The Moral Travesty of Trumpcare

By Robert Reich

Shame on every one of the 217 Republicans who voted to repeal the Affordable Care Act on Thursday, and substitute basically nothing.

Trumpcare isn’t a replacement of the Affordable Care Act. It’s a transfer from the sick and poor to the rich and healthy.

The losers are up to 24 million Americans who under the Affordable Care Act get subsidies to afford health insurance coverage, including millions of people with pre-existing conditions and poor people who had access to Medicaid who may not be able to afford insurance in the future.

The winners are wealthy Americans who will now get a tax cut because they won’t have to pay to fund the Affordable Care Act, and healthy people who won’t have to buy health insurance to subsidize the sick.

House Republicans say they have protected people with pre-existing health problems. Baloney. Sick people could be charged premiums so high as to make insurance unaffordable. Trumpcare would even let states waive the Obamacare ban on charging higher premiums for women who have been raped – which actually occurred before the Affordable Care Act.

America has the only healthcare system in the world designed to avoid sick people. Private for-profit health insurers do whatever they can to insure groups of healthy people, because that’s where the profits are. They also make every effort to avoid sick people, because that’s where the costs are.

The Affordable Care Act puts healthy and sick people into the same insurance pool. But under the Republican bill that passed the House, healthy people will no longer be subsidizing sick people.  Healthy people will be in their own insurance pool. Sick people will be grouped with other sick people in their own high-risk pool – which will result in such high premiums, co-payments, and deductibles that many if not most won’t be able to afford.

Republicans say their bill creates a pool of money that will pay insurance companies to cover the higher costs of insuring sick people. Wrong. Insurers will take the money and still charge sick people much higher premiums. Or avoid sick people altogether.

The only better alternative to the Affordable Care Act is a single-payer system, such as Medicare for all, which would put all Americans into the same giant insurance pool. Not only would this be fairer, but it would also be far more efficient, because money wouldn’t be spent marketing and advertising to attract healthy people and avoid sick people.

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