In the seven years since Obamacare passed, congressional Republicans enthusiastically voted to repeal the program scores of times. Not tweak, kill. Of course they knew the attempts would die in the Senate or under President Obama’s veto pen. It was wonderful theater.
Now, they face the reality that they can actually repeal it, and they have a Republican president to sign off on it.
And they’re simply not up to the task. The American Health Care Act — or Ryancare or Trumpcare, if you wish — fiddles with some Obamacare taxes and fees and changes some Medicaid eligibility rules. But it keeps the heart and soul of the plan it would replace — an individual mandate to have health insurance. Instead of paying a fine to the government for not enrolling in a plan, though, miscreants who drop coverage then get it again would pay a hefty penalty to the insurance company.
The American Health Care Act, at its core, continues and reinforces the Obamacare premise that it is the federal government’s duty to see that as many Americans as possible have health insurance.
As slight as the act’s drift from Big Government is, it goes too far for some of the nation’s Republican governors, including Indiana’s Eric Holcomb. They object to the plan’s intended rollback of Medicaid expansion.
Obamacare’s most successful way to getting new health insurance enrollees was the provision that expanded Medicaid to include any adult living under 138 percent of the federal poverty level — an income of $27,821 for a family of three in 2016. It was up to states to decide whether to participate. States that expanded Medicaid under the new Obamacare requirements received federal funds to do so.
Indiana did so, creating its Healthy Indiana Plan 2.0, through which more than 400,000 poor people in the state have health insurance. The federal government picked up 90 percent of the tab for the estimated $18 billion cost from 2015 to 2021. Indiana Republicans want to continue to keep providing the benefit but want Washington to keep paying for it.
Remember that the next time they brag about how conservative they are. Remember it, too, the next time they complain about the big, bad federal government throwing nasty mandates at poor, defenseless state governments.