By Scott Harris
Between the Lines, April 3, 2019
After congressional Republicans failed in their more than 70 attempts to repeal the Affordable Care Act, widely known as the ACA or Obamacare, President Trump has adopted a new strategy to end the now popular health insurance program. Trump directed the U.S. Justice Department on March 25 to file a legal brief supporting a lawsuit by conservative attorney generals, upheld by a lower federal court, that ruled the ACA was unconstitutional. If upheld by higher courts, ending the ACA would by some estimates eliminate 20 million Americans’ health care coverage. Dissolving the program would also dramatically reduce Medicaid coverage for millions more — and remove protections for some 50 percent of non-elderly Americans with pre-existing conditions.
Although Trump campaigned for president promising the country that he would replace Obamacare with something better, his administration put forward regulations that will increase premiums for sick Americans, allowed the sale of junk insurance plans that cover very little and permitted state Medicaid programs to require beneficiaries to work, which has led to thousands of low-income citizens to lose their coverage. When asked in recent days what will replace the ACA if he wins his court case, Trump said a replacement plan won’t be announced until after the 2020 election, and then, only if Republicans win.
Between The Lines’ Scott Harris spoke with Dr. Ed Weisbart, chairman of the Missouri chapter of Physicians for a National Health Program. Here, Dr. Weisbart assesses the damage that will be done to the nation’s healthcare system if the lawsuit ending Obamacare is upheld – and the most formidable obstacle preventing the establishment of a universal health care program in the U.S., such as Medicare for All.
DR. ED WEISBART: If we reverse the law, we’ll suddenly go back to these even worse insurance policies that have no limit … Today, they cannot restrict you by the dollar amount of your healthcare. They used to put million dollar limits on your care, which you could burn through in a few days in a week or two in a hospital. They used to not cover things if you were sick beforehand; they used to not sell you insurance. They used to drop you when you got sick. There’s a long list of things that the country as a whole has frankly started to take for granted now because they are improving. They are better than how things used to be and it’s hard to imagine losing them.
But that is indeed the current administration’s plan – it’s to take away healthcare from tens of millions of people and make it worse for many of the rest of us. So it’s a dreadful problem. We’ll see worsening of diseases and other things like that. So it’s a terrible strategy for them. On the other hand, they really have managed to put healthcare front and center in our debate again. So good for them, you know, renewed attention to this topic.
BETWEEN THE LINES: If upheld by the courts, as I understand it, dismantling Obamacare would not only throw the tens of millions of people off their ACA insurance plans, but would end Medicare expansion, would affect many millions more by repealing protections for people with pre-existing conditions – which pretty much affects almost everybody living here in America. And so we’re talking about tens of millions, over probably over 100 million people would be negatively affected by the repeal of Obamacare. Do I have that right?
DR. ED WEISBART: I think that’s exactly right. And even if you’re not in one of the groups that are directly affected, having an insurance mechanism for these new people means that hospitals don’t have to transfer the cost of that onto the insured, the otherwise insured. So it hasn’t done nearly enough to control the cost of insurance. But it has done quite a bit. And you’re right, we will see. I don’t know the exact numbers, but roughly 10 million people who are now covered by Medicaid, who wouldn’t be covered by Medicaid. And understand most of the people that would be losing this (Medicaid) are working people. They’re people who work at jobs that are paid minimum wage or barely above minimum wage. They do work that we all rely upon and it’s obscene that they would not be able to have any form of health care. But that’s what’s going to happen if they do reverse it.
BETWEEN THE LINES: What is your response to the idea that President Trump says that he can work with the Democratic, newly-controlled House of Representatives and the Senate to come up with a better plan than Obamacare?
DR. ED WEISBART: I would love that to happen. I have no evidence to base that hope on, but I would love that to happen. His party, has had, what – nine years now since the passage, no, 10 years since the passage of the Affordable Care Act to recommend a substitute for the Affordable Care Act. And the reason they can’t come up with a better substitute is because the ideas behind the Affordable Care Act originated in their party. They essentially wrote it a long time ago and it was their best idea that they could come up with and they don’t have anything else. They have not proposed anything else despite 10 years of talking about “Repeal and Replace.” So if Trump decided that he wanted to work with the Democratic party to move forward on a better solution, I know exactly what that solution should be. It would be improved Medicare for All. I have no confidence that he would go down that road. But you know the scenario you’re painting of what if Trump wanted to work with us, bring it on. I’d be delighted.
BETWEEN THE LINES: Dr. Weisbart, one last question. We only have about a minute or two left. What do you feel the biggest obstacle is in the United States to establishing a single-payer Medicare for All type system?
DR. ED WEISBART: Our democracy is on the ropes. We have once again, allowed largely monied interests to corrupt the way our campaign finance system works. And so our legislators are having to compete for the best campaign finance sources they can get and they follow the money and do what the big monied interests say. We have been through this before. Teddy Roosevelt dealt with it. Every 20 to 40 years, our country goes through having to rescue democracy and we are down to the ropes again with this. But the good news is, healthcare is such an important issue to everyone that I believe people understanding how important health care is, how at risk their health care is, and how linked that risk is to democracy’s survival, I think we can use health care to galvanize the rebirth of our democracy in a good way.
Dr. Ed Weisbart is chair of the Missouri chapter of Physicians for a National Health Program.