WAXAHACHIE — As the new presidential term begins this year, so do a new set of changes throughout the country. Since taking office, President Donald J. Trump has pledged to “repeal and replace” Obamacare, otherwise known as the Affordable Care Act, with a rumored substitute as early as 2018.

Bringing the issues of Washington to Waxahachie, the Waxahachie Chamber of Commerce hosted a congressional forum for businesses and healthcare providers at a luncheon Tuesday, Feb. 21 to discuss what to expect in the coming year.

“The United States economy is about four trillion dollars a year, healthcare is about a third of that, a little over 1.6 trillion dollars — healthcare is big,” stated guest speaker and U.S. Congressman Joe Barton. Barton serves as Vice-Chairman of the House Energy and Commerce Committee. 

Barton explained that by dismantling the structural ailments of the ACA with its high premiums and deductibles, crumpling exchanges, and CO-OPs, any new plan for healthcare would prove to be a challenge for the Republican Party.

“In November, defying all expectations, candidate Trump became president-elect Trump. A lot of people who voted for Trump to be president, and for me to be congressman have said, ‘Okay, you control the House, you control the Senate, you control the presidency, let’s see you deliver,’” Barton recalled.

As he has stated himself, changing healthcare has been one of President Trump’s biggest priorities, taking it from default insurance monopolies and flipping it into a free-market.

“We want to create a healthcare marketplace that is open, that is vibrant, and it’s based on you folks deciding what’s best for you. We want you to decide what kind of insurance you have, and where you get your actual healthcare from – where you pick your doctor and hospital,” Barton expounded on the overall goal to repeal the ACA. “For those of you that are in the insurance business, we want to let you customize your plans you’re offering in the marketplace, based on what you think is best, not on some government mandate that has to be provided."

With hopes to give the deciding factors on health insurance back to the people, Barton continued by stating that the changes would allow for every American citizen to receive customized healthcare in some form or fashion.

“At the federal level, we do have health care for our senior citizens and Medicaid for lower income, and then through the tax code, we provide the incentives that a lot of businesses use to provide healthcare for their employees. So for all intensive purposes in the modern era, you could say healthcare has become something that the federal government has guaranteed. The question is – what do we do” Barton asked the luncheon audience.

RECONCILIATION

First things first in this three-legged stool approach – revoking the ACA begins through a process called, Reconciliation.

“We have tried numerous times in the past to repeal Obamacare, but because we had President Obama as president, he never had to really veto one of those bills because it never got through the Senate. We did do a Reconciliation bill in 2015 that repealed most of Obamacare, but it didn’t get to his desk, and it didn’t repeal. Well, this year we’re shooting with real bullets,” Barton began to describe the legal method.

“There’s two processes that legislation in Washington. You have the regular process where the House passes a bill, and the Senate passes a bill. They’re not identical, and you go to conference and work out the differences, and then have a conference report. That conference report comes back, passes the House, passes the Senate, and it goes to the President, and he either signs it or doesn’t sign it," he explained. "Then there’s a special kind of legislation that’s called ‘Reconciliation,’ and that’s used to change entitlement.”

The Reconciliation process specifically allows budget bills to be passed through the Senate without being subjected to a drawn-out filibuster. According to the Guardian, this would effectively change the threshold for passage in the upper chamber from the 60-vote supermajority to a simple majority of 51.

“In other words, once you pass Medicaid, like food stamps and pension benefits – those are entitlements, and you can’t amend them in a regular way, you have to use what’s called Reconciliation,” Barton continued. “There’s a rule in the Senate that’s called the ‘Byrd Rule,’ and it says, ‘ If it doesn’t have a budgetary impact, it is disallowed as part of Reconciliation.’ That’s pretty complicated, but when we say we’re going to repeal the ACA, because of all these complications and procedural things, it will not be in one bill, it’ll be in a series of bills.”

The second step of this process, as stated by the Guardian, involves executive actions through the Department of Health and Human Services, following the confirmation of Georgia Congressman Tom Price, who has been nominated by President Trump to lead the department.

The third phase would be a separate standalone bill. This approach stands in contrast to that outlined by President Trump who has urged a replacement “very quickly” after repeal.

ELIMINATE FEDERAL MANDATES

President Trump began his term in the Oval Office signing an executive order to give federal agencies authority over disentangle regulations created under the ACA, permitting relief to all areas affected by the collapsing 2010 healthcare law, purging a list of ACA taxes and requirements.

“We want to eliminate federal mandates on individuals and companies. Under the ACA every American is supposed to have health insurance of some sort, either through your employer, or the individual marketplace. The goal is to require everybody with health insurance. That didn’t work,” Barton stated.

Trying to cover every American citizen with health insurance through strict mandates, the Obama Administration failed to achieve their objective, creating a monopoly mess.

“Before the passage of Obamacare, there were about 14 percent of the American people who didn’t have health insurance of some kind. Last year that number decreased by two percent, so for all the huffing and puffing of mandates, we didn’t get 100 percent of the American people having health insurance,” Barton clarified.

“We’re going to go back to a free marketplace. We hope within incentives for the private sector, providing the healthcare, and private insurance companies providing the health insurance that we have a proliferation of plans. We are going to allow insurance to be sold across state lines. We’re going to try to incentivize open markets,” he included.

Alleviating the marketplace by offering adaptability to states and insurers, and granting patients access to more coverage options, the new directive will help protect Americans as expected improvements are discussed.

MAINTAIN COVERAGE, PORTABILITY, & PROTECT LIFE

As transition brings about change, so do worries backpacked on concerns.

“Whether you’re an individual seeking insurance or health care, or whether you’re a provider trying to provide; if you have healthcare insurance today, of any shape, form, or fashion - you will keep that health insurance for a transition period," Barton explained.

Although the transition period is subject to debate, Barton guarantees insurance through their transitional stage, regardless of its unscheduled date.

“It will be a minimum, in my opinion, of two years. It could be as long as five or seven years, but there will be a transition period, and if you have health insurance today and you want to keep it, at least for a transition period, you will be allowed to keep it. We’re going to keep that promise,” Barton simplified.

Confirming the importance of customizable health insurance, Barton sets worries at ease, as the incoming replacement plan will maintain coverage for those who purchased insurance through the exchanges.

“The Republicans want everybody to have healthcare, and I know that comes as a shock to a few people in the room, but we want to be able to pay for it. We want it to be quality, we want individuals to have choices, and we want doctors in hospitals to be able to provide care based on how they feel what’s best for the patient. But even though we say we’re going to repeal the ACA, doesn’t mean we want to take the federal government out of the healthcare industry. That’s not the case,” he confirmed.

As for those with pre-existing conditions, they will also be guaranteed coverage.

“If you have a preexisting condition, you will be guaranteed health insurance regardless. If you have health insurance where you work and you change jobs, you’ll take your health insurance with you - that’s called Portability,” he added.

In an article in the National Review, it states, the law caters to insurance companies that love having a broader base of patients, especially if the government subsidizes it. But critics of Obamacare have maintained from the beginning that portability of health insurance across state lines is essential to foster competition and drive down inflated premiums.

This could also decrease the need for federal subsidies. As it is now, premium increases are uneven, in some cases rising as much as 30 percent a year. But if you could go across state lines to get a comparable policy, insurance companies would be kept more honest in terms of the premiums they set.

In addition to portability, Barton also expresses the Republican’s pledge to protect life and ensure that no taxpayer dollars will go towards abortions.

“The last one, we’re going to do everything we can to prevent any of these insurance plans from covering elective abortions, and it’s called The Right To Life Provision, and most of us on the Republican side feel very strongly about that,” Barton affirmed.

WHAT TO EXPECT

Though many components of change are in the massive undertaking of repealing and replacing the ACA, Barton is confident the American people will make the best health choice for their lifestyle.

“We believe people can make intelligent choices on healthcare, you don’t have to have the federal government tell you what to do,” Barton acknowledged.

As for the reveal of the Reconciliation package, Barton said that next week they would divulge the first round of plans to revamp the ACA to the public.

“We’re going to roll out the reconciliation package next week, and in the weeks and months ahead we’re going to roll out the other parts of it. It’s going to be an open and transparent process,” he concluded.

To connect with the Waxahachie Chamber of Commerce, visit waxahachiechamber.com or call (972)-937-2390.

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Chelsea Groomer, @ChelseaGroomer

(469)-517-1450