The Obamacare Follies
Speaker of the House Paul Ryan (R-WI) has taken to saying that the Affordable Care Act (ACA) is in a “death spiral”. This is demonstrably untrue. The so-called “death spiral” has a very specific meaning. It’s what happens when health insurance premiums rise so much that young and healthy enrollees drop coverage in large numbers. But as of December 24 about 11.5 million individuals had signed up for an ACA plan, a slight increase over the same period last year. And if enrollment is not declining, by definition the market can not be in a “death spiral”. So why is Ryan saying this? Because it’s all part of his plan. First, you keep repeating that Obamacare is in a death spiral, even though it’s not true. Then he and his Republican cronies institute what they call “Repeal and Delay”, which means they pass a bill that repeals the ACA, but that doesn’t go into effect until January of 2019 (conveniently after the 2018 midterm elections). But insurance companies, due to the nature of their business, plan for the long-term. So when they learn that the ACA will expire at the end of 2018, they will immediately scale back their participation in the country’s insurance exchanges (set up under the ACA), which very well could ignite a real death spiral. This would happen before the repeal became technically effective, allowing Ryan to say “See, I told you that Obamacare was in a death spiral and therefore had to be repealed”. The ACA will then be replaced with nothing, because the idea of helping anyone other than the rich and powerful is anathema to Ryan and his fellow Ayn Rand acolytes.
Ryan may have felt confident that his scheme would succeed, especially since he and his fellow GOPers hold the presidency and both houses of Congress, but now it looks like there may be a few roadblocks along the way, courtesy of Ryan’s own party. On January 17 Senator Susan Collins (R-ME) took to the Senate floor to say “We must fix Obamacare and provide reforms at nearly the same time that we repeal the law”. Say what? Is Senator Collins even dimly aware that this makes no sense? Why bother to fix and reform a law that you’re just going to repeal? It’s like painting a house that’s scheduled for demolition. I guess the GOP has railed so bitterly against the law for so long that now they feel for political reasons that they have to repeal it, even if the last of the Republican moderates like Collins know it would be a horrible mistake to do so. So at least one GOP senator is putting the brakes on Ryan’s plan, whether out of principle (nah, can’t be that), or because she knows throwing millions of people off their health insurance won’t play too well back home (that’s more like it).
And then there’s the Great Trumpkin himself, who says whatever he thinks serves him best at any particular time, with no regard whatsoever to pesky things like facts, and to whom consistency is a truly foreign concept. Trump has been saying things like the ACA will be replaced “almost immediately” and that “everybody will have insurance; everybody will have coverage”. Of course, he has no plan for this; he just said it because, well why not, it sounds good, right? But of course it gives Ryan agita because the Speaker has no intention of ever coming up with a replacement for the ACA, no less coming up with anything any time soon. So Ryan’s ingenious/devious/inhumane plan to kill the ACA, replace it with nothing, and blame Democrats for the resulting fallout just may fall victim to a few elements from his own party, to whit: 1) a few “moderates” (boy, there’s a low bar for that term in today’s GOP) like Collins who are fearful of how it all might play out politically, and 2) a president from his own party who will say anything at any time, has no problem contradicting himself with every other word, and who hasn’t bothered to read Ryan’s game plan. If it weren’t for the fact that the stakes are so high, what with people’s lives being at stake and all, this might actually be funny.