Under GOP health plan, Americans pay more but get less

The poll-tested message lipstick trotted out by Republicans won’t make the GOP healthcare pig any prettier to American families. The grassroots uproar around the country against Republican plans is because people look beyond the spin to the details of whether their families will be able to afford healthcare or not.

President Trump and Republicans in Congress have a basic problem they are desperately trying to message around. They have campaigned against President Obama’s high premiums and deductibles, but every one of their health proposals would raise the amount most people pay for health coverage and increase reliance on high-deductible plans.

Since the election, they have sought to reassure Americans they would not lose their health coverage. Trump even promised to cover everyone! But their plans would take healthcare away from millions of people.

In his address to Congress, Trump fell back on the bedrock of conservative rhetoric, railing against “government-approved healthcare.” But what Americans fear a lot more than government is insurance company-run healthcare. Their everyday experience with insurance corporations consists of getting claims denied and making them jump through hoops to see a doctor.

They see insurers hiking premiums and deductibles. And they fear that Republicans will go back to the days when insurance companies could deny them coverage or raise their premiums because of a preexisting condition.

{mosads}Unable to reassure people that insurance companies will not be able to deny coverage to people with preexisting conditions, Trump could only say that “Americans with preexisting conditions [will] have access to coverage.” Does he and the GOP really think people won’t catch the difference? Not when their family’s health security depends on it. And not when that access — in the new GOP bill — comes with a 30 percent surcharge if, for any reason (like they lost a job), they could not afford coverage for 63 days.

They also won’t like it when they learn that their “access” will be through high-risk pools, which Trump never mentioned by name. GOP pollsters have obviously told Republicans that’s a scary term: Why would anyone want to be in a high-risk pool?

Which is why, in the GOP bill, they are part of a “patient and state stability fund.” But what defenders of the Affordable Care Act (ACA) will make clear is that the GOP will push people with preexisting condition into those high-risk pools, where the only plans offered come with sky-high premiums and high deductibles.

For people healthy enough for insurers to be willing to cover, Trump and the Republicans are offering “tax credits and expanded health savings accounts.” Yes, tax credits are popular, but people can do math. The ACA tax credits are much bigger for most people than the skimpy credits certain to be offered in a Republican plan. Which is why millions of Americans will no longer be able to afford health coverage, with older people and those with moderate incomes getting the biggest cuts.

Health savings accounts were named to be popular. But they assume that people have money to save for health coverage — at a time when most Americans live paycheck to paycheck. They do that math every week.

Trump reinforced the GOP anti-government message when he said that people should choose “the plan they want, not the plan forced on them by the government.” Instead, Trump and the GOP want to go back to health plans forced upon families by insurance corporations. Insurers will offer the most profitable products: high-deductible plans, which limit their exposure to actually paying for the healthcare people need.

American families hate these plans.

Trump argues for giving governors “the resources and flexibility they need with Medicaid to make sure no one is left out.” But the GOP’s plan for capping Medicaid will slash state funding for it, only giving states the flexibility to decide which of the 74 million seniors, people with disabilities, children (33 million) and adults to leave out.

What Republicans are now learning is that when it comes to healthcare, the solution is the problem. It was easy to demonize ObamaCare and blame it for every problem in the healthcare system. But once you have the responsibility of solving those problems, people take a hard look at what those changes will mean for their lives.

And if you believe, as Trump asserted, that “a truly competitive national marketplace that will bring cost way down and provide far better care,” it turns out your task is impossible.

The GOP and Trump can spin until they turn blue, but the bottom line is what they are selling Americans is “pay more, get less and put the health insurance corporations back in charge.”

No one wants to buy that.

Richard Kirsch is the director of Our Story: The Hub for American Narratives and the author of “Fighting for Our Health: The Epic Battle to Make Health Care a Right in the United States.” Follow him on Twitter @_RichardKirsch.

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