Democrats look for opportunity in healthcare

One week ago Republican Senator John McCain stood on the floor of the U.S. Senate floor and with a thumbs-down gesture and a firm and loud “no,” killed the last Republican attempt to repeal the Affordable Care Act.

The possible end of Republicans’ “Obamacare” repeals now opens a bipartisan window for some healthcare reforms according to congressional Democrats.

“I am of the view that we just closed the door on these repeal and ravage campaigns,” said Rep. Jamie Raskin (D-8).

For seven years, repeal of Obamacare — President Barack Obama’s crowning legislative achievement — was the main promise that Republicans gave to voters as they swept into office and took control of the House of Representatives in 2010 and the Senate in 2014. With insurances pulling out of the healthcare exchange, where people can sign up for the ACA and if qualified can get publically subsided insurance, President Donald J. Trump made repeal of Obamacare and its replacement as a top campaign promise and early priority in his administration.

“ObamaCare is torturing the American People. The Democrats have fooled the people long enough. Repeal or Repeal & Replace! I have pen in hand,” Trump tweeted on July 25.

Since the beginning of the new Congress in January, Republicans have failed to unify under a single plan to repeal the Affordable Care Act. While House Republicans passed a repeal bill in May, Senate Republicans failed to even  get 50 votes on a number of bills, including “repeal and replace,” a repeal-only bill and the so-called “skinny repeal,” which would have taken out the individual mandate requirement, one of the ACA’s main funding sources.

Some Democrats now feel that the Republicans failed attempts to repeal Obamacare can open a bipartisan window for healthcare reforms.

“I think there are a whole bunch that would do it,” Raskin said of House Republicans who may work with Democrats on healthcare. “I’m not sure if I want to call them out right now.”

While bipartisan cooperation may be a rare thing in Washington now, it is not unheard of. In January the Senate voted down a bill that would allow imported prescription drugs from Canada, and while the bill was defeated it was not done so on party lines as conservative senators Ted Cruz (R-Texas) and Mike Lee (R-Utah), voted with progressive senators Chris Van Hollen (D-Md.), Ben Cardin (D-Md.) and Bernie Sanders (I-Vt.) in support of the bill.

Van Hollen, unlike his fellow Maryland Democrat Raskin, is not as convinced that repeal of the ACA is dead.

“We need to remain vigilant to make sure they don’t bring it back from the dead,” Van Hollen said of Republicans’ plan to repeal Obamacare.

Republican Gov. Larry Hogan joined nine other governors in signing a letter asking for a bipartisan solution rather than the straight repeal or “skinny repeal” options the Senate was considering.

While the ACA has dropped the uninsured rate in Maryland by one-third – according to a 2017 state study – it has been manly due to the ACA’s expansion of Medicaid, a federal insurance program for poor and disabled people. According to the state, fewer people than expected have signed up for the state healthcare exchanges and only two insurers – Kaiser Permanente and CareFirst BlueCross BlueShield – offer plans.

Maryland is part of a national trend where insurers are pulling out of the ACA exchanges, leaving only one insurer left in some jurisdictions. After the Senate Republicans’ last attempt to repeal Obamacare failed, Trump said the federal government should not try to save the ACA.

“We’ll let Obamacare fail,” Trump said.

Democrats said they are worried that Trump could sabotage the ACA by not paying necessary subsidies to insurance companies still in the healthcare exchanges. With premiums rising and insurers pulling out of the exchanges, the Democrats as an opposition party are now split on determining the long term solution for healthcare.

While during the Obama administration most Democrats opposed European-style single payer healthcare, or publicly-funded national health insurance, support for it is now growing among Democrats. Senate Minority Leader Chuck Schumer said on ABC News that Medicare for all – or a single payer system – is now “on the table.”

Although Van Hollen and Raskin both support Medicare for all, they don’t necessarily support it in the short term.

“I’m not sure we're going to get everyone ready for a mammoth fight for single payer in 2018,” Raskin said.

Van Hollen, who said he supports a Medicare-for-all insurance option within the ACA exchanges, said he think the Democrats are steadily moving toward a single payer option.

“I'm for heading in the direction of single payer but I think it's going to need to be more than one step,” Van Hollen said.



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