GOP Needs to Speak Out on Obamacare Now

Kurt Hahn
Kurt Hahn was a delegate to the 2012 Tampa Bay GOP Convention. He is currently the part time Interim Executive Director of the Northern California Healthcare Authority.

The Affordable Care Act, known broadly as Obamacare, may be the law of the land however that does not mean those who sought it’s repeal should be silent and acquiescent.

Many now believe Obamacare will fail because of cost and public dissatisfaction, which could be true. Costs far in excess of expectations may occur because of greatly expanded coverage of mental health treatments described in recent regulations as well as some medicaid patients previously treated at clinics going to conventional providers. Another yet unknown cost factor involves the potential shift of up to half of those previously covered by employer funded plans who may now seek coverage thru subsidized Exchange offered plans.

Public dissatisfaction is most likely to occur most among Medicare enrollees who see higher premiums as a result of reduced financial support of Medicare Advantage Plans as well as broadened Mental Health coverage. Additional dissatisfaction will come shifting to virtually all remaining eligible to Medicaid with it’s delayed access to providers, and most significantly provisions in the Affordable Care Act that will force regular Medicare Enrollees into Accountable Care Organizations much like abusive HMO’s of the past, which will restrict access to specialists, especially those at University Teaching Hospitals involved in Trials and others outside the ACO  to save money.

Additional efforts are likely to extend more and more healthcare coverage to undocumented residents of our nation as part of futre Immigration Reform measures.

Once costs are out of control and public dissatisfaction is on the rise one can see a quick and fast move by Congressional  liberals and the Obama Administration to substitute a Federal Single Payer Plans or shift everyone over to Medicare without new legislation.

What then and now should Republicans be advocating and pushing politically? Well if you don’t want a Socialistic Single Payer Plan, one certainly needs to get involved.

Certainly Republican Governors who chose not to establish ACA Exchanges and leave that task to Health and Human Services should be supported and encouraged.

Republicans in Congress in the meantime may continue to seek repeal or total de-funding, however such effort will only be symbolic because absent the President’s signature neither can be approved.

Targeted defunding of very unpopular sections or failure to fund narrow sections initially not funded might offer some promise if initially put forth by a Democrat and attached to an important piece of legislation that the President would not want to veto.

Secondly those Governors who wish to exercise their right as sustained by the Supreme Court to to not participate in the Medicaid expansion should be supported in most cases because their State may not be able to sustain down the road State matching requirements. Some State’s currently serving all or most of the population may find it financially desirable to accept increased Federal funding even with increased downstream matching and should not be criticized for doing what makes sense for their state.

Republicans should encourage employers to keep employer funded  plans that can be catered to employer needs rather than paying the fines and shifting their employees to Exchange offered plans.

Most significantly Republicans in the Senate and House need to seek bipartisan support to correct the many things needed in Obamacare. The Mental Health coverage reflected in recent regulations goes much farther than the authors may have originally contemplated and needs to be changed. Forcing Medicare enrollees who believed with AARP that they should be able to go to any Doctor or Hospital accepting Medicare and self refer to specialists into Accountable Care Organizations that takes away that right should be changed. While some abuse occurred under Medicare Advantage Plans those who did a good job like Kaiser Permanantee should not be penalized.

BiPartisan agreements should be sought for limits on compensatory damages under Medical Malpractice Insurance. Multi State Plans should be encouraged well beyond those contemplated under Obamacare to broaden competition.

Smokers who were told by AARP and others they could keep their existing coverage who now face a 50% premium surcharge should be told that such discrimination violates every promise inherent in Medicare and will be reversed.This could be a precedent for other methods of discrimination such as those who are overweight or those who don’t exercise.

Other constructive changes to the Affordable Care Act  such as elimination of the remaining donut hole might very well be achieved thru use of savings generated from elimination of regulations permitting Prescription Drug Advertising should be sought, as well as an entire list of good ideas put forth by members of the House GOP Doctors Caucus, the Berkeley Form and MIT’s Reform Study.

Those of us who opposed Obamacare now need to get out in front on this issue especially among senior voters many of whom stayed home in 2012 because they believed Ryan Voucher Care was bad as Obamacare. We must have viable alternates or the public will not accept our ideas over a single payer plan.

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