Protections available to older, poorer and sicker Americans under the country’s existing healthcare system could be curtailed if a bill passed by the U.S. House of Representatives on Thursday is approved by the Senate. The Republicans who control the White House and both chambers of legislature celebrated the passage of the bill as they moved a step closer to dismantling the existing Affordable Care Act, or Obamacare, which was introduced by former President Barack Obama.
As the Republican leadership conceded more and more demands by extreme conservative lawmakers, the bill in its current version makes health insurance costlier for older and sicker people, while restricting the scope and reach of the state-run Medicaid programme for the poor. Those with pre-existing conditions will find it increasingly difficult to buy insurance.
Republicans have a 52-48 majority in the Senate, and several Senators have said they would not support the bill in its current form. The bill had a narrow victory in the House, 217-213, even as 20 moderate Republicans voted against it.
In Senate’s court
‘Repeal and replace Obamacare’ has been a slogan of the Republicans ever since its passage in 2010. President Donald Trump also campaigned on that promise, though he also promised a wider, cheaper and more effective health care system if he were elected.
The bill as passed by the House moves in the opposite direction, but Mr. Trump presented it differently. Flanked by Republican members of the House, the President said he was “confident” the Senate would also vote to repeal Obamacare.
“Yes, premiums will be coming down. Yes, deductibles will be coming down. But very importantly, it is a great plan and ultimately that’s what it’s all about,” Mr. Trump said. “This has brought the Republican Party together.” Mr. Trump has earlier been a supporter of a universal health care system modelled after Australia and Canada, but has never put out any detailed plans. As President, he has moved along with the Republican legislative leadership that is ideologically against subsidies.
If the new proposals become law, the younger and richer cohorts will gain as they would not be cross-subsidising others. The proposals could, however, exclude 24 million people from insurance coverage over the next decade, the Congressional Budget Office has estimated. Taxes on richer segments that supported part of the subsidies in Obamacare have been removed.
Sweeping changes
A bill that proposes such sweeping changes was passed without any hearing, and giving hardly any time for the lawmakers to study or discuss it. The bill has provoked widespread condemnation as hospital associations, consumers and insurers have said the new proposals would make health care less affordable.
“The bill that Republicans passed... really has nothing to do with health care. It would cut Medicaid by $840 billion, and substantially increase premiums on older Americans,” said Senator Bernie Sanders.
