Health in America: Trumpcare vs. Obamacare

By Dorothy Inman-Johnson
Special to the Outlook

One of President Obama’s major achievements was the passage of the Affordable Care Act (ACA) in late 2009 that went into effect in 2010. Except for Medicaid for the poor and Medicare for the elderly, passed in the late 1960s, no President before Obama had been able to get a comprehensive health program through Congress for all Americans. Republicans tried desperately to defeat it, but did not have the votes. They vowed to repeal it out of their anger and hatred toward President Obama, though most Americans now understand the value of having access to real health care. The GOP renamed the ACA Obamacare as a strategy for their supporters to transfer the anger they felt for Obama to a piece of legislation that actually helps people. The tactic backfired as people signed up and realized the benefits of the program. And calling it Obamacare helped to seal it forever as part of President Obama’s legacy.

 
When Republicans took over power in Washington after the 2016 election, the repeal of Obamacare was at the top of their agenda, even if it would leave about 20 million Americans without healthcare. When Obama left office in January 2017, the biggest criticism of Obamacare was the rising cost of insurance premiums for those not covered by an employer’s health plan, Medicaid, Medicare, or eligible for a subsidy. However, Trump and the GOP neglected to note they vigorously fought attempts by Democrats to adopt a “Medicaid for all” or a “Public Option” in the ACA to prevent the plan being totally dependent on private insurance companies to control the cost of health services. Further, with the cost being the major public concern for Obamacare, Congress had an easy fix. It could have simply added the public option, a government subsidized plan, like the one Congress has, to the mix.

 
Trump and the GOP are finding it harder to repeal ACA than they thought now that Americans have experienced the benefits of the health plan. Under ACA, people who had been denied coverage for cancer, or charged very high premiums in the past because of pre-existing conditions like high blood pressure, diabetes, asthma, etc. now must be covered at an affordable rate. Women cannot be charged higher premiums than men. Annual well-care examinations and mammograms that catch health problems early are free under ACA or Obamacare. These measures actually save lives because everyone can now afford to have them done. Co-pays on other medical procedures and prescriptions are also lower.

 
There is no wonder that medical professionals, hospitals, the AARP, and millions of Americans are opposed to Trump and Paul Ryan’s plan to repeal and replace Obamacare. Hospitals do not want a return to emergency rooms full of patients needing basic health care, making it difficult to give their attention to real health emergencies. All of these groups have read the Trumpcare/ Ryan plan and know health services will be eliminated, cost will go up even more, and health coverage will again be denied to many Americans placing a heavy burden on local tax payers. Here are some of the changes proposed in the Republican Plan.

 
1. Most alarming to me is their stated intent to privatize Medicare which is problem-free and one of the best government-run health programs since passed six decades ago. My advice to them_ Keep your hands off my Medicare!

 
2. Republicans will put sick people in a high-risk health pool with premiums too high to afford, and separate healthy people into another plan with premiums probably no lower than in ACA. This is the opposite of the way private insurance works. With healthy and sick people in the same pool, the premiums for everyone can be lower. The GOP plan would allow insurers to again deny coverage for pre-existing conditions by making the cost so high the sick can’t afford health insurance.
3. Government subsidies that currently offset the cost to lower income Americans who do not qualify for Medicaid would be eliminated or drastically reduced under the Republican plan.

 
4. Federal funds for states to expand Medicaid to cover all low-income Americans with incomes under 138 percent of poverty would be eliminated or phased out, leaving states to either kick poor people off Medicaid or increase state taxes on residents to continue the coverage. The most vulnerable_ children, pregnant women, poor families, the disabled, and elderly_ would be hurt most by this change.

 
5. The individual and employer mandate to participate in the program would be eliminated, passing off their responsibility for their coverage or their employees’ health insurance to hospitals and tax payers. This would also reduce funds to the program that allow government to provide a plan with quality care at an affordable cost.

 
6. Trumpcare would allow private insurers to charge the elderly five (5) times more for their premium than young adults. The elderly pay more now, but the GOP plan would almost double the premium.
If high premiums were the only major problem with Obamacare, then Trumpcare certainly is not the solution. Everything proposed by Republicans will eliminate health coverage for 15,000,000 to 20,000,000 Americans, and increase costs for premiums beyond most Americans’ ability to pay. It is insane and irresponsible to repeal a program that for the past 7 years has provided health security and hope to millions of Americans, without having anything better to offer. We must hold our Congressional leaders’ feet to the fire to oppose the Trump/ Ryan plan and lies, and act in the interests of the people of Florida who elected them. We must preserve and improve Obamacare, not repeal and replace with something much worse.

 
One voice speaking out can easily be ignored. Many voices speaking together cannot. Join the chorus in protecting our right to good and affordable healthcare.

 
Dorothy Inman-Johnson is host of Just the Facts_ a weekly, progressive radio talk show on WTAL 1450 AM Radio, newspaper columnist, author of Poverty, Politics, and Race in America and Lessons from America’s Best and Worst Cities, former Tallahassee Mayor and City Commissioner, and former long- time educator.