The GOP Is Still Determined To Overturn Obamacare

(This photo of Paul Krugman, from wired.com, is by Fred R. Conrad.)

The Republicans were unable to completely overturn Obamacare (the Affordable Care Act), thanks to John McCain. But they did do away with the individual mandate, which has caused insurance premiums to skyrocket. And they are going after the "pre-existing conditions" part of it in the federal courts, which would make insurance unaffordable for millions of Americans.

But make no mistake. They still want to completely abolish Obamacare -- and if they win in November and keep control of Congress, they will do that. And they won't replace it with something better, because they have no plan at all (let alone something better).

Here's the truth from Paul Krugman in his New York Times column:

McCain is gone, and with him, as far as we can tell, the only Republican in Congress with anything resembling a spine. As a result, if Republicans hold Congress in November, they will indeed repeal Obamacare. That’s not a guess: It’s an explicit promise, made by Vice President Mike Pence last week. . . .

The G.O.P. can’t come up with an alternative to the Affordable Care Act because no such alternative exists. In particular, if you want to preserve protection for people with pre-existing conditions — the health issue that matters most to voters, including half of Republicans — Obamacare is the most conservative policy that can do that. The only other options are things like Medicare for all that would involve moving significantly to the left, not the right.

Health economists have explained this point many times over the years; but as always, it’s difficult to get a man to understand something when his salary depends on his not understanding it. Still, let’s try one more time.

If you want private insurers to cover people with pre-existing conditions, you have to ban discrimination based on medical history. But that in itself isn’t enough, because if policies cost the same for everyone, those who sign up will be sicker than those who don’t, creating a bad risk pool and forcing high premiums. That was the case in New York, where premiums for individual policies were very high before the A.C.A. — and promptly fell by half when Obamacare went into effect.

For what Obamacare did was provide incentives to get healthy people to sign up, too. On one side there was a penalty for not having insurance (the individual mandate). On the other, there were subsidies designed to limit health expenses as a share of income. Republicans have tried to sabotage health care by doing away with the mandate, and have succeeded in driving premiums higher; but the system is still standing thanks to those subsidies.

The point, again, is that Obamacare is the most conservative option for covering pre-existing conditions, and if Republicans really cared about the scores of millions of Americans with such conditions, they would support and indeed try to strengthen the A.C.A.

Instead, they’re going to kill it if they hold on in two months. But covering pre-existing conditions is popular; therefore, they’re pretending that they’ll do that, while offering proposals that would, in fact, do no such thing. . . .

So if you’re an American who suffers from a pre-existing medical condition, or fear that you might develop such a condition in the future, you need to be clear about the reality: Republicans are coming for your health care. If they hold the line in November, health insurance at an affordable price — maybe at any price — will be gone in a matter of months.