Congress is in recess, and members are back in their home districts. This means House Republicans - especially the tea party caucus - will say some of the craziest things about politics. The most recent “crazy things conservatives say about health care” reveals just how much Republicans are willing to risk on killing health care reform, and how badly they want to take away the health benefits Americans are already enjoying - and stop future benefits before they start.
One of the most jaw-dropping statements of the August recess thus far comes from Florida. Rep. Ted Yoho (R. Fla) recently told a crowd that the Obamacare tax on tanning beds is a “racist tax” on white Americans. At the same event, Yoho agreed to cosponsor a birther bill being floated by Texas Rep. Steve Stockman.
That’s nothing. Last week, Republican congressional candidate Bill O’Brien told a group of New Hampshire supporters that the Affordable Care Act was “as destructive as slavery.”
It’s easy to laugh a Republicans like Yoho and O’Brien, but it’s dangerous to forget how close their outrageousness is to becoming the mainstream in the GOP, where health care reform is concerned. Sen. Ted Cruz (R. Tex.) is among the most high profile tea party Republicans willing to shut down the government unless health care reform is “defunded.” It’s not likely to work. Conservatives want to “defund” the Affordable Care Act by voting against any continuing resolutions to keep the government running that included funding for health care reform. But the legislation contains more mandatory than discretionary funding.
But conservatives like Cruz couldn’t care less if their tactic for “defunding” health care reform makes sense. They care about what it will accomplish if it succeeds. Republicans in Congress want to take away from Americans the benefits that the Affordable Care Act is currently providing, and will provide in the near future, because they know that its success will mean even more support for reform.
A number of benefits from the Affordable Care Act have already taken effect.
- Insurance companies may no longer use simple mistakes and typos to deny cancel coverage if a person become ill.
- Insurance companies can no longer deny coverage to children with pre-existing conditions -- from asthma to allergies to old injuries -- with the exception of “grandfathered” plans in the individual market.
- Young adults may stay on the their parents insurance up to age 26.
- Insurance companies may no longer limit the amount of coverage available to those who face expensive medical conditions. This will help Americans who develop chronic illnesses.
- Many plans, with the exception of those “grandfathered” plans in the individual market, must phase out annual limits over the next three years.
- Insurance companies must pay for preventative care, such as mammograms and immunizations.
- Insurance companies must improve the appeals process for insurance claims, giving Americans a better process to received benefits they have paid for, but that insurance companies have denied.
- Insurance companies must let Americans choose any available participating physician as their primary care doctor, and any available participating pediatrician as their children's doctor.
- Insurance companies must provide more direct access to OB-GYN care, instead of requiring women to have referrals from a primary care physician.
- Senior caught in the Medicare “Donut Hole” -- where “Part D” beneficiaries pay all of their own prescription costs -- will receive a one-time rebate check from Medicare this year.
Health care reform will continue to benefit Americans and expand coverage in the next several years.
- Tax credits will help small businesses cover employees.
- Medicare will provide 10% bonus payments to primary care physicians and surgeons.
- Medicare will cover the full costs of annual wellness visits and personalized prevention plan services.
- A Medicaid program will allow states to offer home and community-based care for disabled Americans who would otherwise receive institutional care.
In the the near future, Americans will benefit even further from health care reform.
- As of 2014, health insurance companies will no longer be able to deny coverage to people with pre-existing conditions.
- In 2014, state health insurance exchanges will open for small businesses and individuals.
- Individuals with income up to 133% of the poverty level will qualify for Medicaid coverage.
- For people with incomes up to 400% of the poverty level, health care tax credits will become available to help them purchase coverage on the exchange.
- By 2019, health care reform will extend coverage to 32 million Americans who would not otherwise be insured.
Yet, the work of health care reform is only beginning. It must be defended against obstruction and attack, in order for Americans to experience all of its benefits. Like other programs that the overwhelming majority of Americans support -- such as Social Security -- the support for health care reform will continue to grow as more Americans feel its positive impact in their lives:
The next benefit of health care reform to be implemented is probably the biggest. Americans can now visit healthcare.gov and open up personal accounts in the Health Insurance Marketplace, a set of government-regulated and standardized health care plans administered by the states, formerly known as health care exchanges. The Marketplace provides a way for Americans to shop for and compare affordable health care plans, and will be geared towards people who don’t have health insurance through their employers, and who will likely be eligible for tax credits to help them afford premiums.
The Health Care Marketplace will start open enrollment on October 1st, and all exchanges must be fully certified and operational by January 1, 2014 under the Affordable Care Act. The Obama administration aims to sign up 7 million people next years. That’s 7 million more people who will have access to health coverage they didn’t have before, if Republicans fail to block the implementation of health care reform. That’s not only spells a victory for President Obama, but would deal a severe blow to conservative ideology, because successful health care reform would prove conservative critics wrong.
That’s why conservatives have gone to war over the exchanges. Senate Republicans bullied the National Football League and other sports associations out of talking with HHS secretary Kathleen Sebelius about ways to inform their fans about health exchanges. Meanwhile, conservative groups have launched campaigns against the idea of health insurance itself, urging Americans to refuse to purchase health insurance until the law is repealed.
Not all Republicans are buying it. Republican governors like Wisconsin’s Scott Walker are urging congressional Republicans not to shut down the government over health care reform. Paul Ryan thinks the idea of a government shutdowns is “swinging for the fences.” Tom Coburn doesn’t think its achievable. Karl Rove calls it a “political loser.”
Walker, Ryan, Coburn, and Rove are all right. (And as a progressive, that’s hard for me to say.) It’s more likely that health care reform will boost Democrats in 2014 and beyond, because if its biggest successes will happen on a personal level, millions of times over, when Americans have health insurance where they had none before, and access to health care that they didn’t have before.
Meanwhile, Republicans will still have not offered an alternative. Conservatives can’t offer an alternative that’s in keeping with an ideology that conservative economist Tyler Cohen encapsulated when stated the defining principle of conservative health care “reform”:
A rejection of health care egalitarianism, namely a recognition that the wealthy will purchase more and better health care than the poor. Trying to equalize health care consumption hurts the poor, since most feasible policies to do this take away cash from the poor, either directly or through the operation of tax incidence. We need to accept the principle that sometimes poor people will die just because they are poor. Some of you don't like the sound of that, but we already let the wealthy enjoy all sorts of other goods -- most importantly status -- which lengthen their lives and which the poor enjoy to a much lesser degree. We shouldn't screw up our health care institutions by being determined to fight inegalitarian principles for one very select set of factors which determine health care outcomes.
“We need to accept the principle that sometimes poor people will die just because they are poor.” That’s the very state of affairs health care reform is in the process of repairing. That’s what conservatives want to return to by stopping the implementation of health care reform, and taking its benefits away from Americans. This is who they are.