Affordable Healthcare and Obamacare

¶ … Republican stance on the Affordable Care Act has been decisively antagonistic and contrarian, and was machinated to address the main problem with the ACA, which is that it was authored by Obama. Likewise, Republican hostility toward the ACA represented the conservative platform's ignorance of the issues and the reasons underlying the ACA in the first place. The ACA was a step forward in creating a more progressive United States in which healthcare would be seen as a basic human right, and in fact did not go far enough in driving down healthcare costs. Instead of suggesting a new policy that would improve upon the ACA by restructuring the way insurance and privatized healthcare works, the Republicans introduced a bill that quickly died.

Specific problems the Republicans identified in the Affordable Care Act center on paranoia over federalism, what the Republicans call "federal entitlement," and the perceived pitfall of mandating that all Americans have health insurance (Goldstein, DeBonix & Snell, 2017). The most inflammatory language used to decry the ACA include Sean Spicer's comment, "Obamacare has proven to be a disaster with fewer options, inferior care, and skyrocketing costs that are crushing small business and families across America," (Fox & Walsh, 2017, p. 1). The Republicans decried the mandated insurance principle and that employers had to offer insurance to their employees. Similarly, ideology-driven religious conservatives decried the ability for women to have access to equitable care, and recognized that the Affordable Care Act might actually provide reproductive care for female clients. Republicans were also uncomfortable with providing help to disadvantaged clients, fearing a means-based subsidy program might be too compassionate (Goldstein, DeBonix & Snell, 2017). The Republicans also recognized that millions of people had accessed and used Obamacare subsidies, which made the ACA a success and thus a thorn in the side of the Republicans (Holan, 2017).

There are several fundamental provisions of the Republican proposal including eliminating the insurance requirement. The ACA would fine people for not having insurance and companies would also be fined, something that the Republican proposal suggested to replace with a different kind of penalty (Holan, 2017). In fact, a main feature of the Republican proposal was to release the mandate for health insurance, yet simultaneously place the onus on the individual with a 30% surcharge on any insurance client who has a lapse between payments (Fox & Walsh, 2017). Similarly, replacing the federal insurance subsidies that were the cornerstone of the ACA with a scheme involving tax credits plus grants to the states. How those healthcare financing mechanisms would improve the fiscal outcomes of the ACA was not clarified in the text of the Republican bill, which was named the American Health Care Act (Goldstein, DeBonis & Snell, 2017). Holan (2017) claims that the Republicans suggested an "advanceable tax credit," with different amounts based on income. However, the Republicans did not offer a solution for self-employed individuals or low income individuals, which the ACA had specifically addressed. Regarding pre-existing conditions, insurers would be allowed to charge more for new applicants (Holan, 2017). The Republican plan did include a provision for children to stay on a parent's plan until the age of 26 (Fox & Walsh, 2017). Therefore, there were several core provisions in the Republican proposal that mimicked Obamacare under the pretense of meaningful change.

The Republican proposal did not garner enough votes to pass in Congress for several reasons. First, the proposal was not grounded in evidence, fact, or financial wisdom. It was hastily crafted "without broader input," especially from the healthcare sector itself (Fox & Walsh, 2017). Even Conservatives opposed the American Health Care Act because they disagreed with the principle of refundable tax credits, saying they are "little more than a new entitlement program," (Fox & Walsh, 2017, p. 1). Essentially, the American Health Care Act, which would have retained the same acronym had it been adopted, was a weak copycat version of Obamacare. It had been dubbed "Obamacare Lite," (Goldstein, DeBonis & Snell, 2017). One of the most significant areas of concern for all who opposed the American Health Care Act was its restructuring of Medicare. Obamacare had improved Medicaid and Medicare and "Republicans from Medicaid-expansion states have said they would not support plans that could kick millions of people off the Medicaid rolls," (Fox & Walsh, 2017, p. 1). Similarly, taking away affordable healthcare from millions of Americans once they had already enjoyed it was a tough item to sell, even to fellow Republicans. Democrats universally opposed the Republican proposal, signaling the final death knoll.