Trump Voters Now Have Second Thoughts on Repealing Obamacare

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The Kaiser Family Foundation has issued the results of a new poll concerning repeal of Obamacare. Anyone with a pulse knows that repeal has been made a rallying cry for Republicans in Congress, in fact their centerpiece in the ideological attack on the Obama administration. But it appears that Republican ideology has gotten out ahead of the desires of voters, who are not as much interested in ideology as they are in understandable, affordable and stable healthcare.

When asked about a series of health care priorities for President-elect Trump and the next Congress to act on, repealing the ACA falls behind other health care priorities. Two-thirds of the public (67 percent) say lowering the amount individuals pay for health care should be a “top priority” for President-elect Trump and the next Congress. This is followed by six in ten (61 percent) who say lowering the cost of prescription drugs should be a “top priority,” and nearly half (45 percent) who say dealing with the prescription pain killer addiction epidemic should be a “top priority.”

When given two competing approaches to the future of health care, six in ten Americans (62 percent) prefer “guaranteeing a certain level of health coverage and financial help for seniors and lower-income Americans, even if it means more federal health spending and a larger role for the federal government” while about one-third (31 percent) prefer “limiting federal health spending, decreasing the federal government’s role, and giving state governments and individuals more control over health insurance, even if this means some seniors and lower-income Americans would get less financial help than they do today.” This level of support  for federal healthcare spending is the stake in the heart of the conservative ideological vampire.

Overall, 49 percent of the public think the next Congress should vote to repeal the law and 47 percent say they should not vote to repeal it. But of those who want to see Congress vote to repeal the law, a larger share say they want lawmakers to wait to vote on repeal until the details of a replacement plan have been announced (28 percent) than say Congress should vote to repeal the law immediately and work out the details of a replacement plan later (20 percent).

In its reporting on the KFF poll, the Washington Post pointed out that the same repeal question has been asked 16 times in the last two years and the most recent poll results show the lowest support for immediate repeal without a replacement — a drop of 6% since October. The biggest part of this drop is among Republicans whose support for immediate repeal without replacement has dropped 17%.

In 2016 Rep. Alex Mooney, the Panhandle’s Congressional representative, voted to repeal Obamacare through budget reconciliation. That is once again the method favored by Congressional Republicans. Attention Rep. Mooney! Only 20% of all respondents in the KFF poll want you to repeal Obamacare without a replacement. Here’s hoping you can think for yourself.

Sen. Joe Manchin can spot a bad deal for West Virginia when he sees one. Manchin told reporters on January 4, 2017 that he would not vote to repeal the ACA without a replacement on the table. Manchin’s office said that if the law is repealed, 172,000 West Virginians would lose health insurance coverage and the state would lose $840 million in federal funds to provide health care for low-income families.

“Most of the people [in West Virginia] that have benefited from this one way or another voted for Trump,” Manchin said. “They don’t know what they have or how they got it. I will tell you this: You repeal it and take it away, they will know who took it away.”

Progressives may be conflicted. Sen. Charles Schumer urges Democrats not help the Republicans in Congress come up with a prompt replacement if they vote to repeal immediately through budget reconciliation. His view is let the Republicans suffer the wrath of the voters for creating the unnecessary healthcare disaster that Sen. Manchin predicts. That is certainly attractive in a partisan way, but it seems like more one-upmanship and political posturing. The real suffering from this approach will be by the people who are back to having no healthcare.

Del. Michael Folk: No Friend of Education

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Del. Michael Folk (R – Berkeley, 63) professes to be interested in promoting quality education in West Virginia, but he has an odd way of showing it. In February 2016, Del. Folk was the lead sponsor of two bills that would have abolished key components of the education system in West Virginia. One of these, HB 4611, would have abolished the West Virginia Council for Community and Technical College Education.

HB 4611 would not have abolished the colleges themselves, but instead would have transferred to each of them the power and duties of the Council. Perhaps Del. Folk believed that this would eliminate an unnecessary level of bureaucracy and cost. But that appears to be incorrect.

The non-partisan fiscal notes attached to the Bill state the problem with this potential legislation:

The enactment of this legislation would have a substantial negative financial impact on the State, institutions and students served by public higher education. The Council is a critical and necessary partner in [sic] with the West Virginia Department of Commerce and others in the process to support existing businesses and attract businesses such as Proctor and Gamble and Macy’s to West Virginia. Corporations will not locate to the State without significant workforce investment commitments from a State agency that serves as the coordinating entity for Community and Technical Colleges. This coordination cannot occur at the local level.

There would be other financial consequences as well. The Council receives federal and state grants of over $2.8 million that would not be received directly by institutions. The Council also provides facilities management services to each college. The fiscal notes estimate that if each college were forced to hire its own director of facilities management the net additional cost would be $1,134,000.

Inadequate education is holding back our economy. In 2015, the West Virginia Center on Budget & Policy published its eighth annual report on the state’s economy. The report focused on West Virginia’s labor force participation rate (LFPR), the lowest in the nation — where it has ranked since 1976. Using a regression analysis, the Center isolated several factors that are drivers of the low rate. One of the most important was inadequate education.

West Virginia’s educational attainment rate is also one of the lowest in the nation. Only 21% of the state’s prime working-age population (25-54) has a four-year college degree, compared to the national average of 31%. In this same age category, 42% have only a high school education, the highest rate in the country. But when the LFPR statistics are parsed, it is clear how critical education is. Those West Virginians with a college degree have a higher LFPR than the national average, ranking the state 14th highest.

More working West Virginians mean a more prosperous economy, more secure and stable families, and much more. A more educated West Virginia means more of our fellow citizens will be working. Against this backdrop, Del. Folk’s attempt to abolish the West Virginia Council for Community and Technical College Education was reckless and irresponsible. Let’s hope he does not repeat the attempt during the new legislative session.

Repeal of Obamacare: A Disaster for West Virginia

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In January 2016, Congress passed a budget reconciliation bill repealing much of the Affordable Care Act by simply removing the funding for it. President Obama vetoed the bill. Now congressional Republicans threaten to do the same in the upcoming new session.

Most likely, Congress will not have a replacement for the ACA ready to go for quite some time. Republican leaders propose to make some provisions of the repeal effective immediately and defer the effectiveness of other provisions until a replacement bill can be passed.

A repeal through a reconciliation bill can only affect those provisions that have an impact on the federal budget. Among those is the expansion of Medicaid adopted by 31 states, including West Virginia. A recent study by the Urban Institute details the disastrous effects on the nation’s healthcare system of a repeal by reconciliation, even if the effectiveness of major parts of the repeal is delayed two years.

The bottom line is that repeal by reconciliation will hit states like West Virginia the hardest because these states would lose the most federal funding. Even if the elimination of funding for Medicaid expansion were to be delayed until 2019, the number of uninsured in West Virginia would rise from 88,000 now to 272,000 in 2019 – an increase of 208%.

Who will become uninsured? The Urban Institute study predicts that nationwide 82% of the newly uninsured would be members of working families and 56% would be non-Hispanic whites. A majority of the newly uninsured – 53% –would have earnings between 100% and 400% of the federal poverty level. Another 25% would be people with incomes below the poverty level.

One effect of the loss of health insurance is that people who need to see a doctor simply won’t. These people are at risk that their health status and earning capability will decline. And uninsured health emergencies are often the cause of a breakdown in family financial stability. Others will get emergency treatment at hospitals and clinics, but will have no insurance to pay for it. This is called uncompensated care.

How does uncompensated care get paid for? The people receiving care may pay out of their pockets. More likely, state and local governments or the hospitals and clinics themselves could be forced to absorb the cost. On December 6, 2016, the two main hospital trade groups sent a letter to President-elect Trump and congressional leaders stating that repealing Obamacare could cost hospitals $165 billion by the middle of the next decade and trigger “an unprecedented public health crisis.”

A recent  op-ed piece in the Charleston Gazette by Renate Pore, Chairwoman of the West Virginia Medicaid Coalition, said correctly that “[h]undreds of thousands of lives — pregnant women, children, working parents, seniors, people in nursing homes and who need long-term care – every family in West Virginia has a real stake in this debate.”

West Virginia voted for President-elect Trump, and our congressional representation is heavily Republican. Now is the time for them to help West Virginia avoid the financial disaster that would occur through a repeal of Obamacare that does not simultaneously replace it with acceptable policies and federal spending to insure the poor and middle class.