Here are a few consumer protections that Republicans will repeal:

  • Requires insurance plans to cover people with pre-existing health conditions, including pregnancy, without charging more
  • Provides free preventive care
  • Gives young adults more coverage options
  • Ends lifetime and yearly dollar limits on coverage of essential health benefits
  • Helps you understand the coverage you’re getting
  • Holds insurance companies accountable for rate increases
  • Makes it illegal for health insurance companies to cancel your health insurance just because you get sick
  • Protects your choice of doctors
  • Protects you from employer retaliation
  • Breastfeeding equipment and support
  • Birth control methods and counseling
  • Mental health and substance abuse services
  • The right to appeal a health plan decision
  • The right to choose an individual Marketplace plan rather than the one your employer offers you

When Obamacare became law, there was an incorrect assumption that it would be a job killer. In reality, jobs were created as a result of the Affordable Care Act helping lower the unemployment rate to 4.6% under Obama.

A Kaiser Family Foundation report found that Obamacare led 7% of employers with 50 or more full-time equivalent employees to bump part-time workers to full-time, whereas just 2% did the opposite.  Obamacare was not a job killer based on this report.

Trumpcare, though, could be a job killer. A new report from the Milken Institute School of Public Health at the George Washington University and the Commonwealth Fund estimate that the repeal of Obamacare could cost almost 3 million jobs by 2021. The lack of federal funding is expected to cut gross state product by $1.5 trillion between 2019 and 2023, meaning there will be less money to spend on hiring.

Only about a third of the nearly 3 million job losses are expected to be in the healthcare sector. The remainder will come from other industries as consumers are forced to spend more on their healthcare and have less disposable income to spend elsewhere (e.g., food, clothing, entertainment).

Without a firm plan to replace Obamacare, around 20 million people could lose their health insurance, and around 3 million people could also eventually lose their jobs.

Cassie Dagostino wrote an article on Rantt about Republicans’ attempts to replace ObamaCare without a replacement.  When the ACA became law in 2010, 16.3% of the population, or 49.9 million Americans, lacked health insurance.

Since the ACA’s enactment, the uninsured rate has been cut in half and the trend-line of record lows continues. In 2015, the percentage of people without health insurance coverage for the calendar year was 9.1 or 29.0 million, down by 1.3 percentage points (10.4 percent or 33.0 million) in 2014.

In Q1 of 2016, the uninsured rate hit a record low of 8.6 percent of Americans (persons of all ages uninsured at the time of interview), marking the first time it fell below 9 percent in the nation’s history, per the U.S. Department of Health and Human Services.


Slate had an interesting article about the millions of Americans in dozens of rallies protesting to keep ObamaCare.  “At each of the rallies, speakers talked about specific men and women whose health and/or finances were saved by the ACA in an effort to build up opposition to the Republican repeal efforts.”

Speaking on CNN, Sen. Rand Paul gave broad details about what could be in the Obamacare replacement package but pointedly did not say whether the almost half a million people in his state that have insurance under the current law would be able to keep it.

Why repeal ObamaCare without a replacement?


The Chicago Tribune reported that two social workers, Kenneth Allen and Olufunmibi Ogunyipe, allege they were fired from Burnham Healthcare now known as Bria of River Oaks nursing home after refusing to fabricate medical records related to incidents of patient abuse.  Some of their patient-abuse allegations were investigated separately by the Illinois Department of Public Health, which cited the facility for safety violations, records show.

The nursing home has withstood years of state citations for violence, patient neglect and filth. Last year it received $16.5 million from Medicaid and Medicare while reporting $1.38 million in profits.  Records show that some of those federal health-care dollars went to Weinfeld’s uncle, nursing home magnate Morris Esformes, whose son and close business partner, Philip Esformes, is being held without bond in a Miami federal detention cell on charges that he orchestrated a $1 billion Medicaid kickback scheme in Florida.

Allen alleges that a supervisor told him to falsify the medical chart of a female resident who was hospitalized in 2012 with facial bruises and black eyes. Allen believes the woman was beaten by a fellow resident, but he was told to write that she had fallen. A state inspection report later found that the facility failed to properly investigate her family’s complaint that she was assaulted.

Allen alleges that after he documented a resident’s rape complaint, a supervisor ripped Allen’s report out of the medical file and tore it up. The state health department inspection concluded the facility had failed to thoroughly investigate the sexual assault allegation and to notify authorities.

Ogunyipe alleges that, in the case of a 60-year-old resident who had repeatedly requested a discharge, a supervisor told him in 2013 to write up medical notes falsely stating that Ogunyipe had tried repeatedly to transfer the man but couldn’t find a program with an open bed. A state health department inspection cited the facility for failing to assist the resident’s request for a discharge.

Ogunyipe alleges that a supervisor tried to deceive state inspectors by removing disheveled residents who might trigger state scrutiny because they appeared neglected. A supervisor gave him $30 to $50 to take the residents out of the building, buy them cigarettes, feed them at a McDonald’s and claim they were going on a field trip, saying: “They can’t be in the building,” the suit states.

Ogunyipe said that the administration wanted to conceal residents with untrimmed hair and soiled clothes because “you would know that they were not being cared for.”

He witnessed fellow employees entice residents back to their rooms with a cigarette or snack, then punish them. “They would just close the door and — boom, boom, boom! Deal with the resident. Beat him up. Spit on his face and then walk out, close the door,” Ogunyipe said.  (A 2012 state inspection report said two residents alleged guards beat or roughed them up in separate incidents. The report says that at least one guard at the home was fired as a result.)

The Indianapolis Business Journal had an article about the fraud and greed that led to the indictment of nursing home owner and operator James Burkhart.   In an explosive federal indictment unsealed in October, kickback money was used to buy gold bullion, casino chips, and vacation homes in a massive fraud scheme.  The fraud and kickbacks combined totaled more than $16 million, with the proceeds going to fund the men’s lavish lifestyles.

The indictment states that Burkhart, former CEO of Indiana’s largest nursing home company, and three other men orchestrated a scheme that used kickbacks and shell companies to defraud American Senior Communities which is owned by the Jackson family of Indianapolis; Health & Hospital Corporation of Marion County, which hired ASC to operate its nearly 70 nursing homes; and federal health care programs.

The defendants are former CEO James Burkhart, former Chief Operating Officer Dan Benson, Joshua Burkhart and Steve Ganote.  A 35-page indictment alleges that the four launched the brazen scheme to enrich themselves in 2009 and continued it until Sept. 15, 2015, the day FBI agents raided the nursing home company’s offices.

“The scheme was characterized by unbridled greed,” U.S. Attorney Josh Minkler said.

WCCB Charlotte reported the tragic assault of a resident suffering from dementia by police with tasers.  When the incident happened in March, the sheriff made excuses defending the police by claiming the resident assaulted another resident and was resisting officers when they tried to get him to a doctor’s appointment.  The police body cam video shows the man waving his hands near the officers. When he attempted to walk away, the deputy tased him.  The family says the man died two months after the tasing, and believes his death is connected with what happened.  See more info at WWLP.

Herald Mail Media reported on the accusation of resident dumping by the owner/operator of five Maryland nursing homes.  The suit alleges that during a 17-month period between Jan. 1, 2015, and May 31,  Neiswanger Management Services LLC issued involuntary discharge notices to at least 1,061 residents at the five facilities it operates.

NMS and a number of its officers were named in a civil suit and charged by the state Office of the Attorney General with dumping “frail and disabled” Medicare and Medicaid residents in sham assisted-living facilities and homeless shelters, and submitting false claims to the state.

A number of dumping incidents are listed in the 62-page complaint including a woman with cancer who was driven to an unlicensed care facility in Baltimore and a woman who was left in the driveway of a relative’s home on a 95-degree day, the document said.

 “In at least 1,038 of these cases, the reason for discharge cited by NMS was the resident’s failure to pay for his or her care, or to arrange for payment by Medicare, Medicaid or another third party payor,” the suit states. By contrast, the suit noted, Maryland’s other 225 nursing homes issued about 510 such notices during that period.

NMS facilities received more than $100 million in Medicare and Medicaid reimbursements in 2015, $35 million of that from the Maryland Medical Assistance program, the suit states.

NMS preferred Medicare patients for admission because of the higher rates of reimbursement, then “aggressively seeks to evict Medicare participants as close as possible to their last covered day” without regard to their medical needs, the suit alleges.

An email from owner and former chief executive officer Matthew Neiswanger is quoted in the suit. In the email, he states, “Total of 22 empty beds! … Fill beds with Medicaid if you can’t get Medicare!!!”




Jonathan Chait for New York Magazine had a great article on the Republican strategy to repeal ObamaCare and replace it with nothing.  He argues they have no plan and no political courage to pass anything.  Below are excerpts:

The Republican Party has used health care to its advantage for the last seven years by following the same strategy: advocating an alternative plan that does not and cannot exist. During this entire time, President Obama has held power. This has afforded them the luxury of posturing against the status quo — and, indeed, doing everything in their power, at both the federal and the state level, to make it worse.

The closer they get to taking action, the more clear it becomes to Republicans that their own propaganda has trapped them and given them no escape. Railing against Obamacare was easy, but the responsibilities of power have taken all the fun out of denying medical care to the poor and sick.

A large number of Trump voters who get coverage through Obamacare “simply felt Trump couldn’t repeal a law that had done so much good for them,” reports Sarah Kliff, who spoke with many of them.

But any plan to replace Obamacare with something “terrific,” or even something almost as good as Obamacare, will violate conservative dogma. There’s no way around this. Despite the apparent complexity of the issue, it’s a very simple problem of resource allocation. In a free-market system, tens of millions of Americans will not be able to afford medical care because the cost of their treatment exceeds their income, either because they’re too poor, or because they’re too sick.

A Kaiser Family Foundation analysis finds that 52 million Americans under the age of 65 have preexisting conditions that would make it impossible for them to purchase health insurance in the individual market that existed before Obamacare.

Covering people who can’t afford to pay for their own medical care means making other people pay for it. You can do that through direct tax-and-spend transfers, or through indirect regulatory methods (like making insurance companies overcharge healthy people and undercharge sick ones). Republicans oppose these methods because they oppose redistribution in general.

And yet politics requires them to promise a plan that does not deprive Americans of access to treatment. This is the reason none of their plans has advanced beyond the white-paper concept phase —either they contain too much redistribution to be acceptable to the GOP, or too little coverage to be acceptable to the public, or both.

Republican health-care plans go much, much farther in this direction. They offer threadbare, catastrophic coverage with enormous deductibles.

Congressional staffers tell Philip Klein, a staunch Obamacare critic, that they plan to repeal the law quickly, and then replace it not all at once but with a series of “legislative changes that could be enacted in a series of shorter bills … for instance, one bill could theoretically be passed to address individuals with preexisting conditions.” This plan is so laughably hopeless it’s difficult to believe Republicans would attempt it. It’s impossible to gauge the impact of one change to the health-care system without knowing what other changes will be enacted. None of the stakeholders in the health-care system is going to support any discrete changes that could dramatically alter their business models without knowing what other changes may or may not follow.

Preexisting conditions are an obvious example of this problem. If insurers will be required to provide below-cost plans to people with expensive medical needs, they need to know what other measures will be put in place to compensate them: Subsidies? Regulations on healthy customers? Hospitals need to know how many uninsured patients they should expect to show up in their emergency rooms. In particular, popular parts of health-care reform (like benefits people get) need to be attached to unpopular parts (like ways to pay for it).

If Republicans blow up Obamacare, “the media and the left will blame the repeal vote for any turmoil in insurance markets,” editorializes The Wall Street Journal, “Republicans will own health care, like it or not.”

John Goodman, a conservative health-care-policy activist, concedes, “It’s not going to be politically possible to throw 20 million people out on the street without health insurance.”

Repeal-and-delay is the ultimate backhand acknowledgement that the party has no answers.

If Republicans repeal Obamacare without creating a replacement, insurers will have little reason to stay in the marketplace. They’ll start canceling plans immediately, and the news will be filled with stories of Americans being thrown off their medication and, in some very real cases, dying.

Repeal-and-delay will actually require taking additional action to prevent a meltdown. Insurers have begun negotiating behind-the-scenes with Republicans in Congress for concessions that would allow them to continue to cover their existing customers.

Hospitals are also warning Republicans that blowing the system up without a replacement would expose them to massive financial risk.

The most likely answer is that Republicans never craft a replacement. They repeal Obamacare, but delay the effective date of the repeal, and then Obamacare becomes a “cliff” that Congress votes to keep extending.

There is no majority in Congress behind any one specific plan to replace Obamacare, but there is probably a majority against blowing it up immediately.

If Republicans truly believed Obamacare creates more victims than beneficiaries, they would blow it up immediately. And if they really had an alternative that was more popular, they would wait to write it before they eliminated it. Repeal-and-delay proves that neither one of these is true. They have no better plan. All they can do is promise some better plan lies over a horizon that will never arrive.


The L.A. Times reported that millions of Americans are scrambling to get insurance coverage through ObamaCare before the Republicans attempt to replace the successful health care law.  As of Dec. 24, more than 11.5 million people had enrolled in a health plan through one of the insurance marketplaces created by the law according to federal data. The coverage expansion has recorded historical gains in the last three years, as more than 20 million previously uninsured Americans obtained health insurance and the nation’s uninsured rate dropped to the lowest level ever recorded.

“Nationwide demand for health coverage is higher than ever, as Americans prove again that marketplace coverage is vital to them and their families,” Health and Human Services Secretary Sylvia M. Burwell said.

More than 10 GOP senators have publicly questioned the current push to repeal the law now and develop an alternative sometime in the next several years.  Republicans have never coalesced around an alternative or even submitted one to review by congressional committees or independent budget analysts.