Upgrade Health Plan O

Senate Majority Leader Mitch McConnell.

Senate Majority Leader Mitch McConnell.

Senate Majority Leader Mitch McConnell and many of his fellow Republican senators told the nation they could improve health care and cut costs by paring down insurance.

McConnell said they could cover people with serious illnesses and pre-existing conditions too.

Overall, their lightweight insurance proposal saved money by focusing on colds and flu, aches and pains, and other problems that require everyday care by a doctor or nurse practitioner.

This minimalism ignored a fundamental rule of insurance: Plan for the worst.

McConnell’s proposal did the opposite by planning for the routine.

This backward approach would strand patients with difficult diseases. It would cut coverage short for extended hospitalization or long-term treatment.

Thankfully, the nation has a plan in place that takes health care seriously — the Affordable Care Act.

Better known as Obamacare, it needs some maintenance and upgrades.

The reason: A wanton blockade by the Republican Congress and Trump administration has halted updates, routine upkeep and promotion of Obamacare — all in hope of failure.

Now is the time for Republicans to invite Democrats to join an equal effort to eliminate inefficient aspects of the program and put better practices in place.

However, since Trump’s election, he and congressional Republicans have intensified their attack on Obamacare and, thus, on the health of Americans.

Their disregard for the nation’s people continues with a Trump demand for a vote to repeal Obamacare and create a replacement through Senate debate. McConnell says the vote will be next week.

PLAN AND PLAN AGAIN

The House of Representatives passed the American Health Care Act on May 4. The bill was intended to replace Obamacare.

If any Republican group was going to tame the draconian House bill and treat health care sensibly, the national expectation was that it would be the Senate majority — 52 of the 100 senators. The Senate is known for deliberation, experience and caution in comparison to the House.

McConnell took the opposite tack. He appointed an all-male, all-Republican group of senators to meet in a series of closed sessions to write the bill. Suspicion spiked.

In what would become known as Plan A, McConnell rolled out the Better Care Reconciliation Act on June 22. It split his caucus.

Conservatives complained it retained too many Obamacare tenets. Moderates, a number of whom were backed by their state governors, bemoaned stark cuts to Medicaid and other coverage on which many of their constituents rely for health care — and for life itself.

Not enough Republicans supported Plan A. No Democrat supported any Obamacare replacement.

McConnell rolled out Plan B on July 13. It aimed to pull in more conservative and moderate Republicans alike. 

Plan B’s lack of support proved the contradiction of its premise.

Tuesday, the ever-more-desperate McConnell proposed Plan C. It would have eliminated Obamacare two years from now, with the Senate using the interim to write a new health care bill from scratch. Trump and Vice President Mike Pence stated their support. Plan C collapsed almost as quickly as it was proposed.

Wednesday, Trump changed his mind and insisted that Obamacare should both be repealed and replaced — immediately. “We have to stay here. We shouldn’t leave town, and we should hammer this out and get it done — and not just a repeal,” the president told a large group of Republican senators during a White House luncheon.

McConnell acted on Trump’s instruction promptly. Outside the White House, after the lunch meeting, McConnell said, “No harm is done by getting on the bill.” He added that the bill would be “wide open for amendment.”

Left unclear by McConnell was which version of the bill would be debated. If the idea gains the 50 votes needed for discussion, a hagglefest will result.

With Trump’s influence among senators weakened by limp leadership that includes his erratic proclamations and changes of course, a chance of victory is barely visible.

TOOLBOX

Plan O is a more productive way to go. Grab the toolbox and pound out the dents in Obamacare. Time has identified them, but Republican interference has made repairs impossible until now.

The nation prefers Obamacare over the Republican approach 50 percent to 24 percent, says a Washington Post-ABC News poll released Sunday.

Democrats have a duty and a need to ensure that Plan O is upgraded effectively and to show the way forward. They passed Obamacare, over Republican opposition, in 2010. Respondents in the Post-ABC poll said the Democratic Party “just stands against Trump” rather than “stands for something” 52 percent to 37 percent.

Health insurance should cover pre-existing conditions. Health insurance should cover young-adult children on parental plans. Health insurance should cover preventive tests and lab work to detect problems when small and curable. Health insurance should cover emergencies to take substantial cases directly from an emergency room to a hospital room. Health insurance should cover mental care equally with medical care. Health insurance should cover maternity care for mother and child.

The only plan that provides such meaningful coverage is the Affordable Care Act — Obamacare.

Republicans should swallow their party pride and join with Democrats on Plan O. It is the people’s preference 2-to-1. Solve Obamacare’s problems to protect and improve the health of Americans in every state.


APPENDIX I — CBO CHARTS

2L. Insurance Coverage — Change in Medicaid Portion (millions).jpeg
5L. Insurance Effect on Federal Deficit (billions).jpeg

APPENDIX II — CBO DATA

Under the House’s American Health Care Act, the Congressional Budget Office estimated on May 24 that:

  • Fourteen million people would lose health insurance in 2018, compared to present, 19 million in 2020 and 23 million in 2026.
  • Over 10 years, an $834 billion cut to Medicaid would result in 14 million people among those uninsured coming from that program.
  • Premiums would be 20 percent more in 2018, compared to present, and 5 percent more in 2019. The amount in later years is uncertain.
  • The federal deficit would decrease $119 billion over 10 years.

Under Plan A of the Senate’s Better Care Reconciliation Act, the CBO estimated on June 26 that:

  • Fifteen million people would lose health insurance in 2018, compared to present, 19 million in 2020 and 22 million in 2026.
  • Over 10 years, a $772 billion cut to Medicaid would result in 15 million people among those uninsured coming from that program.
  • Premiums would be 20 percent more in 2018, compared to present and 10 percent more in 2019, but 30 percent less in 2020 and 20 percent less in 2026.
  • The federal deficit would decrease $321 billion over 10 years.

Under Plan B of the Senate bill, the CBO estimated on July 20 that:

  • Fifteen million people would lose health insurance in 2018, compared to present, 19 million in 2020 and 22 million in 2026.
  • Over 10 years, a $756 billion cut to Medicaid would result in 15 million people among those uninsured coming from that program.
  • Premiums would be 20 percent more in 2018, compared to present, and 10 percent more in 2019, but 30 percent less in 2020 and 25 percent less in 2026.
  • The federal deficit would decrease $420 billion over 10 years.

Under Plan C of the Senate bill, the repeal-only Obamacare Repeal Reconciliation Act, the CBO estimated on June 19 that:

  • Seventeen million people would lose health insurance in 2018, compared to present, 27 million in 2020 and 32 million in 2026.
  • Over 10 years, an $842 billion cut to Medicaid would result in 19 million people among those uninsured coming from that program.
  • Premiums would be 25 percent more in 2018, compared to present, and 50 percent more in 2020 and 100 percent more in 2026.
  • The federal deficit would decrease $473 billion over 10 years.

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