We recently received this comment on Facebook: “You can repeal the whole thing in one bill. You already did in 2015 with Obama as president.”
It is a valid and frequent question these days, so let’s tackle it directly.
First, the American Health Care Act (AHCA) in fact does repeal all the components of Obamacare that the 2015 bill did: the taxes, the mandates, and the spending. This effectively guts the law. What is not repealed are some of the parts of Obamacare that have to do with regulations. Of course we’d love to include those parts, but those provisions are not allowed under the Senate rules we are using to avoid the filibuster. The same was true in the 2015 bill.
Bottom line, we are repealing just as much with President Trump as we passed with President Obama in office, but we’re also transitioning to a better, patient-centered system.
Indeed, were we to pass the old repeal bill and leave it at that, we would be giving up an opportunity to make good conservative reforms that can’t be filibustered by Senate Democrats.
So, passing the old repeal bill, or the ‘2015 bill’ as it’s sometimes known, means:
- No reforms to equalize the tax treatment of health care, leaving the deck stacked against people who don’t get insurance through work.
- No reforms to health savings accounts, leaving in place old limits on what you can contribute and how you can use those dollars.
- No reforms to repair state insurance markets, so that states can support high-risk pools, cut out-of-pocket costs, and improve access.
- No reforms that give states greater flexibility over Medicaid dollars so they can better serve people in need, meaning no major entitlement reform whatsoever.