Republicans in Congress have been trying to repeal the ACA since it was enacted in 2010. But unlike previous efforts, a successful House bill now would go not only to a Republican-majority Senate, but potentially to the desk of President Donald Trump, another Republican who has vowed to replace Obama’s legacy health insurance legislation.
Actual repeal and replacement is the “third bucket” of expected Republican actions on the ACA, Allen told the Statesboro Herald.
“What we’re hoping to do is have it done and over to the Senate by Easter,” he said.
Easter this year is April 16.
Allen, the Republican representing the 12th District since 2014, was interviewed briefly inside the Statesboro Regional Library while some constituents protested outside, demanding a town hall meeting on many topics. One woman, who attended the Georgia Free File tax preparation briefing Allen kicked off at the library, approached him in the hall to express a view of Obamacare very different from Allen’s.
ACA ‘death spiral’
Allen says that Obamacare is collapsing under its own weight. Among other things, the ACA mandates that people have medical insurance through employers or on their own, imposes tax penalties on those who don’t and subsidizes coverage for people at certain income levels.
“Premiums have exploded, Obamacare is in a death spiral, and the only way to bring down costs is competition,” Allen said.
Some insurance companies that originally offered coverage through state and federal ACA exchanges have withdrawn, at least in certain states and counties.
“What we have to do is restore the marketplace,” Allen said. “Obamacare has pretty much destroyed the marketplace. In other words, there are counties in this country that have no insurance carrier, and we’ve got hundreds of counties that only have one insurance carrier. In fact, in most of my district, since Humana pulled out, we only have one insurance carrier, and that’s Blue Cross.”
Georgia was also one of a number of states where Republican governors and legislatures refused to expand Medicaid to people with higher incomes than previously qualified. This was part Obama’s plan, passed by what was then a Democrat-majority Congress. It came with a promise of federal funding, but states also pay a share of Medicaid costs.
The first “bucket” in this year’s Republican-led steps that Allen says will restore a competitive health insurance market, rests in the budget reconciliation process between the House and Senate. In this process, Congress cannot repeal the mandates but can remove the fines, he said.
Congress could also turn Medicaid funding into block grants to the states and create high-risk insurance pools for people with pre-existing conditions “which will take some of the pressure off the marketplace,” Allen said.
The second “bucket” began with Tom Price’s confirmation as secretary of health and human services. The Senate did that Feb. 10.
In his previous role as Republican congressman from Georgia’s 6th District, Price, an orthopedic surgeon, authored a bill that passed both chambers of Congress that would have repealed many aspects of Obamacare. But Obama, as promised, vetoed it.
The Affordable Care Act, many times in its 2,700 pages, says “the secretary may,” Allen said. Price is now that secretary.
“So there are many things that he can do inside the law to help the marketplace, to build the marketplace back, and these are interagency regulatory reforms,” Allen said.
In the last “bucket” is the legislation to repeal and replace. The plan Allen supports would eliminate subsidies, but also penalties, and instead provide tax incentives for people to buy health insurance. It would also provide for health savings accounts, which he said would operate like a 401(k) retirement plan.
“The idea is to allow the marketplace to provide policies that are custom-fitted to everybody’s needs,” Allen said. “The problem with Obamacare and the reason the costs are so massive is it’s one-size-fits-all. In other words, you can only buy one type of coverage, and it covers everything. Well, people don’t need that, and don’t need to pay for that.”
The ACA exchanges were designed to provide bronze, silver, gold and platinum levels of coverage. But Allen said that aspects of coverage, such as for childbirth, were mandated. He remarked that he and his wife are not having more children.
A different view
Statesboro resident Joanne Atekha, whose husband is a doctor, spoke to Allen upstairs at the library as he was leaving the Free File event.
Atekha has a family member with a pre-existing condition, for which insurance companies denied coverage, she said. The ACA has barred insurers from doing this.
Her family is privately insured, but she said she knows people who welcomed Obamacare coverage. In regard to rising premiums, Atekha said she is aware of the insurance provided employees through her husband’s medical practice and that premiums have always gone up, not starting with Obamacare.
Many efforts, she said, have been directed at killing Obamacare, with little done to make it work.
“OK, we’re great at killing things, so let’s get good at building something,” Atekha said to Allen. “People need health care.”