Since the House of Representatives passed the American Health Care Act and its impact on New York has become more clear, the reaction has been angry towards the Republican Party which pushed it through. After several false starts with Paul Ryan repeatedly delaying a vote on Donald Trump’s signature proposal, the measure squeaked by on a 217 to 213 vote. A series of polls in early May found a paltry 31% approval rating for the plan to repeal and replace Obamacare, the Affordable Care Act, while nearly 50% of the country disapproved.
Why is Trumpcare so unpopular?
Since the Affordable Care Act became law, Congressional Republicans voted more than 50 times to repeal the ACA. At the time many pundits and reporters saw those votes as symbolic, rhetorical and lacking substance because the disgruntled disrupters knew that then-President Barack Obama would immediately veto the measure.
Now the dog has caught the car. Conservatives have seemingly spent the past 8 years complaining rather than formulating concrete plan for how to change the one-sixth of the economy that is the health care industry. Even in the passage of the bill, it seemed that it was more about the optics with a Rose Garden press conference and beer-filled celebration, despite the fact that the bill hasn’t even passed the Senate.
In between shaming the poor and revealing their ignorance around what exactly they voted for, the GOP’s principal talking point has been that the version of the bill that passed the House will be altered by the Senate and the ultimate law will be significantly different.
However, the some of the latest polling revealed that 55 percent of Americans support the Affordable Care Act and only 30 percent want it repealed. In the unlikely event that Congress decided to actually listen to the constituents they represent, the health care debate would not surround a replacement but amendments and alterations to the existing framework.
What does the AHCA mean for New York?
“Far from improving our health care, the Republican plan will strip millions of Americans of their coverage, raise costs for the sick, the elderly, and those with pre-existing conditions, and penalize progressive states that protect the rights of women,” New York State Governor Andrew Cuomo remarked on the legislation.
The version of AHCA that passed the House would have a huge impact for New York. Hundreds of thousands of New Yorkers would lose their healthcare coverage, it would cost the state billions and disrupt insurance markets in unforeseeable ways. More profoundly, Trumpcare would conflict with state laws that ban age rating insurance which prevents insurers for charging more to older people. In addition, New Yorkers would be ineligible for tax credits to make insurance more affordable because state regulations require insurance plans to cover abortion.
One of the most troublesome parts of the legislation for New Yorkers is an amendment proposed by John Faso and Chris Collins. The Collins-Faso Amendment threatens to blow a hole in New York State’s budget by shifting the bill for Medicaid programs from counties to state government (except for New York City, which would still be on the hook). That would leave a more than $2 billion budget gap for the state to fill.
How will New York respond?
The most likely sequence of events, proposed by Lieutenant Governor Kathy Hochul, would result in significant tax changes. Albany would divert a share of county’s sales tax revenues to pay for the new healthcare costs. Under one estimate, more than a quarter of the state counties would lose money.
“The Medicaid changes being proposed in Washington would cut taxes for wealthy special interests while devastating New York State’s finances and all but eliminating health care for the most vulnerable New Yorkers,” said Hochul.
Governor Cuomo estimates the phase-out would cost the state $4.6 billion over the next four years.
Will this lead to bigger changes?
In response to the upheaval from Washington, some New York activists are actually pushing a proposal to cut the state off from the national healthcare debate entirely. Instead, the Campaign for NY Health and other organizations are pushing a single-payer healthcare plan.
“New Yorkers are fighting to pass and implement a plan with huge public support—improved Medicare for All,” said Dr. Oliver Fein, chair of Physicians for a National Health Program NY Metro Chapter. “This plan will allow me to care for my patients without wasting hours on fighting insurance companies, and it will allow patients to have the peace of mind they will get the care they need without going bankrupt. The worse things get in D.C.—the more pressure there is on Albany to do the right thing.”
Assembly Health Committee Chair Richard Gottfried, the prime advocate of single-payer healthcare in the legislature, agreed that single-payer healthcare is picking up support: “every day the news from Washington makes the need for and support of the bill stronger.”
While the bill has picked up some support, including from Senate powerbroker Jeff Klein (the IDC leader from the Bronx), it’s still a longshot. However, as the Senate vote looms and Trumpcare’s impact on New York becomes more clear, expect greater support for a single-payer system and other efforts that respond to the American Healthcare Act.