IMAGE: CNS photo/Mike Blake, Reuters
By Carol Zimmermann
WASHINGTON
(CNS) — The Affordable Care Act — on the
examination table since President Donald Trump came into office — has been poked,
prodded and even pronounced dead while the fight to keep it alive keeps going.
President Trump told Cabinet members Oct. 16: “Obamacare is finished. It’s
dead. It’s gone. … There is no such thing as Obamacare anymore,” but
that is not how those who want health care reform, including Catholic leaders,
see it, and it’s not the general public’s view either, according to a recent
poll.
The Kaiser
Family Foundation poll said seven in 10 Americans think it is more important for
Trump to help the current health care law work than cause it to fail. Sixty-six
percent of Americans want Trump and Congress to work on legislation to bolster
the health insurance marketplaces rather than continuing their efforts to
repeal and replace the ACA.
The poll,
conducted by the Washington-based group that examines key health policy issues,
was released Oct. 13, the day after Trump announced some changes to
the current health care law.Â
By executive order, he directed federal agencies to
make regulatory changes to the ACA to allow consumers to buy
health insurance through association health plans across state lines and lifting
limits on short-term health care plans. He also announced that he was ending
federal subsidies to health insurance companies that help pay out-of-pocket
health care costs for those with low incomes.
The Obama administration had authorized the subsidies, but in 2016, Republicans filed a lawsuit, saying they were illegal because Congress had not authorized
the payments.
The
president’s plan to end the subsidy payments prompted swift criticism from
Democrats, U.S. health care groups and the U.S. Conference of Catholic Bishops.
Bishop
Frank J. Dewane of Venice, Florida, chairman of the USCCB’s Committee on
Domestic Justice and Human Development, said the bishops “will closely
monitor the implementation and impacts of this executive order by the relevant
administrative agencies.”
He
said flexible options for people to obtain health coverage are important
strategies, but he also cautioned that “great care must be taken to avoid
risk of additional harm to those who now receive health care coverage through
exchanges formed under the Affordable Care Act.”
A possible fix to Trump’s cuts that would continue federal subsidies to insurance
companies through 2019 was offered in a bipartisan Senate proposal by
Sens. Lamar Alexander, R-Tennessee, and Patty Murray, D- Washington, which
Trump initially appeared to support but then backed down from a day later.Â
When the Obama administration authorized the subsidies, Republicans filed suit, saying they were illegal because Congress had not authorized the payments.
By Oct. 20, there
was no word on when the bill — which also aims to provide states flexibility
to skirt some requirements of the health care law — might come to the Senate
floor for a vote. Several senators have said they are waiting to see more
details in the bill’s text. Support from the House doesn’t seem likely since House
Speaker Paul Ryan, R-Wisconsin, has said he opposes it.
Sister
Carol Keehan, a Daughter of Charity and president and CEO of the Catholic
Health Association, a leadership organization of more than 2,000 Catholic hospitals
and health care facilities, has been keeping a close eye on the president’s
action on health care and the response by Congress.
“Working
out a deal to keep the subsidies for a longer-term plan is something that is
very important and critical to the future, particularly for the most vulnerable
among us,” she said.
Sister
Keehan, who also is a nurse, told Catholic News Service Oct. 18 that she
encourages the House and Senate to take immediate action to stabilize the
insurance markets and delivery and “allow time for us to have a national
conversation” about improving the health care law without letting those now
covered with health insurance lost it or for “premiums to go out of
sight.”
So
far, she has only seen parts of the Senate bill, but she said the Catholic
Health Association is “willing to do what we can to craft a compromise
that will work in the short term until we have a longer-term solution.”
The
Alexander-Murray bill is not the only text that needs a closer read to
understand the future of the country’s health care system. The new rules that
will be written by federal agencies, per Trump’s executive order, will also need
a close look. These changes could appear within weeks but are unlikely to take
effect before the end of the year.
Dr.
Steven White, a pulmonary specialist in Ormond Beach, Florida, who is chairman of
the Catholic Medical Association Health Care Policy Committee, said he
is awaiting to see how new rules and regulations are written but is hopeful
that some changes will be a move in the right direction.
White
said his association sees less federal control and more patient control as a
good thing and also would like the health law to offer more options, freedom
and flexibility.
He
told CNS Oct. 18 that pouring more money into health care isn’t the solution,
but he also echoed Bishop Dewane’s concern that changes shouldn’t be made on
the backs of those with low incomes. He said if Congress backs legislation that
supports subsidies, they need to balance that with the realization that such a
plan “can’t last forever.”
“Something
has to be done,” he said a few times during the interview.
But
just what will happen still remains a mystery.
Another
finding of the Oct. 13 Kaiser poll showed that despite
Americans’ support for a bipartisan approach to health care, their confidence
that Trump and Congress can work together to make this happen remains low.
Seven
in 10 Americans said they are either not too confident or not at all confident that
cooperation can happen.
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Follow
Zimmermann on Twitter: @carolmaczim.
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