Jerri-Lynn here: This Real News Network interview with Carol Paris, President of Physicians for a National Health Program, provides a brief overview of the implications of Thursday’s House vote to repeal Obamacare for the prospects for a single-payer alternative, such as Medicare-for-all. Note that this is by no means either the last nor a particularly comprehensive look at the subject. I’m nonetheless posting this short interview to provide readers with a chance to discuss the health care reform issue more thoroughly.
Aaron Maté: It’s The Real News, I’m Aaron Mate. The Republican controlled House of Representatives has voted to repeal and replace key parts of the Affordable Care Act known as Obamacare.
Speaker 1: The ayes are 217, the nays are 213. The bill is passed and without objection the motion to reconsider is laid upon the table.
Aaron Maté: The American Healthcare Act cuts hundreds of billions of dollars in healthcare spending by repealing taxes on high income earners and the healthcare industry. It phases out Medicaid expansion and allows states to make even deeper cuts. It also undoes the protection of people with preexisting conditions. Several provisions target women’s health including defunding Planned Parenthood and making essential benefits like maternity coverage optional. After the vote House Minority Leader Nancy Pelosi said Republicans will pay a political price.
Nancy Pelosi: The Republicans have the majority, they won the vote but the American people now have to judge them by how they have acted. Not by how we’ve characterized what they stand for, now they are on record. As I said, this vote will be tattooed to them as I also said they will glow in the dark.
Aaron Maté: The vote comes weeks after House Republicans failed to pass their first attempt. It now goes to the Senate where it faces an uphill battle. Joining me is Dr. Carol Paris, President of Physicians for a national health program. Dr. Paris, welcome.
Carol Paris: Thank you for having me, Aaron.
Aaron Maté: When Republicans failed to pass their first go at this, Trumpcare 1.0, the Congressional Budget Office estimate was that 24 million people would lose their health insurance. Now this time, perhaps intentionally, the CBO was not given a chance to score this one so we don’t know how many people exactly will be affected. It appears that Trumpcare 2.0 is even more draconian because now it drops the requirement that insurers cover people regardless of their medical history. It also takes away the requirement that insurers offer essential health benefits. Tell us what the impact would be if this manages to become law?
Carol Paris: Well you’re right, the CBO has not scored it and so we can only guesstimate that it will be at least 24 million people who will be kicked off of their health insurance. The more interesting thing that happened when the bill failed to pass last time is that H.R. 676, the expanded and improved Medicare for all bill, gained 24 co-sponsors including my Congressman, Jim Cooper, who is a blue dog Democrat who has never co-sponsored H.R. 676 in the past. There are some unintended consequences of this move and I’m expecting to see possibly our first Republican co-sponsors now that the House has passed this onto the Senate.
Aaron Maté: As this current one goes through the Senate there is uncertainty about its fate. Certainly Senators from states that stand to cut Medicaid as this one entails will face pressure to keep it. Talk to us about one of the key provisions which is taking away the requirement that insurers cover preexisting conditions and replacing that with this concept of high risk pools.
Carol Paris: Well, high risk pools was something that the ACA I think tried to avoid by mandating that everyone have health insurance which would have brought and was intended to bring young, healthy people into the risk pool hence making premiums more affordable for people who would otherwise be uninsurable and unaffordable because of their preexisting conditions. What they’ve now done is create these high risk pools which may sound good in some theory but in fact are thoroughly inadequately funded. Essentially, they are creating a situation where older, sicker Americans will simply not be able to afford healthcare. Younger Americans may be able to purchase a health insurance plan but that doesn’t mean they aren’t going to find out when they actually try to use it what the limitations of it are especially if they eliminate the essential health benefits.
Aaron Maté:Yeah. The numbers on this are, eight billion dollars in this current bill would go towards high risk pools. That’s enough to cover maybe a few hundred thousand people. Conservative estimates say that you need at least 25 billion dollars more so at least three times that amount to cover high risk enrollees. Let’s talk about Democrat’s response. After the vote Democrats in the House broke out into a chant of na-na-na-na, hey-hey, goodbye, a message to Republicans that this vote is going to hurt them politically. What do you think of how Democrats have handled the healthcare debate?
Nancy Pelosi who we heard from before, when she was asked today if Democrats are going to make single payer an issue in 2018 with the mid-terms she said definitely not. What’s your assessment of how Democrats have been handling the healthcare issue?
Carol Paris: I don’t have any hope that the Democrats are going to suddenly have a change of heart. After all, they had a majority in the House and the Senate and a president in 2010 and single payer didn’t get a seat at the table. All that says to me is that the American people are clearly in the majority and a growing majority of people who are beginning to understand and truly want a Medicare for all single payer solution. We’re not going to get Republicans or Democrats to get on board with it until we have a vocal and sustained movement of Americans who make it toxic for both Democrats and Republicans not to get on board.
We’ve seen that in the Civil Rights Movement as well, this is not surprising. I’m not looking to the Democratic Party to do the work of movement building for single payer, that’s the job of activists and I’m one of them. Trust me, I am going to do that job. I’m disappointed that the Democrats are not championing single payer but I’m not expecting them to. I’m just letting them … I’m putting them on notice that we’re working to make this toxic for them not to get on board, Democrats and Republicans alike.
Aaron Maté: Are you worried though that because this measure is so draconian it moves the goalpost from pushing through a single payer universal healthcare program to simply defending those who stand to lose their health insurance, the millions of people who stand to lose their health insurance under the repeal of the Affordable Care Act?
Carol Paris: There are many people who are defending the Affordable Care Act, the indivisible movement and our revolution, and that’s fine if that’s what they want to do. My experience when I’ve gone to town halls that are sponsored by local indivisible groups is that the minute someone stands up and asks the member of Congress to give them what they really want which is a single payer Medicare for all play the town hall erupts in cheers and applause. You know, my own feeling about this has evolved over time. I had been saying that I can walk and chew gum at the same time, I can defend the ACA from going backwards and continue to support single payer Medicare for all going forward but my feeling on that is changing.
The ACA is a flawed piece of legislation and I don’t want anyone to lose their insurance. I’m glad that there are people who are working to keep the Senate from passing this piece of legislation but there are others of us who are simply saying neither of these pieces of legislation is the solution. If we don’t keep talking about what the real solution is then we’re just going to keep talking and not getting there. Like I said before, we gained 24 co-sponsors the last time the Republicans tried to pass this legislation. I predict that while the Democrats and the Republican legislators may not know what to do with this the American people are going to respond and they are going to respond with a lot of anger and frustration. They’re going to realize that they’re standing to lose a great deal.
Aaron Maté: Dr. Carol Paris, President of Physicians for a national health program. Thanks so much.
Carol Paris: You’re welcome.
Aaron Maté: Thank you for joining us on the Real News.