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OP-ED | Republican ‘Alternative’ To Obamacare Really No Alternative At All

by | Feb 9, 2015 4:04pm () Comments | Commenting has expired | Share
Posted to: Business, Health Care, Insurance, Opinion, Health Care Opinion, Reprinted with permission from the Center for Public Integrity

We got a glimpse last week of what would happen to our health care system if Republicans increase their control of Congress and win the White House in 2016.

Gone would be the part of Obamacare that Americans tell pollsters they don’t like: the requirement that they enroll in some kind of health plan or pay a penalty that grows more severe every year. In addition, the GOP would get rid of the provision mandating that employers with more than 50 workers offer subsidized coverage.

But the GOP would also eliminate the existing parts of the law protecting us from insurance company practices that used to keep millions of us in the ranks of the uninsured and underinsured – and just an illness or accident away from financial ruin. 

Of course, the sponsors of the Republican alternative – called the Patient Choice, Affordability, Responsibility and Empowerment Act – or Patient CARE – don’t spin it that way. In fact, the language they use makes their plan sound like a simple, common sense, no-brainer alternative to the Affordable Care Act (a.k.a., Obamacare.)

“We can lower costs and expand access to quality coverage and care by empowering individuals and their families to make their own health care decisions, rather than having the federal government make those decisions for them,” said Sen. Richard M. Burr (R-North Carolina), one of the three authors of the plan. The others are Sen. Orrin Hatch, (R-Utah), who now chairs the Senate Finance Committee, and Fred Upton (R-Michigan.), the chairman of the House Energy and Commerce Committee Chairman.

As always, though, the devil is in the details. The reality is that the GOP plan would take us back to the days when insurers could sell junk policies, charge older folks more than they can today and calculate premiums based on a person’s health status. This means that a breast cancer survivor or a diabetic or someone recovering from a heart attack – or even a young person born with a disability or congenital disease – would have to pay a fortune for decent coverage if, God forbid, they let their existing policy lapse for two months or longer.

The Republican sponsors say their plan would restore freedom of choice they claim was taken away by Obamacare. There is some truth to that. The Affordable Care Act requires health insurance policies to cover 10 essential benefits, ranging from preventive care to prescription drugs and a stay in the hospital. People no longer have the freedom to buy policies so skimpy they have to pay almost all of their medical bills out of their own pockets. The Patient CARE Act would restore that freedom. And it would also restore to insurance companies the freedom to set annual limits on coverage.

The health insurance exchanges would disappear in most if not all states because the federal funding to help run them would evaporate under the GOP plan. One of the benefits of the exchanges is the ability it gives us to shop online for coverage and compare features and costs of one plan versus another. Health insurance agents and brokers would probably love to see those features disappear, but their gain would be our loss.

To increase competition, the GOP lawmakers say they would allow insurers to sell coverage across state lines. They made no mention of the fact that health insurance is regulated largely at the state level and that federal law doesn’t bar insurers from crossing state lines today.

The Medicaid expansion under Obamacare would also go away, as would the federal subsidies available to help low-income families and individuals pay their premiums and cover some of their out-of-pocket expenses. Under the GOP plan, the states would receive block grants from the federal government to help finance their Medicaid programs, meaning the feds would have far less say as to how the states provide coverage to the poor.

The GOP plan would also provide aid only to people making up to three times the federal poverty level – and in the form of refundable tax credits – as opposed to four times the poverty level via federal subsidies under Obamacare. 
As a result, many – probably millions – of low- to moderate-income people who were able to buy coverage as a result of Obamacare would once again find the cost of health insurance prohibitively expensive.

Many folks in their 40s, 50s and early 60s would also be dumped back into the ranks of the uninsured or underinsured. Against the wishes of insurance industry lobbyists, Congress restricted insurers’ ability to charge older folks more than three times as much as younger people for the exact same coverage when it passed Obamacare. The industry wanted to be able to charge them at least five times as much. The GOP plan would grant that wish.

It’s important to note that the Patient CARE Act is not really a piece of legislation. If it were a bill instead of just a “vision,” as Burr, Hatch and Upton refer to their ideas, the Congressional Budget Office would have to assess the effect it would have on the budget and our health care system. That would not be pretty. So don’t expect the Patient CARE Act to become a bill anytime soon. 

Former CIGNA executive-turned-whistleblower Wendell Potter is writing about the health care industry and the ongoing battle for health reform for the Center for Public Integrity.

DISCLAIMER: The views, opinions, positions, or strategies expressed by the author are theirs alone, and do not necessarily reflect the views, opinions, or positions of CTNewsJunkie.com.

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(25) Archived Comments

posted by: Bluecoat | February 10, 2015  12:13pm

Out of curiosity, now that this said author is been on every left wing news site over the last few years peddling obamacare, has anyone investigated how much money the advocates of this monster of a law have funneled to Mr. Potter? Does Mr. Potter endorse the provision in this law, that progressives wrote, that bails out the insurance companies when the whole system comes crashing down?

posted by: SocialButterfly | February 10, 2015  1:03pm

The continual tillion dollar wasted cost travesty of having elected Pres. Barack Obama to office TWICE lives on. Can we survive two more years of Obamaism?

posted by: Bluecoat | February 10, 2015  2:28pm

Great piece today on PJ Media by Michael Walsh entitled - The Skull beneath the skin of the “Affordable Health Care Act”
Glenn Reynolds cross posted and commented - “The Skull is yours”
Walsh Writes:
“And now we can see it for what it really is: a vicious assault on free enterprise, a whopping tax increase on the middle class, a new way to get the Internal Revenue Service involved in the most personal aspects of our lives, the addition of another layer of complexity to the citizens’ interactions with the federal government and, most of all, a way to break the public’s will to resist further intrusions by the Leftist fascist state of Obama’s dreams. All masquerading under the guise of “health care.” It is the greatest scam in American history, and every single Democrat who voted for this fundamentally un-American monstrosity should be tarred, feathered, and run out of town on a rail, beginning with former Speaker Maerose Prizzi and Sen. Pat Geary. ”

posted by: Politijoe | February 10, 2015  4:24pm

Politijoe

Can either Socialbutterfly or Bluecoat manage to articulate anything of substance, based in fact regarding their perceived failings of Obamacare, or are they simply regurgitating the conservative Faux news misinformation that was spoon-fed to them over the last few years?

posted by: SocialButterfly | February 10, 2015  4:38pm

@Bluecoat: Michael Walsh told the truth. Obama has created the leftist state of Obama’s dreams that the Democratic Congress shoved down our throat’s as ObamaCare. Shame on this motley crew that “sold us down the river.”

posted by: SocialButterfly | February 10, 2015  5:57pm

@Politijoe: Why must you become agitated and abrasive sty when you can’t accept views that do not coincide with your mandated deliverance? Perhaps you are the one suffering from the act of regurgitation?

posted by: Politijoe | February 10, 2015  7:14pm

Politijoe

Socialbutterfly: this has absolutely nothing to do with my inability to engage in dissenting opinion so please stop using that ridiculous statement as cover.
I asked a very direct and simple question….

“Can you articulate anything of substance, based in fact regarding your perceived failings of Obamacare?”

I dont think you can, however Im offering you an opportunity to share some intelligent thought regarding the healthcare mandate-absent the rhetoric about socialism, totalitarianism, leftist, death panels, etc… simply the facts….
possible?

posted by: Commissioner | February 10, 2015  10:23pm

The Affordable Care act is neither affordable nor about healthcare—it is about insurance, not healthcare. It is not affordable without the subsidies. Eventually   those subsidies will either become less proportionate to the total cost of the premiums as costs increase or will need to increase, resulting in higher taxes or government deficits as the costs of coverage goes up.
It is not about healthcare—the ACA/ObamaCare has not added any new physicians, nurses, medical diagnostic facilities in this state that I know of.
What it has done is increase the Medicaid rolls in CT to over 700,000 people. And on the commercial side it has offered people “affordable” policies with huge deductibles and co-pays.
It is analogous to offering someone a drivers license and then saying that they have transportation when they have no automobile.

posted by: art vandelay | February 10, 2015  11:38pm

art vandelay

And who says the United States of America must have a cradle to grave taxpayer funded healthcare system.
What’s wrong with a market based system based purely on supply and demand.  Do advocates of socialized medicine forget that the small pox & polio vaccines were not invented in countries with single payer systems.  The instruments and procedures for open heart surgery were perfected in the good old USA not Cuba or the USSR.  It’s market forces that advance medicine not socialism.

posted by: Politijoe | February 11, 2015  8:40am

Politijoe

Commissioner:
You stated “It is about insurance, not healthcare.”….

I didn’t think we were discussing semantics; the fact is the ACA provides affordable access to healthcare to those who could not afford or were denied services. It also provides preventative care. Furthermore, it provides new consumer protections-using your argument does that make it a financial product?

You also stated ““The ACA/ObamaCare has not added any new physicians, nurses, medical diagnostic facilities in this state that I know of”…..

I don’t think you understand the intent of the ACA. It wasn’t designed to add clinicians or facilities, it was designed to lower the national costs of our healthcare while providing access to millions who were uninsured because they were denied or could not afford healthcare. 


You cited “It has offers people affordable policies with huge deductibles and co-pays.”…….

Again it has added individuals who previously couldn’t afford healthcare or couldn’t obtain healthcare due to pre-existing conditions. The numbers you cited are a reflection of the need for this legislation. The reality is healthcare premiums have been exploding over the last fifteen years, for many this was an opportunity to access healthcare services.

posted by: Politijoe | February 11, 2015  8:48am

Politijoe

Art:  You questioned “Who says the United States must have a cradle to grave taxpayer funded healthcare system., what’s wrong with a market based system based purely on supply and demand.”……..  with all due respect, this is an opinion from someone who obviously has not done their homework and read the data. The ACA addresses the national cost of our healthcare. The U.S. leads the world in healthcare spending but our outcomes do not reflect this cost.  The reason is the way we manage our healthcare and the multi-layer complexity of our model. As just one example, the French spend about $3,165 per capita each year for a health system with significantly better outcomes and still cover everyone. France spends about 11% of GDP on healthcare costs. The US spends about 20%.  Spending more than $7,000 per capita with marginal outcomes and still leaving millions without coverage. This isn’t fiscally sound governance. The U.S. is an out-of-pocket employer-based system with more than 40 million Americans who are too young for Medicare and to well off for Medicaid and therefore go without health insurance. For these people medical care is an out of pocket cost. Short of active labor or being on the verge of death the uninsured cant afford to pay for their care. In addition the uninsured do not have access to preventive care and as a result don’t get early diagnosis of potentially fatal diseases. Additionally families should not have to enter bankruptcy due to a lack of healthcare. They should not loose their homes in foreclosure due to a lack of healthcare or loose their healthcare with a job loss. Uninsured individuals with catastrophic illness should not be denied potentially life saving early diagnosis and treatments due to a lack of health insurance.


You mention “Do advocates of socialized medicine forget that the small pox & polio vaccines were not invented in countries with single payer systems.  The instruments and procedures for open heart surgery were perfected in the good old USA not Cuba or the USSR. ”….. I urge you to read the studies. This is not the boogey-man socialized medicine. The US does have the most advanced research and education model in healthcare, however what were talking about here is healthcare delivery-which for the U.S. is the most expensive, convoluted system in the world that delivers far worse outcomes. The financial argument for healthcare reform is self-evident, once you look at the facts and not just the rhetoric there is little room to deny healthcare reform based upon costs.

As Americans we should protect and ensure all citizens receive the basic requirements of life, food, clothing, shelter, constitutional protections, and basic healthcare. As Americans we are better than this. We take care of the least of our citizens…..which include the poor, the disadvantaged, the homeless, the addicted, the incarcerated, the children and the uninsured.

posted by: Jaykle | February 11, 2015  10:44am

@socialbutterfly
“...Obama has created the leftist state of Obama’s dreams…”
Um…you do realize that Obamacare was invented by Republicans, right?
You should probably spend less time reading right-wing websites…they seem to make you angry and afraid…which is exactly what they are trying to do.  Don’t be so easily manipulated.

posted by: SocialButterfly | February 11, 2015  10:59am

@Politijoe: Let’s get down to the taxpayer cost of ObamaCare. The Daily Signal reveals that ObamaCare coops are costing taxpayers $17,344 per enrollee. With the coops receiving an average of $108.7 million from the federal government. Twenty-three coops received a total of $25 billion dollars from the federal government and enrolled more that 520,000 people in plans through September. However, an analysis conducted the The Daily Signal yesterday found just one, Maine Community Health Options was profitable last year.
This is not your description of a perceived, but actual accounting of the failings of ObamaCare.

posted by: art vandelay | February 11, 2015  1:37pm

art vandelay

@PoliJoe,
I don’t think you understand the true intent of Obamacare.  It was designed to FAIL!  When it self implodes the Progressive Socialist Democrats will finally introduce the law they’ve wanted to pass since the days of Woodrow Wilson. Single payer which in reality is a complete takeover of our healthcare system by the federal government.  You continue to believe or Federal Government can provide better services than the private sector. You refuse to believe that Social Security is broke.  The USPS continually runs in the red. I do give them credit for trying however.  The USPS is making some positive strides against UPS & Fedex.  They have a long way to go. Amtrack is a JOKE!  I can go on and on.  Once our federal government gets total control of healthcare, kiss it good bye.  It will resemble what the people in Cuba have.

posted by: SocialButterfly | February 11, 2015  2:31pm

@Jackye:  If you are for ObamaCare, you have already been manipulated.

posted by: joemanc | February 11, 2015  4:05pm

Politijoe
Can either Socialbutterfly or Bluecoat manage to articulate anything of substance, based in fact regarding their perceived failings of Obamacare…”
Let me help you out - the health insurance premiums at my company rose 24% last year…the initial rise quote was 40% higher. I’ve been at my company 15 years and that is the biggest increase I have seen, including the years leading up to Obamacare. Now, I seem to remember that Obamacare was supposed to slow down the cost of healthcare increases, and not accelerate them. Am I correct?

posted by: art vandelay | February 11, 2015  4:07pm

art vandelay

@Jaykle,
Socialized medicine was a concept formulated by left wing progressive Democrats.  It started with Wilson, progressed through the Roosevelt & Truman Administrations. Roosevelt would have liked to include nationalized medicine but felt he was pushing his luck when he narrowly passed Social Security.  Truman wanted to continue Roosevelt’s legacy by passing it.  A Republican held majority in the House prevented him from doing so.  Ted Kennedy under Nixon almost got it if it were not for his stubbornness on a few small issues Nixon did not agree with.  Nixon by the way was no Social Conservative by a long shot.
Clinton failed with “Hillarycare”.  It wasn’t until Obama along with majorities in both the House & Senate was able to railroad it through.  We have to pass it in order to know what’s in it.  Well now we know.  It’s the worst piece of garbage ever signed into law.  The spineless Chief Justice John Roberts let it slide so now we’re stuck with it.  Don’t go blaming Republicans for this or stating it was their idea.  It wasn’t.  Not by a long shot.

posted by: art vandelay | February 11, 2015  5:02pm

art vandelay

@joemanc,
Rising healthcare premiums to corporations over 40% is exactly what the ACA was designed to do. The goal is to prevent private sector company from offering healthcare.  It will force everyone into the exchanges.  Once everyone is in the exchanges the next step will be to force private insurance companies out of business, thus a complete government takeover which is exactly what the Democrats want. Instead of doing it all at once, it will be done in drips and droves.  These are only the first steps.

posted by: Politijoe | February 11, 2015  9:48pm

Politijoe

Socialbutterfly: Co-ops received $1.9 billion in federal loans designed to compete with established carriers at lower prices. These co-ops are offering the lowest-cost plans in Arizona, Connecticut, Colorado, Idaho, Illinois, Maine, Maryland, New Mexico and New Jersey exchanges. Collectively, co-ops had premiums being paid by only about 523,000 customers, amounting to less than 8% of Obamacare enrollment nationally and while some co-ops bottom lines are threatened by not having enough customers, others face problems having too many customers.

Its bears repeating these exchanges are essentially small businesses still in the start-up phase in a crowded industry with entrenched carriers that have very deep pockets. Any start-up business enters a market with an inherent risk. Furthermore, they have to pay back their start-up loans in five years while facing a very tough environment with more established insurers who can spread out their costs. Subsequently, they simply could not have met state solvency requirements for insurers or paid claims before generating premiums without federal subsidies. However, in spite of the obstacles of such an established industry these co-ops deserve credit for holding down premiums in these competitive marketplaces. The Maine Community Health Options Co-Op grabbed 83% of the exchange market in 2014, largely because it offered the lowest-cost plans. Before 2014, Anthem was the dominant player in Maine’s individual market.

The Signal Daily or the Heritage Foundation has had consistent opposition to healthcare, immigration, same-sex marriage. abortion, budgets, women’s rights, taxation, poverty initiatives, education, affirmative action, military spending reductions, Benghazi, IRS, Shari law, etc…It takes credit for much of President Bush’s policy, both domestic and foreign including the Iraq war. Much of Bush’s policies were straight out of the Heritage play book. What’s most interesting and telling is throughout the 1980s, Heritage argued in favor of the individual healthcare mandate and immigration as free market economics.
immigration. Recent Heritage crusades against moderate Republicans and common sense policies have led even established GOP members such as Renee Ellmers to refer to them as “uninformed bullies.” Representative Westmoreland said they had “lost credibility with the people that were most supportive of them.” Senator Tom Coburn accused Heritage Action of “destroying the Republican Party.” Brian Walsh’s experience as the Heritage communications director accused the outfit of taking extreme stands to generate fundraising dollars. “In our great democracy, you affect public policy by offering a vision, influencing a majority of public opinion and winning elections, not by burning down the House, attacking your allies, and falling on your sword,” he wrote. None of this compares to the costs of spending nearly 20% of GDP and still not insuring everyone.

posted by: Politijoe | February 11, 2015  9:56pm

Politijoe

Art: lets be clear and honest. Obamacare was taken right out of the Republican playbook, same as Rommneycare-the individual mandate was in the Heritage platform. Regardless, the issue is cost. our current out-of-pocket, employer-based, for-profit healthcare system is convoluted and fragmented that costs more than any other nation in the world and provides fewer outcomes while still leaving millions of citizens uninsured. Please address those issues, absent the rhetoric about socialism, death panels and bankrupting America. Address the real issues and offer an alternative but spare us this sophomoric diatribe.

posted by: Politijoe | February 11, 2015  10:14pm

Politijoe

joemanc: you stated ” the health insurance premiums at my company rose 24% last year…the initial rise quote was 40% higher. I’ve been at my company 15 years and that is the biggest increase I have seen, including the years leading up to Obamacare. Now, I seem to remember that Obamacare was supposed to slow down the cost of healthcare increases, and not accelerate them.”......

Premiums have been increasing significantly for over a dozen years at an average rate of 8% annually without Obamacare. The ACA was designed to address the rising cost of our national healthcare costs (20% compared to GDP)  largely due to the profit motive and individuals who could not afford or were denied coverage. The ACA is intended and affects those without insurance or those with sub-standard (junk) policies. Otherwise it hasn’t effected the remaining 85% of Americans.

Private insurance premiums at your company rising 24% in one year is concerning and there is no indication it has anything to do with Obamacare and everything to do with our system of healthcare delivery.

As I suggested to Art, Look at the global comparative models, although he obviously chose not inform himself with the data you may gain a broader perspective regarding the fiscal soundness of healthcare reform.

posted by: SocialButterfly | February 12, 2015  12:06pm

@Politijoe:  And who do you think must pay for these federal loans to co-ops?  You apparently agree with the Obama Democratic doctrine of adding federal loans to our
bankruptcy-driven massive trillions of dollars of national deficit prosperity.

posted by: SocialButterfly | February 12, 2015  4:42pm

@Politijoe: When you praise ObamaCare you are not rooting for the Yankees or Red Sax to win the pennant.  According to the Weekly Standard ObamaCare train-wreck coverage provisions will cost the federal government $1.5 trillion dollars (Net). It’s too bad that you boast about the failing Obama economic policies that are leading us to fiscal bankruptcy as you as a good Democrat must support. Please try to support some federal fiscal maassive deficit prudence before it’s to late for all of us. We are realistically being spent to oblivion and you choose to close your eyes to it.

posted by: Politijoe | February 12, 2015  8:21pm

Politijoe

Socialbutterfly: why must everything in your perspective be veiled in the the “Democratic Doctrine” why cant this issue simply be based on the fiscal soundness of the argument?

You mentioned the costs of the exchanges as the central reason you oppose Obamacare. As I pointed out that these are essentially start-ups in a very entrenched, competitive and well financed industry. Therefore there is some context, justification and perspective with regards to the costs. You then cite that provisions will cost the federal government $1.5 trillion dollars. This of course is spread over many years. This costs includes Medicaid, the Children’s health insurance program, subsidies for exchanges and tax credits for small employers. However, the objective of the ACA is to reduce the federal deficits and the cost of healthcare which currently runs about 20% of GDP. Therefore, we would have to compare these projected costs with the current costs-which as I mentioned is 20% of GDP and determine if that difference begins to justify the costs of ensuring affordable access to millions of uninsured Americans.

This really shouldn’t become an issue based in ideology. but instead a very simple math problem. When you consider that perspective, and look at the global comparative healthcare models the answer becomes clear pretty quickly. Our current employer-based, out-of-pocket, for-profit healthcare system is not sustainable. it costs us more, delivers less and still doesn’t insure millions of Americans which creates extraordinary financial hardships on families, market disruptions, a morally inferior system and increased consumer costs to everyone else. therefore, aside from ideology, Im uncertain where the sticking point is.

posted by: art vandelay | February 13, 2015  10:35am

art vandelay

@PolitiJoe,
I’m just opposed to the federal government being involved in healthcare PERIOD!

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