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June 21, 2018

10/10/2017 7:27:00 AM
'Zombie Trump-care'

To the Editor:

The current iteration of the AHCA bill (aka zombie Trump-care), introduced last week by Sens. Lindsey Graham, Bill Cassidy, Dean Heller, and our own Ron Johnson (R-Wisconsin) was endorsed by this paper in an "Our View" editorial, although with a caveat, saying "the bill isn't perfect." Right, it is an abomination.

Obamacare was presented to the House of Representatives in July of 2009 and after months of revisions, amendments, and debates was signed into law on March 23, 2010. The GOP zombie bill had a gestation period of two weeks with no committee scrutiny, no public hearings and no senate debate, except that if it comes up for a vote a 90 second comment period will be allowed. If Obamacare took almost 10 months to become law and was imperfect, how could any reasonable person expect that this 2-week zombie bill would be better. No, as put forth, the zombie bill would dramatically worsen the nation's health care system and restrict the delivery of patient care for millions of Americans. The GOP promotes the claim that they are stuck with a "binary choice"- a 100 percent guarantee that Obamacare remains in place or just pass a bill, any bill, no matter what, just to say they repealed Obamacare.

They don't care what is in the zombie bill or what consequences it has for the American people. This paper boasted that 15 governors endorsed it, but failed to say that a bipartisan group of 12 governors opposed the attempt to repeal and replace Obamacare in a letter to Senate leaders. This paper failed to mention that everyone of the 50 state Medicaid directors came out against this bill. Nor did this paper mention that every health care organization, medical professional associations, health insurers and affiliated groups concerned with accessible and affordable health care oppose this legislation.

The bill would repeal the penalties for large employers that fail to offer affordable insurance to workers. It would do away with subsidies and end Medicaid expansion funding. It would eliminate the Obamacare subsidies that lower premiums, as well as, deductibles and co-pays in 2020. It would get rid of federal funding for Medicaid expansion. Thirty-five states are expected to lose Medicaid funding by 2026 or specifically, under the new block grants $107 billion less than what the federal government would have spent over the period 2020-2026 for ACA coverage according to an analysis by the Kaiser Family Foundation. The bill would also let states weaken regulations or waive several key Obamacare protections for those with pre-existing conditions. While it would still require insurers to provide coverage to everyone, states could allow carriers to charge enrollees more based on their medical history. Health insurance companies still wouldn't be able to deny coverage based on pre-existing conditions, but states can dispense with the provision that caps what they can charge. Will people with asthma, diabetes, allergies, cancer, etc. and even those diagnosed with autism spectrum disorder or Alzheimer's be treated as having a pre-existing condition as was the case in many states before Obamacare? I guess if you are rich enough it doesn't matter. Other mandated coverage under Obamacare, such as maternity care, mental health services and hospitalization can be waived. Senator Johnson said in an interview "this bill provides protection against high premiums and or dropped coverage." But, when pressed as to where this protection was spelled out in the bill and how it would be enforced he demurred. He indicated the protection was implied because states would not jeopardize guarantees of accessibility or affordability because the voters would hold them to account. So we are left with just a promise and have to trust that a state would the right thing and not allow premium gouging or disallow coverage. Riiight!

As a slap in the face and to show what they think of their constituents, Ron Johnson and his three AHCA (aka zombie Trump-care) bill cosponsors, are proposing to exempt themselves from their own efforts to gut pre-existing conditions protections. They want to allow states to waive protections that require plans to offer essential benefits - except if those plans happen to belong to members of Congress and their staffs.

Sen. John McCain in a statement said why he could not vote for this bill: "I cannot in good conscience vote for the Graham-Cassidy proposal. I believe we could do better working together, Republicans and Democrats, and have not yet really tried. Nor could I support it without knowing how much it will cost, how it will (affect) insurance premiums, and how many people will be helped or hurt by it. Without a full CBO score, which won't be available by the end of the month, we won't have reliable answers to any of those questions."

The GOP promotes the claim that they are stuck with a "binary choice"- Obamacare remains in place or just pass any kind of bill just to say they repealed Obamacare. I too believe both parties could do better working together, Republicans and Democrats, and have not yet really tried. How about doing your job and quit posturing.

John Kocovsky


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