Health care solutions up for debate

It was always going to be easier to talk about “repeal and replace” of the ailing Affordable Care Act, aka Obamacare, than to do it, but House Republicans, at the urging of President Trump, have taken the first major step in that direction — albeit into the unknown.

By a razor-thin margin of 217-213, the GOP-controlled chamber gave Speaker Paul Ryan, R-Wisconsin, and the president a major legislative victory while delivering on a major campaign promise.

Whether the legislation, which is derided by Democrats, assailed by activists and replete with questions, will lead to a better system or the equivalent of politically assisted suicide for Republicans is the subject of much debate.

The legislation was stitched together at a frenetic pace with the goal of getting enough Republican moderates and conservatives on board to pass it in Trump’s first 100 days.

There was no hope of any Democrat help — any more than there was any Republican support for Obamacare.

While Democrats were almost giddy at the prospect of voter revolt over House passage of “Trumpcare,” there are some things voters should keep in mind:

Obamacare is broken. Premiums are soaring. Mounting deductibles are a killer for many families. Most of the Obama-established cooperatives that were supposed to change the face of health care insurance and delivery have gone out of business.

And Medicaid? Lots of new people did, in fact, get new insurance via Medicaid expansion: Cadillac insurance plans with no deductibles and virtually no co-pays. Want name brand drugs instead of generics? No problem. Want to go to the emergency room with sniffles because it’s convenient? That’s OK, too.

But there are two big problems with the Medicaid golden goose: Providers say reimbursements aren’t meeting their actual costs, and it is busting state budgets, including New Mexico’s. And that doesn’t even take into account the unintended social consequence of people opting not to take a job, or a raise, or work more hours because the higher income would threaten their Medicaid and other benefits.

House Republicans say their legislation will lead to lower premiums, while protecting people with pre-existing conditions. Those claims and others are up for debate.

And as for fiscal impact, who knows? The legislation was pushed through without even waiting for a Congressional Budget Office score.

But while it’s fair to criticize House Republicans for some aspects of the legislation, as well as the process, they also deserve some credit. It might be bitter medicine, but this process had to start somewhere if the patient is going to survive.

— Albuquerque Journal