Don’t fall for Republican quackery

In January, Senate Majority Leader Mitch McConnell said, “If Hillary Clinton had been elected, if there were a Democratic Senate, we’d be revisiting Obamacare.”

True, but we wouldn’t be making it worse, as McConnell and President Donald Trump are proposing, we’d be making it better.

Trying to sell Americans on their alternative, Republicans are making dubious claims about what we have now. But they can’t build a better system if they won’t admit — or don’t understand — today’s reality. Here’s a look at GOP criticisms of the Affordable Care Act (better known as Obamacare), the law some Republicans love to hate.

▪ It’s an “absolute disaster” for Kentucky.

The ACA covers 500,000 Kentuckians and has brought more than $8 billion into the state over the last three years. Hospitals are being paid for care they once had to write off as charity; their uncompensated care is down by 75 percent or $2 billion a year. Research is showing gains in preventive care, less emergency room use and improvements in health outcomes. The ACA required Medicaid to begin covering addiction treatment as opiate addiction and overdoses spiked. You can argue that Kentucky can’t afford to pick up its share of the Medicaid expansion which started coming due this year. (By putting up $200 million, Kentucky gets $3.4 billion in federal funds.) But a disaster? No way.

▪ The ACA is in “full scale meltdown,” premiums are soaring, insurers are dropping out.

Kentuckians who signed up for health insurance in the ACA marketplace are down to 81,155 from last year’s 93,666. Most receive tax credits to make it affordable, bringing the average cost in Kentucky to a little over $1,700 a year in 2017. If you’ve never been able to afford insurance, having the choice of even one insurer can save you from bankruptcy in case of a health crisis. Republicans in Washington have sabotaged the ACA market by killing a protection against drastic premium increases and canceling advertising before this year’s sign-up deadline. With a little help, the market would stabilize, moderating costs for the few who make too much to get subsidies.

▪ Who in his right mind would settle for Medicaid unless he had no other choice?

Only someone who has a life of privilege or no imagination can fall for this one. Just ask a low-wage worker who can finally afford blood-pressure medicine or to see a doctor about that suspicious lump. The ACA’s Medicaid expansion has given 400,000-plus Kentuckians who earn below 138 percent of the poverty line ($33,465 for a family of four) access to preventive care.

▪ “I don’t need maternity benefits because I don’t expect I’ll be expecting.”

Only someone who misunderstands both insurance and biology would fall for this criticism of the ACA’s standard plans. We all end up paying for each other’s health care, if not through premiums then through higher medical costs and taxes. Paying for someone else’s preventive care saves you from paying for their ER care. Young adults help pay for older people, who need more care, because one day they’ll be old. Women help pay for prostate checks to avoid paying for men’s cancer treatments. A child born without prenatal care is far likelier to become a financial burden on others, perhaps for a lifetime. And there’s no pregnancy that doesn’t involve a man.

▪ Congress has to repeal the ACA before it can take up tax cuts.

The Republican health care plan is a tax cut — for the wealthiest Americans and insurance industry executives. People making more than $1 million a year would enjoy a $144 billion tax cut over the next decade.

▪ It’s OK to rush this through with one party’s support because so was the ACA.

In the end, no Republicans voted for President Barack Obama’s health-care law in 2010. But that came after more than a year of hearings, debate and compromises aimed at satisfying Republicans in Congress.

Republicans would be wise to slow down and get their health-care reform right.

This story was originally published March 21, 2017 at 8:03 PM with the headline "Don’t fall for Republican quackery."