more important than defending Obamacare. Scott continues, "the House health care bill repeals Obamacare’s various taxes on the industry, totaling nearly $200 billion in tax cuts over 10 years for drug companies, health insurers, and medical device companies...Some rough back-of-the-napkin math, based on figures from the IRS, suggests the health care industry could see its collective taxes lowered by $2 billion a year if Trump gets his 15 percent corporate tax rate...Other parts of a reform plan, such as reducing or eliminating taxes on income earned abroad by American companies, could carry enormous benefits for, say, pharmaceutical companies."
In many ways, Republicans have become a retreating army that is determined to destroy as much as possible so that it will take the enemy as long as possible to rebuild. The repeal of Obamacare and replacement with whatever version of the AHCA Republicans can pass will be a disaster for Americans. Americans will be worse off than even before the ACA was passed, millions will lose insurance, and tens of thousands will needlessly die. But the Republican gamble is that it will take Democrats decades to rebuild the infrastructure of Medicaid and health insurance in general.
But, some day, hopefully sooner rather than later, Democrats will have that chance and they should never forget how the health care industry chose to line their own pockets and let thousands of Americans die when they had the chance to save and improve Obamacare.
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