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Repeal Obamacare and 25 Million People Lose Health Insurance. Period.

October 23, 2014

From the beginning, the magnitude of Republicans' lies about Obamacare has been directly proportional to their fears it would succeed. First it was "death panels," which Politifact cited as its 2009 Lie of the Year. In 2010, it was the Affordable Care Act's mythical "government takeover of health care," a fraud that earned the GOP Politifact's 2010 award. Now, Senate Minority Mitch McConnell (R-KY) and Ohio Governor John Kasich, abetted by Forbes' health care fabulist Avik Roy, are pretending that Obamacare can repealed "root and branch" without any of their constituents losing the coverage they obtained this year. And this new Republican hoax is the most cynical and cruel lie of all: if Obamacare is repealed, over half a million Ohioans, 520,000 Kentuckians and over 25 million people across America will lose their health insurance. As a result, thousands of them will needlessly die every year.

The deception behind the Republicans' Obamacare shell game is a simple. The nearly $1 trillion Affordable Care Act program contains several, interconnected components. To succeed in their con, the likes of Mitch McConnell and John Kasich need voters to not grasp that inescapable truth. So, Mitch McConnell says Kentucky's Kynect web site "can continue," even though it would have no policies to sell the customers who could no longer afford them after he repeals Obamacare "root and branch." As for Kasich, he pretends nothing will happen to 330,000 new Buckeye State Medicaid recipients whose coverage is completely funded by $2.5 billion from Uncle Sam over the next three years. As Politico recounted:

"From Day One, and up until today and into tomorrow, I do not support Obamacare," the Republican governor said on Monday evening. "I never have, and I believe it should be repealed."
Except for the Medicaid expansion part -- which wouldn't exist without the law. Kasich thinks there ought to be a way to save it.
"I have favored expanding Medicaid, but I don't really see expanding Medicaid as really connected to Obamacare," he said.

At $792 billion over the next decade, the expansion of the Medicaid insurance program to lower income people who earn up to 138 percent of the federal poverty level (FPL) is the ACA's largest outlay. Thanks to the Supreme Court, states can choose to reject the Medicaid expansion and with it funds from the federal government that cover all of its costs through 2017 and 90 percent thereafter.) But that's not all. For those who make too much to qualify for Medicaid, the ACA also provides subsidies to families earning up to 400 percent of the FPL when they purchase private insurance through the exchanges (regardless of whether their state's exchange is run by the federal government or not.) And on top of that, thanks to Obamacare parents can keep their children on their family insurance policies through age 26.
The positive impact of Obamacare on Americans' lives cannot be overstated. Gallup surveys have shown the uninsured rate plummeted from 18 percent to just over 13 percent nationwide. All told, Charles Gaba of the ACASignsups web site currently places the number of newly insured at between 24.0 and 28.7 million. As the Department of Health and Human Services (HHS) reported in September, 7.3 million people signed up and paid premiums for private insurance through the exchange marketplaces. Almost 80 percent of them received federal subsidies to make that purchase possible. Another 8 million, including 367,000 in Ohio and over 400,000 in Kentucky, gained insurance through the Obamacare's expansion of Medicaid and the State Children's Health Insurance Program (CHIP) accepted by their states. But the gains don't end there. As Gaba explains, 2.3 million Americans have been documented as having bought qualifying health plans (QHP's) off of the exchanges through brokers or directly from insurers. Another 5.7 million are also estimated to have done so. In addition, as many as 3.1 million "sub-26ers" ages 19 to 25 were added to their parents' policies.
Obamacare's indivisible benefits to Americans also extend to robust consumer protections repeal would wipe. Patients can no longer be denied coverage due to pre-existing conditions, or face annual or lifetime benefits caps. Women cannot be charged more for insurance than men. The notorious Medicare Part D prescription drug "donut hole" has been reduced, saving seniors over $11 billion so far. The insurance carriers must now spend at least 80 percent of their premium revenue on actual patient care. And insurers can no longer drop their policyholders when the get sick, a grotesque practice known as "rescission."
All of this is part and parcel of Obamacare, a.k.a. the Affordable Care Act. To claim otherwise when advocating its repeal is an affront to voters--and common decency. In the four-plus years since Mitch McConnell first declared the GOP's 2010 midterm campaign slogan "will be 'repeal and replace', 'repeal and replace,'" neither he nor his Republican Party have offered an Obamacare alternative to the American people. Instead, the Paul Ryan House GOP budget that McConnell and 95 percent of Congressional Republicans voted for four times repeals Obamacare, slashes Medicaid funding by 40 percent and hands over what little remains as block grants to the states. All of which is why John Kasich's simultaneous support for repealing Obamacare even while accepting the $850 million a year Medicaid expansion it made possible is so disgusting.

If Republicans take the Senate, Kasich said, "you better believe they're gonna repeal Obamacare and I agree with that." But, he added, "there's got to be an accommodation" for Medicaid expansion.

Lies like that may escape punishment at the polls in November, but not on Judgment Day. As Governor John Kasich once preached to Buckeye State Republicans on the need to accept Obamacare's extension of Medicaid coverage to over 300,000 of their state's residents:

"When you die and get to the meeting with St. Peter, he's probably not going to ask you much about what you did about keeping government small, but he's going to ask you what you did for the poor. You'd better have a good answer."



Jon Perr
Jon Perr is a technology marketing consultant and product strategist who writes about American politics and public policy.

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