Some of the things you’re hearing now sound a bit different than what you’ve heard for the past eight years.
On how long the bill is in Congress
Then: The ACA was “written in the dark of night and rushed through Congress.” – House Ways and Means Chair Kevin Brady (R-TX)
Democrats started holding hearings on healthcare in 2008, before Obama was even elected President. The first draft of the ACA was introduced in the house in July 2009. Town hall meetings were held all summer and fall, and the public had access to full language throughout the process. The bill spent hundreds of hours being debated in committees. Both the House and Senate held full hearings on it. It was signed by the President on March 23, 2010, after nine months in Congress and nearly two years of input and debate.
Now: “We want to move our Obamacare legislation by the end of the first quarter.” – House Speaker Paul Ryan (R-WI)
The AHCA passed out of its first committee – Ways and Means – only four days after its language became public to both citizens and other members of Congress, and only 2 days after the bill was introduced in the House. The GOP wants this bill to pass through the House before the end of the month and through Congress before the Easter recess on April 10. If this before-Easter deadline is met, it will mean the AHCA was in Congress for less than six weeks.
On the Congressional Budget Office
Then: “We cannot afford to guess when it comes to health care. This is not some think-tank experiment; these are people’s lives, people’s jobs we are talking about … his committee has no business marking up a bill of which CBO cannot tell us its cost or impacts.” – House Ways and Means Republican Ranking Member Dave Camp (R-MI)
When the ACA was introduced in the House, it was with CBO estimates instead of full scores. These scores measure the impact of the bill across a variety of factors, including the budget, to measure cost v. benefit. Republicans were up in arms about having estimates instead of scores. Thankfully, they didn’t have to wait long – CBO scores were available just three days after the bill was introduced.
Now: “If you’re looking at the CBO for accuracy, you’re looking in the wrong place.” – Sean Spicer, White House Press Secretary. “The CBO is consistently inconsistent.” – Senator Tim Scott (R-SC)
Unlike in 2009, not even preliminary estimates have been introduced from the CBO, and no Republicans seem that upset by it. In fact, they have begun actively trashing the CBO. This is probably because CBO scores aren’t going to reflect well on the AHCA: Brookings, a highly regarded, independent think tank, analyzed the bill against other past healthcare estimates and found that at least 15 million people will lose coverage in the next ten years.
On the individual mandate
Then: “Congress has never crossed the line between regulating what people choose to do and ordering them to do it. The difference between regulating and requiring is liberty.” – Senator Orrin Hatch (R-UT)
This is one of the pieces of the ACA that Republicans hate the most. Man oh MAN do they HATE it. They spent years talking about freedoms and rights and loss of liberty. You can read more on the individual mandate here, but all it does is require people to buy health insurance – the same way they’re required to buy car insurance. It’s very important way to keeping the insurance system solvent and successful.
Now: In the AHCA, instead of people without insurance paying the government a penalty, they have to pay insurance companies a penalty. A major difference in this penalty-payment system, however, is that the ACA requires you to pay a penalty when you do not have insurance – this encourages everyone to get insurance in order to stop paying the penalty. Under the AHCA, however, you pay a penalty to get back into the market in the form of a year-long 30% surcharge. This actively discourages those whose insurance has lapsed to get covered again, and means the only people who are willing to pay that high cost are those who are really sick – and when insurance companies are covering really sick people without healthy ones paying into the pool, it’s bad for everyone.
Then: “I’m not going to cut Medicare or Medicaid.” – Donald Trump (This case is a bit different, because Republicans always hated Medicaid expansion and are now halting it, just like they said they would)
Now: Although Donald Trump promised poor white voters he’d protect their Medicaid, he supports the AHCA and its gutting of the program (#shocking). Since passage of the ACA, more than 11 million people in 31 states have been able to attain health insurance through the expansion of Medicaid availability (a collab between the federal gov’t and states to provide healthcare access to low-income people). The AHCA decreases the amount of federal money available to states (so they can’t cover as many people) and freezes Medicaid expansion (so even a family of 4 with a household income of just $32,000 isn’t eligible). These changes to Medicaid mean, quite literally, that people will die.