- Laurie Garrett: The life expectancy of Americans is lower than those living in some third-world countries
- The GOP health care bill would have decreased it even more by cutting funding to life-saving preventative care, she writes
Laurie Garrett is a senior fellow for global health at the Council on Foreign Relations and a Pulitzer Prize-winning writer. The opinions expressed in this commentary are hers.
(CNN)As House Speaker Paul Ryan pulled the Republican health care bill from voting, I could almost hear the giant sigh of relief from Atlanta and across the nation's health care establishment.
- Americans didn't want the ACA repealed until Congress created a replacement for Obamacare.
- Replacing the ACA is much harder than repealing it. As President Trump put it on February 27, "Nobody knew that healthcare could be so complicated. I have to tell you, it's an unbelievably complex subject."
- As debate unfolded over ACA replacement millions of Americans learned, apparently for the first time, that "Obamacare" and the "Affordable Care Act" are the same thing. In early February, a survey found that 35% of Americans were unaware that the federal health insurance system that many of them were relying upon was "Obamacare," and as realization sank in, opposition to changing or repealing the ACA swelled. By mid-March nearly 60% of Americans opposed changing or repealing the ACA, and members of Congress were hearing complaints from constituents all over the country about AHCA provisions that would decrease or eliminate many types of coverage, and increase costs to most individuals.
- The AHCA's reliance on individual tax credits to offset elimination of direct subsidies for health care never won favor with most voters, as only the wealthiest Americans would garner sufficient tax deductions to cover their health costs.
- The GOP leadership touted the AHCA as "health freedom," liberating average Americans from the chains of federal mandates and control. But they would accomplish the liberation by passing funds to the states in the form of Medicaid block grants, which each state would use as it deemed fit. Republican governors howled in protest, realizing this "freedom" simply shifted the burden of health regulation and most costs from Washington to the cash-strapped states.
- It is impossible to separate the "healthy" from the "sickly" and affordably place them in different insurance pools. Obamacare could only satisfy the insurance industry's financing needs if it mandated pooled enrollment of both healthy young adults, people suffering from chronic diseases, and the sicker older adults.