Friday, 31 October 2014 19:52

How will Cassidy, Maness, Jindal and GOP repeal and replace Obamacare?

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 repealI will Repeal and Replace Obamacare?

“I will pull it out by its roots”

Both Republican candidates for the Louisiana US Senate seat, Congressman Dr. Bill Cassidy and Lt. Rob Maness (a Tea Party candidate), stated during the recent debates, on campaign stump speeches, commercials and just about every place they can find an audience, that they will repeal Obamacare and replace it with a new healthcare system.


They are not alone in making these campaign pledges.

Throw in Louisiana Governor Bobby Jindal, US Senator David Vitter, Congressman Steve Scalise and virtually any and every Republican in this country running for elective office this year or sometime in the near future.

Unfortunately, while they have various ideas and theories as to what they would replace Obamacare, none of them have ever told us how they would even get there.

Let me explain my concerns in a different way. 

You might want to go to Venus, but, how exactly would you get there.  Sure, they say, Venus is lovely this time of year.  But, do you have a map?  Who’s driving or flying?  What happens if you encounter bad weather?  Will you have enough to eat on the way and when you get there?

While the promises of Venus vacationing sounds heavenly, getting there might be awfully rocky or dangerous, if you’re even able to do it at all.

Which is my problem with all of these “repeal and replace” advocates’ campaign pledges and slogans.   They have no roadmap or itinerary.  If they do, ask them for the details.  I surely have not heard or seen any details that get us from A to B.

Obamacare was cobbled together in a totally emotional partisan political environment.   It needs plenty of work.  The product unveiled to date, at times, looks like swiss cheese, or worse,  New Orleans pot-holed streets.   But, making political “repeal and replace” promises with a straight face without a realistic way to do it makes for great political rhetoric, but defies credibility.

In short, you cannot repeal Obamacare without major disruptions to the healthcare, to the insurance industries and unfortunately, to millions of Americans.

Recently, I focused upon repealing Obamacare and the impact this action would have upon pre-existing conditions, impacting millions.

People with pre-existing cancer, diabetes and all types of ailments would no longer be able to get coverage for these conditions if they sought or were forced to obtain new insurance.   Actually, the insurance companies would likely argue that they are no longer obligated to pay for these conditions on the existing and in future policies.  Those who suffered a new condition during the Obamacare law and coverage period also would be at serious risk for coverage for those new conditions.

Once the law would be repealed, it would not just be those with pre-existing conditions who would be in jeopardy.

As a general rule, the insurance companies that now insure you just might not be obligated to continue that current insurance policy.  Currently, under Obamacare,  your condition is insured and other coverages for your conditions would be available.  If you like the coverage you currently have, there is absolutely no guarantee you can keep it, or anything even close under a repeal.  Nor are there any guarantees that you would be able to find affordable insurance or find insurance at all for any condition you might already have encountered or even suffer from in the future.

Annual and lifetime insurance caps could be a thing of the past if somehow lawmakers repealed the existing law.

There are other major uncertainties—and we all know that insurance companies  and major institutions greatly fear the unknown.

For example, if Obamacare were repealed, would those states that have accepted the Medicaid expansion, continue to rely upon those future funds?   Those state budgets would be out of whack since the states expected hundreds of millions and in some cases billions of dollars each year to pay for those people eligible for Medicaid.  What are those states to do?  What programs will they be forced to cut to balance their future budgets?

As Amit Roy, highly-respected heathcare expert, former advisor for Mitt Romney  recently  wrote in Forbes, “This issue of disruption to existing health insurance arrangements is the biggest policy issue with Republicans’ desire to “repeal and replace” Obamacare. Even if the Republican “replace” plan is better than Obamacare, getting from here to there without mass dislocation in the health insurance market is a non-trivial problem.”

The Affordable Care Act is far from a perfect healthcare law.   Like many major legislation instruments, especially one that encompasses one-sixth of our economy, it needs to be modified, fine-tuned and perhaps, parts of it removed.  This requires surgery and precision, not by bushwhacker or high-explosives causing chaos.

In cobbling the plan together, in acquiring supporting groups, the Democrats envisioned a new insurance-healthcare world that sounded viable on paper after decades of advocacy,   And, so it passed in a patch-work form.

Now, consumers have had a chance to understand the rules, the nuances, the benefits and the disadvantages.  It is now not simply theoretical, as before.   The exaggerated claims, either in favor of or against have been more rationally accepted or rejected. There have been delays and website crashes.   Millions also have insurance coverage when none were available or provides coverages that were previously denied.

As Roy pointed out, the vast majority of Americans don’t want repeal but want the system fixed.  In many circles, conventional wisdom appears to be that repealing Obamacare is too late and that politically, the votes aren’t there to defeat  Obama’s veto.

But those republicans who are campaigning or promising “repeal and replace” are doing no better than the Democrats did in passing the law, if not worse.

They are telling future voters they will remove the cancer.   Unfortunately, they are not providing us with any details as to how they will do it without damaging existing organs or worsening the patient’s condition.

Let me be clear.  As we are now days away from Election Day, I am not encouraging anyone to vote for any party.  Nor am I endorsing any candidate.   There are many issues other than Obamacare although I admit, some republicans are focused upon the healthcare law as if it were the main or only issue this election season.   But to the extent that your vote is due to campaign promises to repeal Obamacare, perhaps you might want to ask some hard questions.  Ask these politicians if they really have a plan to “get us to repeal”.  And, if so, what is it and how exactly would it work?

Otherwise, on this controversial issue, as time passes, my best belief is you will be utterly disappointed and might even feel betrayed by promises not likely or very harmful to keep.

Here are some questions I asked in my prior column regarding pre-existing conditions, which apply here:

My wife had cancer (diabetes, herniated disc, heart issues—fill in the blank) and since the new law went into effect, she now has received pre-existing conditions, will those benefits still exist the very day Obamacare is repealed?  If not, when would they start up again?  Will they? Don’t you know? 

Will the insurance coverage that was in effect before the ACA--that covered my family, automatically be in force, retroactively?  What if the insurance company says no?  What if I am no longer employed with the same company that insured me?  What if they want more money for premiums?  What if they are not willing to provide benefits for the medical conditions I now suffer from since Obamacare became law? 

Will I be able to keep my same doctor and my insurance policy if i want to do so? 

After all, Ted Cruz and others have assured me that repealing Obamacare will agenda item number one as soon as Congress convenes.  Are you promising the same now as you have done in the past?  Can you honestly say you have an answer right now to these very questions?  No?  Well, what about in January? 

What if all of those who now oppose Obamacare including many in the insurance industry, the medical community, the hospitals, the healthcare providers, the pharmaceutical companies, the lawmakers--and all involved-- do not come to an agreement when Congress votes on repeal, what happens to my family’s coverage?  What if they don’t agree by the end of the year? By the end of the decade?  Will I have insurance? 


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Stephen Sabludowsky | This email address is being protected from spambots. You need JavaScript enabled to view it.

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