Now is the Time for the Incoming Trump Administration to Re-read Moby Dick
Moby Dick was the mystical Great White Whale that Captain Ahab pursued to the ultimate destruction of his boat, himself and nearly all his crew. The Affordable Care Act has been the Republican Party’s Great White Whale for the past eight years, and now they are finally closing on their prey intent on its repeal and destruction.
There are now over 20 million Americans newly insured by the ACA with the numbers continuing to grow every day; California has been one of the leading states in enrolling its citizens. Many millions more have important protections due to the Affordable Care Act – ten covered benefits guaranteed to be issued and renewed with no exclusions due to pre-existing condition exclusions. People with cancer, pregnant women, people with diabetes, people with heart conditions, people with mental illnesses or genetic disabilities, car accident and crime victims receiving rehabilitative services, poor people, working people and rich people too, their families, friends and relatives, they are not going to look kindly on a new President and his empowered party that takes away their health benefits as their first act to make America Great Again. These are people who live in Ohio, West Virginia, Michigan, Kentucky, Pennsylvania, Arkansas, Iowa, Indiana – all states that have covered many, many of their own citizens due to the ACA (Affordable Care Act). President-elect Trump promised them better jobs, better pay, a revival of the coal and steel industries and American manufacturing; his Republican party is about to take away their health coverage in their first 100 days and then expect them to forget about it by the time of the next election.
Recent polling suggests that only about 1/4th of Americans want to repeal the ACA; the rest want to fix, improve and build upon it. Donald Trump squeaked to Electoral College victory with a distinct minority of the popular vote. It took 60 votes in the Senate to pass the ACA. The Republicans have only 52 seats in the Senate, and thus they do not have the votes for its repeal. Their intent is to use a 51 vote budget reconciliation resolution to gut the ACA – repeal all of its financing and repeal all the coverage expansions and premium assistance for low, moderate and middle income American citizens.
What the heck is that? Each year Congress must pass a budget. Budget reconciliation contains the instruction to the Congressional committees on the savings they need to make. For example trim a little bit from defense, a little bit from discretionary programs, a little bit from entitlement programs, like Social Security, spend a little bit more on tanks and airplanes. It has never been used to repeal duly enacted legislation before. Imagine that with 51 votes in the Senate, the slim majority could repeal the Medicare program’s taxes and benefits. This is the first time budget reconciliation has been used to gut and destroy an existing program for millions of Americans and a very dangerous precedent.
The President-elect has no agreed upon plan to replace the ACA; there are lots of ideas about how to improve the American health system for every American, but no model, no plan, no consensus not even among Republicans, no bill for Americans to review, consider, debate and consider. What can patients, doctors, hospitals, insurance brokers, nurses do? First demand “no repeal” under budget reconciliation, second ask the President-elect and his party to show their plan, put it up for debate and discussion, let’s see if its better than the ACA as the President-elect promised, let’s see how and if its financed, let’s see how many people will be covered and for what benefits. Or is this just a smoke and mirrors subterfuge whose prime purpose is to cut taxes for the wealthiest Americans while taking health benefits from the rest of us without giving the voters the time to weigh in through the political process and without giving their elected representatives the time needed to evaluate and meaningfully debate legislation impacting over 1/6th of the American economy?
Prepared by: Lucien Wulsin