President Donald Trump ran on the platform that Obamacare, also known as the Affordable Care Act, needed to be repealed and replace right away. However, this is a complicated process that requires the Republicans in Congress to come up with a replacement plan that will ensure that the millions of Americans that are receiving coverage through Obamacare do not suddenly lose their coverage. Here are three issues that Republicans are currently grappling as they work to come up replacement plan for Obamacare.
#1 Medicaid Expansion
The Affordable Care Act no only created the individual insurance marketplace, it also expanded Medicaid eligibility so that more individuals could qualify for healthcare coverage under Medicaid. Although there have been cries to repeal Obamacare, only 47% of Americans polled understood that repealing Obamacare would also roll back the Medicaid expansion and insurance subsidies.
According to data provided by the Kaiser Family Foundation, 10.7 million newly eligible individuals enrolled in Medicaid under Obama. Rolling back the Medicaid expansion, that was supported by funding for the federal government, would take away health insurance to at least 10 million, many who live in Republican controlled states.
However, there are also numerous Republican Congress members who are opposed to the Medicaid expansion and want it rolled back. Other Republicans Senators want to roll back Medicaid and use the funds from Medicaid to pay for their expansion plan.
Either way you look at it, Republicans in Congress have different interest and priorities when it comes to the Medicaid Expansion that was rolled out under the Affordable Care Act.
#2 Limiting Expenses
The second issue that Republicans in Congress need to tackle is what part of Obamacare is too expensive. Many Republicans voice opposition to the cost of Obamacare, but are talking about two different things. Many Republicans in Congress are opposed to how expensive Obamacare is for the government, although certain taxes and fees were implements to raise money and cover the cost of Obamacare when it was implemented. Other Republicans in Congress are opposed to how expensive health insurance is for individual tax payers. These are very different perspectives. If you want to cut government funding of health insurance, that will most likely make insurance more expensive for individual tax payers. If you want to reduce the cost of health insurance for individual tax payers, that means more than likely that the government is going to have to foot the bill.
Congressional Republicans need to come together and figure out who they want to help save money – the government or the tax payers.
#3 Popular Features
Finally, Congressional Republicans have to come together and decide if they are going to keep some of the popular features of Obamacare. Obamacare made it possible for children up to the age of 26 to stay on their parent's health insurance. This helped ensure that many students pursuing Bachelor's and Master's degree were able to stay on their parent's health insurance through college. It helped young adults maintain health insurance as they built up their professional experience and worked in lower-paying entry level positions that don't offer health care insurance. This was an incredibly popular feature of the Affordable Care Act that many don't want to see taken away.
Another popular feature of Obamacare is that it took away the ability for insurance companies to deny someone because of a previous health condition or issue. Lifetime limits on healthcare expenses through insurance was also banned. Previously, it was really difficult and very expensive for individuals with chronic lifetime conditions to qualify for insurance. Even if they did qualify for insurance, there was often a lifetime cap on their coverage which could quickly be reached. Obamacare prevented insurance companies from denying coverage due to previous conditions.
Congressional Republicans have to decide if they will keep these popular features that expanded the ability to get and maintain insurance to millions of Americans.
Repealing and replacing Obamacare is a complicated puzzle that is going to take a lot of compromise. Currently, Medicaid expansion, funding and popular changes to insurance laws and requirements are three of the major issues that Republicans need to grapple with and come to a consensus on in order to move forward with a better health care law. To learn more about politics, read more about Katharine Hamilton.