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Mar 28, 2017

Repealing and Replacing Obamacare Becomes Retreating and Regrouping

The bill to repeal and replace Obamacare failed to gather enough support from Republicans to overcome united opposition from Democrats, and was not brought to the House floor for a vote. The repeal was not complete enough for some conservatives and the replace was too generous for them, while it was not generous enough for some moderates.

This is welcome news for mental health professionals and many of their clients/patients because the latest version of the bill would have resulted in 24 million fewer people having health insurance in ten years than under current law, according to the Congressional Budget Office.

Mental health funding became a bargaining chip when the ten essential coverages insurers must provide, including mental health, were eliminated to gain more votes from conservatives. Then, at the last minute,  $15 billion was added to the $100 billion Stability Fund and earmarked for behavioral health and maternity coverage in a bid to gain support from wavering moderates. In the big picture, the $15 billion was far from enough to compensate from the overall loss of coverage nationally. 

Ultimately the bill failed to appeal to a broad enough coalition of Republicans. Efforts to appeal to conservatives drove moderates away and vice versa. The President's efforts to persuade wavering Republicans fell short after he declared that the bill should be brought to a vote without further modifications or debate. That gambit failed.

Obamacare remains in place for the foreseeable future. The President says he will move on to other issues. It is working well in some areas of the country and not well enough in others where not enough insurers participate. There are regulatory steps the Administration could take to further weaken the program or to strengthen it. There are steps Congress could take to shore it up with Democratic support. The insurance companies will make business decisions about participating going forward.

This bill was rushed through the House. Perhaps the majorities in the House and Senate will spend months rather than weeks developing a better bill that would gather a majority in both Houses either with or without Democratic support.  For now, it's a good day for everyone who provides mental health services and for those who need them.

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1 Comment

  1. 1 H. Holmes 07 Apr
    There are several issues involved with this presentation and representation of Obamacare.  First of all, Obamacare was pushed through Congress in a Hasty manner, and made it through because they greatly outnumbered 257 (Dems) - 199 (Reps) in the house, and on April 28, 2009, when Arlen Spector changed from being Rep to Dem, the Senate possessed the 60th Super Majority vote (Walker, Norbeck, 2014).  The Senate pushed Obamacare through based on the supermajority vote as 58 Dems, and 2 Independents, Sanders and Lieberman, gave them the 60 supermajority vote (Walker, Norbeck, 2014). The bill passed the house by a slim margin as 39 Democrats voted against it.  

    The article states that 24 Million people would lose health insurance if Obamacare was over-ridden.  Out of those 24 million people, it is unknown how many people have Obamacare ONLY to avoid the fines that come with not having insurance.  Second of all, President Obama said that people would have the choice of keeping their existing insurance, and can see the doctor of their choice.  This is completely false as many insurance companies have upped and left the states they served, with some states having only one or two choices.  This lack of choice forced the cost of Obamacare to sky-rocket in price, and the people CANNOT choose their own doctor.  So your claim of 24 million people losing insurance is really an unknown, because they may just chose not to have insurance. 

    As far as those suffering from mental illness, there are way too many of these individuals in the streets, homeless and poor.  They are not tracked, so trying to put a number on this population has little basis for accuracy.  Besides that, how many mentally ill people know how to sign up for it, or even realize it is available?  How many are competent to know they have it or how to use it.  

    The way the government pushed Obamacare through, there were too many openings for failure and unweighed risks, especially in the long term.  My opinion as to why they stretched the complete integration and enforcement structure of the plan so far out is because if and when it fails, they would not be in office to answer to the debacle it is becoming to many people.

    There are good things in the plan, but there are many things that need to be fixed as well.  I believe that representing numbers without complete justifications or cause for those who would lose insurance.  I am glad that the Trump plan failed.  I believe the issue is way too important, and way too impactful to our overall economic stature to do as the Democrats did with Obamacare and push it through just to push it through.  There is a lot that needs fixed with Obamacare, and I believe that the author of the article knows it.

    Walker, R, Norbeck, T. (Mar 26, 2014). A look back at how the president was able to sign Obamacare into law four years ago, Retrieved from:


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