One of the main issues that the Republicans campaigned on in the 2016 election, both at the national and the state level, was the repeal of the Affordable Care Act. Speaker Ryan recently announced what the Republicans in the House will seek to replace Obamacare with and it was Draconian to say the least. Many expected that Republicans in the Senate who had taken more moderate positions on healthcare reform like Susan Collins (R-MA) and Lindsey Graham (R-SC) would mean that the Senate bill would be less extreme. In a remarkable turn of events the Senate bill is even more harsh on the poor and provides a massive handout to the wealthiest individuals in America. But thankfully the Senate bill has hit a snag.
The specifics of the Senate bill are breathtakingly horrific. The Better Care Reconciliation Act would roll back the Medicaid expansion of the ACA and therefore throw millions of low-income Americans off of health insurance. Further, fewer middle-income Americans would receive a tax credit to buy private insurance and other tax credits would be reduced so that those who continued to receive government support would see a net cut in the amount they received.
Unsurprisingly a key part of the Senate Republican’s proposals are the repeal of all the taxation measures that currently fund the ACA. Because the ACA was structured so that these taxes disproportionately hit the wealthy so that the poor may be able to access healthcare, their repeal will inevitably result in a massive tax cut for the the wealthiest. Howard Gleckman of the of the non-partisan Tax Policy Center has estimated that those Americans earning over $200,000 per year will expect to see an average tax cut of around $5,640 whereas those earning less than $10,000 will be around $1,400 worse off.
Another provision of the Senate bill is that it would allow states to stipulate that recipients of Medicaid are required to be in employment for a certain amount of time. The motivation behind this is to make sure that people who receive government healthcare are also providing tax revenues to pay for that care however there are three fundamental problems with this idea.
Firstly, it could mean that people who currently receive Medicaid could be kicked off the rolls because they took a break from employment or possibly work part-time, if the state government stipulated as such. Secondly, if you are laid off for a reason beyond your control, you would also lose all access to health insurance unless you had thousands of dollars to pay for private coverage.
Thirdly, and most importantly, the bill reject the idea of of universal healthcare. This is significant because it is the final frontier of the healthcare debate. As soon as the American people collectively decide whether or not healthcare should be a universal right, the debate will be over and single-payer will be introduced. And this is why the GOP are trying to reinforce the notion of it being a commercial decision like any other.
But as I said earlier the Republicans have come into some difficulties. Initially a group of very conservative Senators, namely Rand Paul (R-KY), Ted Cruz (R-TX), Ron Johnson (R-WI), and Mike Lee (R-UT), all said that they would not vote for the bill in its current form. However the latest development is that Dean Heller (R-NV) has also announced that he will not support the bill. This is significant because he one of the GOP senators who has a more moderate approach to healthcare reform.
Don’t get me wrong, no Republican senator is a moderate on this issue because they all believe that the ACA should be replaced by something that will inevitably reduce the number of people on health insurance. But in the context of the US Senate, it is possible that other Republican moderates like Susan Collins (R-MA) will jump ship and oppose this bill. Because of the Senate’s currently electoral composition, the GOP will lose its majority and healthcare reform will not take place. There are some procedural hoops to jump through however any vote on healthcare reform will require a filibuster-proof majority of 60 votes. On current electoral maths, the GOP have around 47, but that number is dropping.
The importance of understanding this bill cannot be understated because ignorance will allow for senators to get away with stripping healthcare from millions of people. The Republicans have demonstrated that they have no substantive ideas to improve the healthcare situation of the United States and also that their big-tent party is so broad that, on this issue, it is totally unwieldy. The Republicans need 60 votes to get this passed and the fact that they can’t even get their own 52 senators on board shows how deep the ideological divisions are within the GOP.
The Democrats will filibuster this because it involves repealing the ACA but the broader Left in the US needs to use this opportunity to attack the third criticism of the AHCA I mentioned above. By arguing that healthcare should be a universal right of all people and marketing it as something like ‘Medicare for all’ the free-market bullshit of the Republicans will be defeated once and for all. The solution to the US healthcare crisis is a massive tax rise to fund a single-payer system which will save both lives and money in the long run.
Organisations like the Nurses United Union are already agitating for change and grassroots pressure will result in such a system being set up. If the Republicans are defeated on this philosophical idea they will lose their majority and millions of people will be free from the fear of bankruptcy because they committed the grand crime of being ill.