‘Trumpcare’ debate divides Pa. politicians

March 23--For years, Republicans in the U.S. House of Representatives demonized the Patient Protection and Affordable Care Act, unofficially known as Obamacare.

They voted to defund the program championed by former President Barack Obama, claimed it threatened the health care of Americans, and made their opposition the centerpiece of many political campaigns across the country. But any plans to repeal the law were moot, since Obama -- with the power of a veto at the ready -- was president.

Now, on Thursday, the House is scheduled to vote on the Republican alternative, the American Health Care Act. But even though the GOP holds a strong majority in the chamber -- 237 to 193 -- and has President Donald Trump in the White House, the legislation's future is uncertain.

All Democrats plan to vote against the AHCA, introduced by Speaker of the House Paul Ryan, a Republican from Wisconsin. Therefore, no more than 21 Republicans can oppose the measure if it is to pass. An unofficial whip count, compiled by The New York Times, listed 142 Republicans in favor of the bill, 56 undecided/unclear, 17 concerned/leaning no, and 22 opposed, as of Wednesday afternoon.

The Times considered the Johnstown area's two congressmen -- U.S. Rep. Keith Rothfus, R-Sewickley, and U.S. Rep. Bill Shuster, R-Everett -- to be undecided/unclear.

"Obamacare has been a disaster," said Rothfus, who represents Pennsylvania's 12th Congressional District, in an email statement on Wednesday. "It must be repealed, and we are looking for solutions to bring relief to Pennsylvanians.

"The current Republican bill has some hurdles that need to be overcome, and we're working to overcome them."

Casey Contres, spokesperson for Shuster, from the 9th district, said: "Republicans have two choices, to stand with (House Minority Leader) Nancy Pelosi and let Obamacare remain law, or to follow President Trump's leadership and finally repeal and replace Obamacare. Congressman Shuster appreciates President Trump's leadership and full backing of the American Health Care Act. While he will continue to review the measure as potential policy changes are discussed, he looks forward to finally eliminating Obamacare and the negative consequences it has had for his constituents."

Opposition has come from hard-line conservatives, including some Freedom Caucus members, who do not think the GOP plan goes far enough to get rid of Obamacare.

Both the ACA and its proposed replacement would prohibit insurance companies from turning down applicants with pre-existing conditions or capping annual and lifetime limits, while allowing parents to keep children on their plans until age 26.

The GOP proposal would undo Obamacare's mandate for citizens to get insurance, but replace it with a policy requiring any customer who goes without insurance for more than two months to face a 30 percent premium surcharge when looking to purchase a new plan.

Ryan and Trump's proposal would place a per-capita cap on Medicaid. It would also eliminate funding for Medicaid expansion by 2020.

"Without a significant federal investment, hundreds of thousands of Pennsylvanians will lose health care coverage," said Pennsylvania Gov. Tom Wolf, a Democrat.

"The state would have to find $2.2 billion to cover the costs of just those in the Medicaid expansion category, a cost we simply cannot absorb without devastating cuts to other critical programs. The majority of the people who will be affected are working people who do not have access to affordable coverage through their employer."

Obamacare currently provides income-based subsidies for customers to purchase insurance. The American Health Care Act would replace those with age-based tax credits: $2,000 (ages 20-29), $2,500 (ages 30-39), $3,000 (ages 40-49), $3,500 (ages 50-59) and $4,000 (age 60 and up).

For example, a 60-year-old resident of Cambria, Somerset or Bedford county -- with an annual income of $75,000 -- would receive $0 in subsidies if Obamacare still exists in 2020. The same customer would get a $4,000 tax credit under the Republican proposal, according to information from the Kaiser Family Foundation website.

The same $4,000 GOP-backed tax credit would be a decrease in funding for a 60-year-old making $20,000.

The 2020 Obamacare subsidy for that person would be $6,120 in Bedford, $7,830 in Somerset and $7,830 in Cambria.

Insurance companies would be allowed to charge older citizens five times more than younger customers under the AHCA, as opposed to the three-time limit used currently under Obamacare, per the Congressional Budget Office.

"For older Americans, TrumpCare is highway robbery," U.S. Sen. Bob Casey said.

"It strips older Americans of the ability to afford health coverage while lining the pockets of the wealthiest individuals and companies. The TrumpCare scheme is a profound betrayal of our seniors, penalizing people for getting older and neglecting the most vulnerable members of our families."

A recent Congressional Budget Office report projected the American Health Care Act would reduce federal deficits by $337 billion over the 2017-2026 period, while increasing the nation's number of uninsured citizens by 24 million.

The CBO forecast the average premiums for single policyholders should be approximately 10 percent lower by 2026 than if the Affordable Care Act remains.

Dave Sutor is a reporter for The Tribune-Democrat. He can be reached at (814) 532-5056. Follow him on Twitter @Dave_Sutor.

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