In the House today, Republicans are arguing for a repeal of the Affordable Care Act. A few points:<\/p>\n
1) The Republicans want to leave up to 129 million Americans with pre-existing conditions without protection.<\/strong><\/p>\n According to the Department of Health and Human Services, up to 129 million Americans (not counting the elderly) have pre-existing conditions that could prevent them from getting health insurance on the individual market. Most of those Americans are getting insurance through their workplaces, but many of those folks are in effect trapped in their jobs by their health, distorting the job market. Up to 30 million simply can’t get health insurance.<\/p>\n Especially in today’s job market, “it’s okay if you can get a job” is not a reasonable response to the problems of people with pre-existing conditions. The Republicans used to have a viable plan to deal with this problem — Romneycare, otherwise known as the individual mandate. But now, for reasons of partisan convenience, the Republicans are passionately opposed to the one good idea they’ve ever had on health care. And as a result, they’re against sick people having affordable insurance coverage that will provide decent care.<\/p>\n Under the Affordable Care Act, insurance companies can’t refuse to help sick people, and can’t drop coverage because someone becomes ill. Republicans want to repeal that protection, and they don’t have any coherent plan<\/a> to help those people.<\/p>\n 2) The Republicans are voting against letting a real competitive market lower prices.<\/strong><\/p>\n Beginning in 2014, anyone on the individual market (with or without pre-existing conditions) will have access to Health Insurance Exchanges, where insurance companies will be forced to compete in a clear, easy-to-understand format online for health insurance premiums. Unlike the status quo — where people rarely have the ability to choose between many health plans, and health insurance companies are allowed to do everything they can to misstate their plans’ true costs and benefits — this allows actual competition to flourish and bring down costs.<\/p>\n 3) The Republicans are voting to add $230 billion to the deficit. <\/strong><\/p>\n The Congressional Budget Office estimates<\/a> that repealing the Affordable Care Act will add $230 billion to the deficit just in the next decade — and it would probably be worse the decade after that.<\/p>\n To this, the Republicans claim that the CBO is lying, but their claims don’t<\/a> stand up<\/a> to examination<\/a>.<\/p>\n 4) The Republicans are voting to leave 32 million Americans without health insurance.<\/strong> From Ezra Klein<\/a>:<\/p>\n In 2019, there will be 32 million Americans who don’t have health insurance, but would have had it under reform: There are a lot of questions about how the Affordable Care Act will work in practice, but this is the part we know for certain: Tens of millions more Americans will have health insurance. About half of the newly insured will get coverage through Medicaid, and about half will get it by purchasing subsidized private insurance on the exchanges. But they’ll get it. Under the status quo, they won’t.<\/p><\/blockquote>\n 5) The Republicans are voting to eliminate the only structure the US has to reduce health care costs.<\/strong><\/p>\n In the long run, only one things matters to the federal budget deficit, and that’s the increasing costs of health care. Compared to that one item, everything else is small.<\/p>\n It’s much easier to make technical changes to existing legislation than to pass new legislation from scratch (look at how much effort and political capital passing even a very mild and limited health care reform has cost the Democrats). The Affordable Care Act provides that base, and nothing the Republicans have proposed serves the same function with even close to the same scope.<\/p>\n Quoting health economist Henry Aaron<\/a>:<\/p>\n As things now stand, the future of the Affordable Care Act is highly uncertain. Yet, its success is of critical national importance. The reason, paradoxically, is the promise of the very provisions that have been subject to most criticism\u2014those related to cost control. …The bill contains, at least in embryonic form, virtually every idea for cost control that any analyst has come up with:<\/p>\n \u2022 The bill retains health savings accounts. This menu includes all available ideas on how to control the growth of health care spending within the next few years. The most practical cost-control strategy that is now available to Congress is to accelerate the implementation of these provisions, not to stymie them.<\/p><\/blockquote>\n The vote (which will probably take place tomorrow) is a simple up-or-down vote. You either want the status quo, or you want the Affordable Care Act. No third alternative is being offered by the Republicans. ((On Thursday, the Republicans plan to hold a vote to throw the question to a hodgepodge of committees to come up with alternative plans whenever they get around to it, no deadline attached — in other words, they don’t intend to come up with a serious alternative plan at all.)) And when it comes down to it, every Republican in the House will probably be in favor of more Americans lacking insurance, less rights for sick people, higher deficits, and doing nothing to address skyrocketing health care costs.<\/p>\n The Democrats were doomed in the 2010 election cycle regardless (due to the combined effects of the economy, mid-term voting patterns, and having more vulnerable seats). But there’s reason to believe that they’ve also paid a cost for supporting the Affordable Care Act, especially since the Republicans have lied about its effects at every turn (“death panels,” et al). Nonetheless, it was worth it.<\/p>\n The Affordable Care Act is a compromised and altogether too mild health care reform, but even so it’s enormously better than the status quo. At some point, politics should be about doing long-term good, not just winning short-term elections by any means necessary. But judging by this vote, Republicans have not reached that point.<\/p>\n","protected":false},"excerpt":{"rendered":" In the House today, Republicans are arguing for a repeal of the Affordable Care Act. A few points: 1) The Republicans want to leave up to 129 million Americans with pre-existing conditions without protection. According to the Department of Health … Continue reading
\n\u2022 It adds pilots and demonstration programs to develop accountable care organizations and medical homes.
\n\u2022 It contains provisions to test the practicality of bundled payments and to develop value-based health insurance.
\n\u2022 It contains additional funding for comparative-effectiveness research. It spurs the introduction of health information technology.
\n\u2022 It directly curbs growth of Medicare spending and establishes a commission to recommend further reforms (although the Commission\u2019s powers are undesirably limited).
\n\u2022 It contains a significant expansion of preventive care, although the cost-reducing potential of preventive care is often greatly exaggerated.<\/p>\n