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“NO” on American Health Care Act (H.R. 1628)
Heritage Action for America ^ | March 23, 2017

Posted on 03/24/2017 12:03:20 PM PDT by NobleFree

At some point, the House is expected to vote on the American Health Care Act (H.R. 1628), which would partially repeal and replace various components of Obamacare. The proposed legislation repeals a number of Obamacare provisions and contains several notable policy reforms, but the most important part of the AHCA is what it fails to include: a repeal of the regulatory architecture of Obamacare that is responsible for the rising cost of health care.

Title I of the Patient Protection and Affordable Care Act (i.e., Obamacare) lays out a number of health insurance mandates and regulations that make up the regulatory architecture of Obamacare including guaranteed issue, community rating, essential health benefits, and actuarial value, among others. While the AHCA does repeal actuarial value and partially addresses community rating by moving the age rating ratio that Obamacare imposes from 3:1 to 5:1, the bill falls far short of comprehensively addressing the overall regulatory framework of Obamacare.

Obamacare’s creators designed this regulatory framework with the intent to take control of private health insurance plans and convert them into a highly regulated, quasi-public utility. As one of the law’s supporters explained back in 2010, Obamacare’s design “transforms health insurance into a public accommodation,” and turns private health insurance into “a regulated industry … that, in its restructured form, will therefore take on certain characteristics of a public utility.” It strains credibility to characterize this bill as repealing Obamacare when the mechanisms for the federal government’s takeover of health care remain firmly in place.   

Taken together, these mandates and regulations restrict consumer choice and drive up the cost of health care premiums by a national average of 44.5 to 68 percent.  As Heritage Foundation Senior Policy Analyst in Simulations Drew Gonshorowski writes:

“Overall, accounting for gender, age, and the relative proportions of all those groups, Americans are paying 44.5-68 percent more in premiums owing just to Title I regulations. That number is even higher when factoring all the other adverse effects of Obamacare. Obamacare’s Title I regulations bid up the price of premiums drastically for many Americans. While the current House bill begins to repeal Obamacare, it does not go far enough, as many of the most damaging regulations are left in place. Alleviating this pain should be strongly considered at every step of the process.”

The AHCA would also subsidize that regulatory framework through new refundable tax credits aimed to help individuals buy their own health care plans – plans that will remain highly regulated and overly expensive. There has already been political pressure to increase those credits, and that pressure will increase so long as premiums remain high.

As Heritage Foundation Senior Research Fellow in Health Policy Studies Edmund F. Haislmaier describes:

“The key problem with the draft House health care bill is that it fails to correct the features of Obamacare that drove up health insurance costs. Instead, it mainly tweaks Obamacare’s financing and subsidy structure. Basically, the bill focuses on protecting those who gained subsidized coverage through the law’s exchange subsidies and Medicaid expansion, while failing to correct Obamacare’s misguided insurance regulations that drove up premiums for Americans buying coverage without government subsidies.”

Yuval Levin, editor of National Affairs, explains that the AHCA is “fundamentally different” from previous Republican health care proposals, including the bill introduced by now-Secretary Tom Price, “because it functions within the core insurance rules established by Obamacare, which means it can’t really achieve most of the key aims of the conservative reforms it is modeled on.”

Lawmakers cannot preserve Obamacare’s regulatory structure and claim to have repealed the law. Without including the repeal of these regulations in the AHCA, congressional Republicans will have failed to keep their seven-year old promise to fully repeal Obamacare and health insurance costs will likely continue to increase leading up to the 2018 elections.

House Republican Leadership claims the AHCA is only phase one of a three-part plan to repeal and replace Obamacare. In phase two, Human Health and Services (HHS) Secretary Tom Price will take action to address the Obamacare insurance mandates and regulations. In phase three, Republicans will pass any additional reforms they failed to achieve in phase one and two. Unfortunately it isn’t that simple. All executive action in phase two is limited, temporary, and will likely face serious legal challenges. All legislative action in phase three will require 60 votes in the Senate, including eight Democrat votes, a nearly insurmountable obstacle for Republicans to overcome.

Thankfully, Republicans in Congress have the legislative tool necessary – budget reconciliation – to fully repeal Obamacare’s regulations and avoid the political and policy complications contained within phase two and three. Some Republicans have argued Congress cannot repeal Obamacare’s insurance mandates and regulations contained in Title I through budget reconciliation because it does not have a clear budgetary impact. This is somewhat surprising considering the AHCA includes some regulatory changes while leaving others out. Regardless, this argument ignores the reality that Obamacare’s regulatory architecture imposes significant costs on taxpayers and is inseparable from the rest of the law. A January 2017 Congressional Budget Office (CBO) report left little doubt that Obamacare’s regulatory regime has budget implications.

As one former Senate staffer wrote:

“To argue that their budgetary impact is merely incidental to the rest of the law is absurd on its face. Even the Obama administration made this very argument before the Supreme Court in King v. Burwell, arguing forcefully that the regulations are inseparable from the rest of the law. Predicated on that alone, Congress has a case that full repeal through budget reconciliation is viable.”

The Wall Street Journal editorial board describes the two managers’ amendments released  Monday night as “mostly modest,” which is true because they do nothing to repeal the regulatory architecture of Obamacare.     

Republicans promised to fully repeal Obamacare, campaigned on full repeal since 2010, and voted more than 60 times to repeal parts or all of the disastrous health care law. The American people rewarded Republicans for their promise to repeal Obamacare by giving them a united government for the first time in more than a decade. An unwillingness to pursue repeal of Obamacare’s Title I insurance regulations through reconciliation based on a narrow interpretation of budget rules is not acceptable.

Unless repeal of Obamacare’s regulatory regime is included in the AHCA, the bill deserves to be defeated because it would leave the architecture of Obamacare in place and ensure health insurance premiums remain far too high.

Then-Representative Mike Pence’s description of his 2003 vote against the Bush-era prescription drug program resonates still today: “House conservatives faced a difficult choice: oppose the president we love, or support the expansion of the big government we hate.” Voting against a leadership-crafted bill was “not a sign of disloyalty, but of true loyalty to principle,” Pence explained at the time. That same principle remains true today.

Heritage Action opposes H.R. 1628 and will include it as a key vote on our legislative scorecard.        


TOPICS: Government; News/Current Events
KEYWORDS: 115th; ahca; obamacare; rinocare; ryancare
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1 posted on 03/24/2017 12:03:20 PM PDT by NobleFree
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To: NobleFree

When the vote fails today or is pulled before a vote, Ryan should resign.


2 posted on 03/24/2017 12:05:03 PM PDT by Reno89519 (Drain the Swamp is not party specific. Lyn' Ted is still a liar, Good riddance to him.)
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To: NobleFree

Obamacare it seems is a better option


3 posted on 03/24/2017 12:05:11 PM PDT by Sybeck1
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To: NobleFree
If they can't pass this, just let Obamacare implode.

The Dems created it.

4 posted on 03/24/2017 12:06:40 PM PDT by mountn man (The Pleasure You Get From Life, Is Equal To The Attitude You Put Into It)
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To: NobleFree

Republicans promised to fully repeal Obamacare, campaigned on full repeal since 2010, and voted more than 60 times to repeal parts or all of the disastrous health care law. The American people rewarded Republicans for their promise to repeal Obamacare by giving them a united government for the first time in more than a decade. An unwillingness to pursue repeal of Obamacare’s Title I insurance regulations through reconciliation based on a narrow interpretation of budget rules is not acceptable.
*****************************************************

FULL REPEAL AND REPLACE******NOTHING MORE, NOTHING LESS!!!


5 posted on 03/24/2017 12:07:05 PM PDT by HarleyLady27 ('THE FORCE AWAKENS!!!' Trump/Pence: MAKE AMERICA GREAT AGAIN!!!)
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To: HarleyLady27; Jane Long; BlackFemaleArmyCaptain; Black Agnes; djstex; RoosterRedux; DoughtyOne; ...

PING...


6 posted on 03/24/2017 12:08:22 PM PDT by HarleyLady27 ('THE FORCE AWAKENS!!!' Trump/Pence: MAKE AMERICA GREAT AGAIN!!!)
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To: NobleFree

REPEAL ONLY!


7 posted on 03/24/2017 12:10:54 PM PDT by New Jersey Realist (The only thing necessary for the triumph of evil is for good men to do nothing. Edmund Burke)
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To: NobleFree

GOPe > Ryan > pals:

Here’s what we’ll do. We remove these five paragraphs from Obamacare, and insert these four paragraphs.

We’ll call it the repeal of Obamacare and nobody but nobody will figure it out.

There! All better...

Well guess what! Everyone but everyone figured it out.

Repeal the damn legislation.

If you need this translated into another language Ryan, just let us know.

And BTW: Tell the GOPe to get stuffed!


8 posted on 03/24/2017 12:11:48 PM PDT by DoughtyOne (NeverTrump, a movement that was revealed to be a movement. Thank heaven we flushed!)
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To: HarleyLady27

Thanks!


9 posted on 03/24/2017 12:13:23 PM PDT by Jane Long (Praise God, from whom ALL blessings flow.)
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To: NobleFree

Now let start dreaming about Single payer and don’t forget to send thanks to Freedom Circus.


10 posted on 03/24/2017 12:13:42 PM PDT by jennychase
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To: Sybeck1
Obamacare it seems is a better option

Cutting the taxes while leaving the expenses and the regulations quite arguably makes it worse.

(Why aren't the Pubs at least voting first on full repeal, win or lose, before serving up this dubious 'compromise'?)

11 posted on 03/24/2017 12:14:03 PM PDT by NobleFree ("law is often but the tyrant's will, and always so when it violates the right of an individual")
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To: NobleFree

market has reversed right now...and gold is up.

If vote is no I think market may tank temp. and gold up temp.


12 posted on 03/24/2017 12:14:36 PM PDT by RummyChick
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To: jennychase

Trump has spent several political capital on this loss. Taxes and trade have to be in doubt after this


13 posted on 03/24/2017 12:17:06 PM PDT by Sybeck1
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To: DoughtyOne
Holdover RINOs 1628
14 posted on 03/24/2017 12:17:22 PM PDT by DoughtyOne (NeverTrump, a movement that was revealed to be a movement. Thank heaven we flushed!)
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To: mountn man

Absolutely correct!


15 posted on 03/24/2017 12:17:23 PM PDT by oldsicilian
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To: jennychase
Now let start dreaming about Single payer

AHCA is the "no payer" option: Cutting the taxes while leaving the expenses and the regulations. Think that'll end any better than Obamacare Classic?

16 posted on 03/24/2017 12:17:25 PM PDT by NobleFree ("law is often but the tyrant's will, and always so when it violates the right of an individual")
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To: NobleFree
Those conservatives thinking that the best option now is to leave Obamacare in place and “let it collapse” are going to be in for a very bad shock. If the party does not repeal Obamacare fully, whatever remains, be it full Obamacare or Obamacare lite, automatically becomes “Republicancare” tomorrow because Republicans are in charge of the federal government, and just like Social Security and Medicare, anything bad that happens to it will be blamed on Republicans, not democrats, not Obama. In a couple years when the exchanges start collapsing (and they will), the democrats will scream that the Trump administration is “sabotaging” the law, then the media calls will start demanding Republicans pass the legislation with more taxes and a trillion dollar infusion to make Obamacare whole or be blamed for those X million people losing their healthcare. So either way party will get the blame...
17 posted on 03/24/2017 12:17:30 PM PDT by apillar
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To: NobleFree

Disagree with you - we must pass this bill. There a FEW things I would change but it is a good bill for starters.

Support the President, support the American people, pass the bill - three phases will work.

Pass the bill - did you hear that Walter Jones!!


18 posted on 03/24/2017 12:17:37 PM PDT by elpadre (AfganistaMr Obama said the goal was to "disrupt, dismantle and defeat al-hereQaeda" and its allies.)
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To: jennychase

Freedom caucus just burned the next eight years for themselves. Freedom caucus likes the swamp.


19 posted on 03/24/2017 12:17:42 PM PDT by longtermmemmory (VOTE! http://www.senate.gov and http://www.house.gov)
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To: NobleFree

Disagree with you - we must pass this bill. There a FEW things I would change but it is a good bill for starters.

Support the President, support the American people, pass the bill - three phases will work.

Pass the bill - did you hear that Walter Jones!!


20 posted on 03/24/2017 12:17:43 PM PDT by elpadre (AfganistaMr Obama said the goal was to "disrupt, dismantle and defeat al-hereQaeda" and its allies.)
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