by Brooke Winters
For the past seven years, Republicans have been pledging to repeal the Affordable Care Act, also known as Obamacare. With control of the House of Representatives, the Senate, and the Presidency, many expected Republicans to follow through on their long-held promise of repealing President Obama’s healthcare reform. The Republicans’ health care plan, known as the American Health Care Act, appeared to be progressing in the House until Speaker Paul Ryan pulled the legislation on Friday, March 24.
Going into the legislation process knowing there would be no Democratic support for the bill, Republicans needed a united front to pass the AHCA. The Republicans, however, are far from a unified party when it comes to healthcare. Members of the Freedom Caucus, an extremely conservative wing of the Republican Party, were adamantly opposed to the ‘replace’ aspect of repealing and replacing Obamacare. The Freedom Caucus holds about 30 seats in the House, so their opposition to Speaker Ryan’s bill indicated it would be dead on arrival if it came to a vote. President Trump met with members of the Freedom Caucus leading up to the potential vote in an effort to sway them. However, the concessions the president offered, which consisted of weakening the essential health benefits that insurance companies must offer, like maternity care and mental health services, did not go far enough to repeal Obamacare in their view.
In addition to opposition by the Freedom Caucus, some moderate Republicans also opposed the AHCA due to extensive cuts to Medicaid. Another factor that pushed moderate Republicans to oppose Speaker Ryan’s bill was the Congressional Budget Office’s report that estimated millions of people would lose their current health insurance. The threat of backlash in upcoming elections swayed Republicans like New Jersey’s own representatives, Leonard Lance (R) and Rodney Frelinghuysen (R), to speak out against the bill.
Along with a fractured Republican Party, another factor that led to the bill’s demise was how quickly it was being pushed through Congress.
On March 25, a day after Speaker Ryan pulled the Republican bill, President Trump tweeted, “ObamaCare will explode and we will all get together and piece together a great healthcare plan for THE PEOPLE. Do not worry!”
President Trump also tweeted about his frustration toward the Freedom Caucus, writing on March 27, “The Republican House Freedom Caucus was able to snatch defeat from the jaws of victory. After so many bad years they were ready for a win!”
Drewids weighed in on the recent turn of events in the House. Kevin Oates (‘20) said, “I’m glad they didn’t replace Obamacare because Obama worked hard to get it passed and the fact that the GOP were going to take away it was very bad. Also, although Obamacare isn’t perfect according to the GOP healthcare plan, many people would lose their health insurance which isn’t good either.”
Joe Bouffard (‘19) added, “Considering the fact that Republicans control both Congress and the Senate, I think it’s crazy that not only could they not repeal the program, they also do not fully support Trump as the Republican president of the USA.”
Drew University faculty also added their input. Assistant Professor Philip Mundo from the Political Science Department discussed the fractures in the Republican Party contributed to the bill’s downfall. He said, “Paul Ryan knew he had lost too many Republicans and knew the bill was going to fail. He decided to pull the bill to avoid a public call out on the vote. This was a very interesting turn of events that I think Trump did not expect.”
Professor Mundo also talked about the implications of Obamacare’s standing as a being a part of public’s conception of health insurance. He said, “The other part of it is once you give people something, it’s hard to take it away. People got the idea that health insurance would be available to everyone in some capacity. That’s a relatively new thing that had become part of the public expectation and has become institutionalized.” Professor Mundo went on to say that “Trump was making concessions to cut people out of health insurance which is not what at all what he said when he started this process, “and this bill would end up hurting the same demographics that voted for him.
Professor Jennifer Kohn from the Economics Department also discussed the recent turn of events. She said, “Anybody who claims that the answer to this problem is easy is kidding themselves. I don’t care if that’s Bernie Sanders with (universal healthcare) Medicare for all, or the Freedom Caucus with the free market. Health care is 20% of our GDP, so it’s too big and complicated of a market to affect costs with any single magic bullet policy.”
Kohn continued, “One of the things I often tell folks is when they make comparisons to smaller countries, you can’t compare us to Sweden or Canada. The only other countries you can compare us to are other land-mass countries, which are Russia, China, and India. Size, particularly distance to emergency medical centers, matters a lot in terms of both cost and outcomes.
Kohn also provided insight into healthcare in the United States outside the scope of New Jersey. She said, “People say that the Obamacare exchanges are in a death spiral, from the economics perspective this is true. There is a growing number of communities where there is only one health insurance provider because companies are leaving. We don’t see this type of flight of insurers in New Jersey, but in more rural areas it is a huge problem.” She shed light on the fact that the United States’ large number of rural areas impacts the cost of healthcare.
Kohn summed up the issue by saying, “Health care is just complicated. I cracked up when President Trump said that ‘nobody knew that health care could be so complicated,’ because we all knew this.”