Most progressives would like to see the Affordable Care Act (ACA) replaced with universal health care, either by expanding Medicare to all or by simply creating universal health coverage, which I presume would mean getting rid of Medicaid and Medicare in favor of Universal Healthcare. Allen Clifton expresses this sentiment quite well. I want to offer my take on the whole topic.

If you read my blog or comments that I leave on this topic, you already know that I am quite vocal that the solution is something similar to what Senate Minority Leader Chuck Shumer proposed on CNN on Friday, when talking about the collapse of Trumpcare, namely adding in a public option, which I presume would be free to those need the help or have no insurance. Personally, I would give every American a bronze level package with the upper levels provided by insurance companies. The ACA would still govern all healthcare.

In my opinion, a “repeal and replace,” where we repeal the ACA and replace the act with universal coverage would not work and would be a mistake. Let me explain. The Republicans back in 1993 had the right idea, just Democrats were not on board and there was this whole wing against the Clintons, not to mention the impeachment when President Clinton lied about his affair with Monika Lewinsky and the “depends on what the definition of is, is” thing.

In 1993 Republican Senator John Chafee of Rhoda Island, the father of current Senator Lincoln Chafee, introduced a bill called “Health Equality and Access Reform Today Act of 1993” or “HEAR Act of 1993”. This webpage compares the ACA with the HEAR Act. There are many similarities and some notable differences.

One difference is of course Medicaid expansion. It is hard to comprehend Republicans embracing Medicaid expansion, when the fought so vigorously against Medicare and Medicaid. The HEAR Act included medical malpractice reform. I do not know the details of what that entailed and if that was good for the rich or benefited society. I can, however see this provision as something with which Democrats could find common ground with Republicans. Heck, depending on the provisions, I might be open to it.

I am not sure what Senator John Chafee had in mind with “Equal Tax Treatment for Insurance of Self Employed”. I know that the ACA does not offer this provision. Equal tax treatment for health insurance for self-employed seems fair. The ACA prohibits insurance companies from setting lifetime spending caps. I see no reason why the right would in that time be open to eliminating lifetime limits like the ACA does today. That is a popular provision and a correct one. The idea is to give healthcare to all Americans.

The ACA extends coverage to depends until the age of 26, a quite popular provision and one that even Republicans of today were happy to keep in Trumpcare, so I see no reason why John Chafee would not have been in favor of that then had the thought come up.

The last difference is that the Congressional Budget Office (CBO did not come up with a price tag. I am not sure the reason here. The CBO estimated the ACA as $871 million over 10-years. The ACA will cover 94% of Americans by 2019, 10-years after the introduction of the bill. The HEAR Act was to cover 92% to 94% by 2005, 12-years after introduction of the bill.

Before going any further, Hillary Clinton and the Democrats wanted universal health coverage with a single payer. Republicans were at the time, as some Democrats, dead set against that. That was why the Republican Party came up with the HEAR Today Act of 1993. As I understand events, House Speaker Newt Gingrich was set to strike a deal with President Clinton and the Democrats on Health Care, but then Monika Lewinsky happened. Republicans were all on board back then for the HEAR Today Act, so the acts demise was at the hands of Democrats, sad, as years later Democrats introduced an updated version of the HEAR Act, which the right hates.

The problem was that Democrats did not realize that you cannot get universal coverage at the stroke of a pen and not have problems and get everyone on board. They eventually realized that back in 2009, when they crafted the Affordable Health Care Act of 2009. The approach was to do something about healthcare, but keep the system largely in place and something that all parties including the insurance companies could buy into. That was, basically the Republican approach.

If the right would get beyond politics, the HEAR Today Act or known today as the ACA is a huge first step, a wonderful step. Sadly, we have the left flanks of the Democratic Party chanting the reframes from 1993 wanting “Universal Health Care or Bust”. Seriously, has the population of the planet not tired of the “Bernie or Bust?” We have bust and see where that got everyone? Unbelievable!

Allen Clifton wrote quite nicely about what Bernie Sanders, himself, and many Progressives want. They talk about the failings of the ACA and the high cost, because insurance companies are for profit. I, however, disagree with part of what Allen said. The reason Republicans effort to rewrite healthcare failed was because moderate Republicans did not think that Trumpcare went far enough, as Allen did say, however the Freedom Caucus, a group of ultra-conservative/radical Republicans, who hold much sway, felt that Trumpcare went too far and that it was “Obamacare Lite” and infringed upon insurance companies and freedoms (to screw people and make huge amounts of money for the rich, IMHO). In the end, the two diverse camps in the Republican Party could not come together.

It is another thing that Republicans want to screw the 99% and do not care about the 99%. “ALL” Republicans are on board with screwing over the 99%. The question is just how much and how soon. The $75 billion would never have gone to the public or if it did would be stripped down. I could have imaged a “block grant” to the states to put into their Republican leader’s pockets.

Democrats had the same problem but were able to come together to pass the ACA. Even now there is fighting within the Democratic Party, like I said.

If you look beyond words, Universal Healthcare, what Allen and Bernie want, is possible with what Chuck Shumer proposed the other day with a “public option” added onto the ACA law. I can imagine Medicare expansion for all at a reasonable or free cost. A Public Option is a next “baby step” to the ACA, a logical progression.

Big changes all at once are rarely possible. When Democrats united and adopted a modified HEAR Today Act and rebranded the document as the ACA, the law got passed and has become quite successful. Now that people start to understand the act and like the provisions, people stood up in droves to defend the law and kill Trumpcare. Nobody wants to go back. See? That was a progressive change, just 16-years later than it should have been. A “Public Option” would be the next logical step and one that the Democratic Minority Leader, Chuck Shumer wants, not to mention I support. Going “Universal Healthcare or Bust” will screw everyone. We have been down this road.

We must win back control of Congress and then get the White House. Additionally, the 2 sides have to stop fighting and have to develop a spine, because passing the ACA was how we lost Congress in the first place. Do not forget that Republicans at the time were spreading lies and saying “no”, which the public bought up.

Also, if Progressives were able to get universal health care, the right would probably be united in unraveling it, as all are opposed to that. A Public Option would seem the most prudent. That is a baby step towards universal healthcare. It was this “baby step” that allowed for passage of the ACA in the first place.

The good news is that hopefully House Speaker Paul Ryan meant what he said that the Affordable Care Act is the law of the land and will be. There is not a Democrat, who would not say that the ACA needs work. That was a common sentiment back when the law was passed. It was a good start, an awesome one.

Republicans should be asking for malpractice reform, equal tax treatment for self-employed, and other reasonable changes to health care. The best way to reduce the deficit and get everyone employed is to start with giving everyone healthcare inclusive of checkups, women’s health care, mental health, and all the other things that one needs to work. Health Care is a right, not a privilege, just we need to get there.

I look forward to Republicans swallowing their pride that Democrats and an African American President passed their bill and called it the ACA instead of the HEAR Today Act and offer real changes, such as the two that I mentioned, which I took from Republican Senator John Chafee’s bill. By the way, his son, Lincoln Chafee, current Senator from Rhoda Island, was originally a Republican, but then switched allegiance.

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