By Ralph Northam
As a doctor, I know some things about healthcare. As a public official who sponsored legislation to create the state exchange and expand Medicaid, I also know how the Affordable Care Act (ACA) benefits Virginia.
So when I saw the Republicans’ plan yesterday — crafted after seven years of deliberation — I knew it didn’t make sense.
For years, they talked about a “better way” to cover more people for less. But it’s no surprise Donald Trump’s party is all talk, no substance. Their “better way” isn’t better at all – it could make the cost of health insurance higher than before, if you’re able to afford coverage at all.
The most remarkable feature of Trumpcare is its trifecta of inadequacy: it covers less people and raises costs for patients, and massively cuts taxes for the wealthy and insurance companies.
This is not unusual for Republicans. Their proposal gives the store away to the wealthy and sticks working folks with the bill. While Republicans can’t even provide a cost estimate, the early analysis is clear – families across the Commonwealth will pay a lot more.
Insurance companies, on the other hand, will make a killing. They will no longer have to cover most healthcare. If this gets through Congress, they’ll be able to create policies that kick in only for major illness or injury. Gone will be the days of requiring insurance companies to cover basic care without exclusions.
Make no mistake, Republicans are kicking working Americans off their healthcare plans to pay for tax breaks for the wealthy. This plan is great news if you’re an insurance executive making over $500,000 a year. If that’s you, you’ll probably get a raise. And your insurance company will get a tax break when they deduct your salary as a business expense.
But there’s no free lunch. To pay for it, Trumpcare cuts subsidies helping low-income seniors afford a plan and allows insurance companies to charge them more. The AARP is calling this an age tax, and I agree. Medicaid expansion — which has helped millions of lower-income Americans afford health insurance — will also come to an end.
What’s more, the plan ends Medicaid as we know it. By capping payments to states, it forces cuts to the program. Talk about a death spiral. That hurts our kids. It hurts our seniors, families, and folks with disabilities. It will hurt Virginia.
By capping the Medicaid payments to states, Republicans are shoving the cost of healthcare onto Virginia. Even Virginia Republicans have expressed concern about this kind of proposal. Noticeably, they are glossing over what this means for states like Virginia that have passed up the opportunity to expand Medicaid. The Commonwealth will have to make tougher choices than states that accepted the money. We will be at a permanent disadvantage to other states that drew down their tax dollars to close their coverage gaps.
Every Virginian deserves access to quality, affordable healthcare. By threatening Medicaid, Trumpcare puts healthcare out of reach for families across the Commonwealth. It makes visiting the doctor a luxury. That’s not right.
Tucked into the bill is a despicable attempt to cut women’s access to reproductive health. The bill bars Planned Parenthood from receiving federal Medicaid reimbursements – effectively defunding it even though none of the money goes towards abortions. Many women go to Planned Parenthood for access to quality, affordable healthcare. This is unacceptable.
Even worse, their plan includes a measure that could effectively end private abortion coverage in the United States. It bars women and potentially employers from using tax credits to purchase health insurance plans that include abortion coverage. This is the Stupak Amendment, Part Two. Rolling back the clock on Roe v. Wade will have real-life, adverse effects on women’s health outcomes across the board. That’s dangerous.
Healthcare choices are best left between a woman and her doctor. I’ve never wavered on defending a woman’s right to choose and I never will. Now more than ever, we must stand strong against these efforts to shame women for determining their reproductive care.
After seven years, this was the best the GOP could do, and frankly, that’s sad. We must defend the Affordable Care Act. I’ll be the first to admit it’s not perfect, but the better way to cover more Virginians, for less money is to build on its progress. Ensuring quality healthcare remains in reach for hundreds of thousands of Virginians is an economic and moral imperative.
In America, people shouldn’t be one illness away from a financial catastrophe for themselves and their families. Now, more than ever, we need someone who understands the healthcare system. As a Senator, Lieutenant Governor, and a doctor, I’ve worked to make healthcare better for my entire career, and that’s why I’m going to fight this plan tooth and nail.
Ralph Northam is a physician and the Lieutenant Governor of Virginia.