Republicans Say They Finally Have a Health Care Alternative -- But Don't Count On It Working for You

Speaker of the House Paul Ryan walks from the lectern after speaking to reporters in the U.S.Capitol in Washington, U.S. May
Speaker of the House Paul Ryan walks from the lectern after speaking to reporters in the U.S.Capitol in Washington, U.S. May 19, 2016. REUTERS/Kevin Lamarque

After multiple attempts to repeal the Affordable Care Act without proposing anything to take its place, House Republicans say that they are finally poised to present their ideas. It's been six years of attacks with no alternatives. If a proposal is finally presented next month, I have one simple question: Will my Republican colleagues propose real improvements or will they take us backwards in time? Will they guarantee affordable health care or will they return us to the days when being a woman meant you paid more for insurance and having a chronic condition meant you might not get covered at all?

Of course there are ways to build on Obamacare and make it even better than the law enacted in 2010. I support negotiating authority to lower prescription drug prices. I've sponsored legislation to provide a public option, giving consumers the choice of a publicly-accountable plan that the non-partisan Congressional Budget Office has said could lower premiums by 5-7 percent. And I've proposed federal backup authority to ensure premiums are reasonable in states like Illinois that don't have the authority to reject excessive rates.

But there are also many troubling proposals - and I imagine we'll hear many of them shortly from my Republican colleagues - that would reverse the gains achieved under Obamacare. Judging their alternative won't be hard, and it won't be hypothetical. It will be easy to see how it stacks up to the progress we've already made and the benefits that millions of Americans are already enjoying.
So here's my scorecard for judging the long-awaited Republican proposal against the gains we've already made under Obamacare. Would the Republican plan:

Increase the number of insured Americans?

In 2010, the year Obamacare was enacted, 16.3% of Americans had no health coverage. 9.8% of children under age 18, 20.8% of African-Americans, and 30.7% of Latinos were uninsured.

Today, 20 million Americans are newly-insured and, for the first time ever, fewer than 10% of Americans are uninsured. Over 80% of consumers buying health plans in new state-based Marketplaces are eligible for tax credits to help them afford premiums.

Reduce drug prices for seniors on Medicare?

86% of seniors take at least one prescription drug -- over half take four or more medications regularly. Many find those costs unaffordable. According to a 2015 AARP survey, 11% of seniors didn't fill a prescription, 8% delayed filling a prescription, 10% took less medicine to make it last longer, and 7% skipped a dose because of costs.

Obamacare has saved 10.7 million seniors with Medicare over $20.8 billion in drug costs (an average of $1,945 per person) by closing the gap in Part D plan coverage known as the "donut hole," during which seniors pay 100% of the cost of their drug.

Guarantee coverage of maternity care and protect pregnant women?

Before Obamacare, only 12% of individual insurance plans covered maternity plans. Even without that important benefit, women were charged up to 48% more than men for the same benefit package. Today, because of Obamacare, prenatal, maternity and newborn care are guaranteed. Gender-rating -- charging women higher premiums just because of their sex -- is a thing of the past. And women have access to preventive services like contraception, mammography and osteoporosis screening without cost-sharing.

Ban pre-existing condition exclusions and guarantee insurance coverage for people with ongoing health needs?

In the three years before passage of Obamacare, the four largest for-profit health insurers refused to sell insurance to more than 651,000 people because they had a pre-existing medical condition and refused to pay 212,800 claims based on exclusions. 129 million Americans were at risk of being refused coverage or charged more.

Today, because of Obamacare, no one can be denied coverage or be charged more because they have a pre-existing condition.

End lifetime and annual limits?

Before Obamacare, insurance companies could limit the amount of benefits they would pay, either through annual or lifetime limits. An estimated 18 million Americans faced the possibility of hitting an annual limit and 102 million faced lifetime limits. The result was that insurance could run out for someone with a costly disease or for a child with lifelong health needs.

Today, because of Obamacare, annual and lifetime limits are gone.

Limit out-of-pocket costs for covered services?

In 2009, medical expenses accounted for 62% of all personal bankruptcies in the United States. While we can and must do more to make health care more affordable, Obamacare limits out-of-pocket expenses for covered services to $6,850 for an individual, $13,700 for a family.

Provide more bang for our premium bucks?

Consumers have saved $9 billion because Obamacare requires that insurance companies spend at least 80 cents out of every premium dollar on health care -- or return the money.

Republicans who oppose Obamacare have a responsibility to show that they can do better -- not return us to the days when insurance companies alone decided who to cover for what benefits at what price. Otherwise, they should move beyond the repeal fights of the past, accept Obamacare as the law of the land, and work with us to make real improvements.