the Voice of
The Communist League of Revolutionary Workers–Internationalist
“The emancipation of the working class will only be achieved by the working class itself.”
— Karl Marx
Feb 20, 2017
The Trump administration and the Republicans in Congress are signaling their intention to attack health care.
Of course, the Republicans have long said they wanted to “repeal and replace” the Affordable Care Act, what they call “Obamacare.” Trump indicated the same intention on the campaign trail, and since taking office.
But they’re running into a problem—people with coverage don’t want to be left without health care! In a recent poll, only 8 percent of Michiganders wanted to repeal the ACA without any replacement. The majority wanted to replace it with something better.
But the Republicans’ plan seems to be to GUT the ACA, not “repeal and replace.” They’re proposing to remove the parts that actually give coverage to low income people, while keeping or shoring up the parts that benefit the insurance industry.
The proposals so far are for changes that can be passed without repealing the ACA itself. Things like: getting rid of federal funding for the Medicaid expansion. This expansion accounts for 60 percent of the people receiving health care under the ACA—12 million of the 20 million people formerly not covered.
For those covered through the ACA Marketplaces, the proposals virtually guarantee that people will eventually drop or lose their coverage, even if their plans still exist. The Republicans propose getting rid of the subsidy for low-income people buying coverage, and replacing it with a tax credit that varies by age. Younger people would receive less of a credit, and older people would receive more—a millionaire would receive the same credit as a poor person.
One proposal is to remove the individual mandate. This sounds nice—it allows the Republicans to say they are for greater choice. Instead, they propose to allow companies to charge much more to people if their coverage lapses at any time. They say that this will encourage people to buy and keep coverage even without the individual mandate—but more likely, it will discourage people from buying coverage that they cannot afford, even when they are sick and desperately need it.
They also say they will keep some kind of “mandatory” coverage for preexisting conditions. BUT they are working on proposals that will allow insurance companies to form “high risk pools” to charge much more to people with those preexisting conditions.
Another proposal concerns the so-called “Cadillac tax” on health coverage through employers. The proposal is to actually lower the threshold for the triggering of the tax on employers, so a much higher percentage of health care plans will be taxed. Employers threaten to gut their employees’ coverage so as not to be taxed. And this proposal includes almost everyone today who has medical care through their employer. Pretty soon, ANY employer-provided coverage will be considered “Cadillac” coverage!
Whatever the Republicans eventually do, it can ONLY mean that coverage for working class and poor people will get worse.
In fact, though, the whole thing is a massive diversion. Republicans have made “Obamacare” the issue, blaming it for the problems people have with coverage and cost. No—the health care system itself is the problem! A health care system built on profit ensures that nothing gets done unless someone is making profit somewhere—and if profit isn’t made, it doesn’t get done. Those who can pay privately can get the best care in the world, while everyone else gets bad care at huge expense—or no care at all. The ACA didn’t change this fundamental fact about the U. S. health care system. It just gave more people access to this broken system, while making sure that insurance companies got paid—and adding to its convoluted confusion.
Republicans talk about getting rid of the ACA. Democrats tell us that the only thing to do is to protect it and keep it where it is. We need to see the reality: both options are not good. The population is being subjected to increasing attacks. Even if your health care is not under attack right now, it will be. An attack on any part of the working class spreads to all parts of the working class eventually.
There is a much better option. We all need, and we ALL deserve, decent medical care—for ALL. At a price our wages can afford!
They want to repeal and replace Obamacare? Replace it with THAT. That is something worth fighting for.