Key provisions of Obamacare prevail

It is fact that the Republican Tax Cuts and Jobs Act repeals the individual mandate of the Affordable Care Act. This is a huge blow. It is expected to cause 13 million more Americans to lack health insurance by 2027, the uninsured rate to rise to 16 percent, and average health insurance premiums to spike by 10 percent. People will suffer – and many will die.

What is “fake news” is the presumptuous pronouncement by President Trump that “[w]hen the individual mandate is being repealed, that means Obamacare is being repealed because they get their money from the individual mandate." Important parts of the ACA remain.

Among other things, even under the tax bill: Medicaid expansion will continue to help millions of low-income adults; people with preexisting conditions still cannot be denied health insurance coverage or charged higher premiums; income-based subsidies for purchase of individual policies remain; insurers must continue to cover "essential" health benefits; and the requirement that larger employers provide coverage stays intact. Also, repeal of the individual mandate does not go into force until 2019, affording voters some time to wise up.

Moreover, just what Trump may have meant as to where the money comes from is unclear. Fines for failure to carry health insurance provide only a small fraction of Obamacare financing. Far more money comes from other ACA sources.

Overall, most of the changes in the GOP tax bill are despicable. The act does a “Reverse Robin Hood.” It takes from the middle class, working families, seniors, children and the most vulnerable among us — all to pay for enormous and permanent tax cuts for the top 1 percent and wealthy corporations.

But still, advice to Democrats and other concerned Americans, especially as to health provisions: Do not declare defeat and crawl away. Live to fight another day!

This story was originally published December 23, 2017 at 1:37 PM with the headline "Key provisions of Obamacare prevail."