The Republican Plan to Repeal and Replace Obamacare by Terry AmRhein

The Republican plan to repeal and replace Obamacare is to provide tax credit on individual’s tax returns to cover the purchase of health care insurance.  It really isn’t a health care plan, it is a tax plan.

            The way the plan would work is you would get a credit on your tax return if you bought health care insurance during the year (no one would be required to obtain insurance).  The tax credit is based on a person’s age and income.  As time passes the tax credit increases based on your age but not your income.  Health insurance premiums therefore would increase faster than tax credits so the tax credit would not cover the premiums.  In addition, the premiums for older people are allowed to increase up to 5 times the costs of younger people’s care thereby increasing health care coverage for the elderly even more.      

            Based on the analysis performed by the Congressional Budget Office (CBO), a non-partisan agency that calculates the financial consequences of government policies, the Republican health care plan would result in 14 million people losing health care coverage in the first year.  By 2026 the number of people without health care would reach 52 million, 24 million more than if Obamacare stayed in place.  This reduction in coverage is caused by three factors.

1)      Without the individual mandate required by Obamacare, many people, especially the young, would voluntarily drop their coverage. 

2)      With fewer people paying for health care and with a higher percentage of older people on the health care roles, the price of health care insurance would increase causing even more people to drop coverage.

3)      As years pass and health care premiums become much higher than the tax credits provided by the government, even more people will be unable to pay for health care insurance.  In addition, expanded Medicaid program offered by Obamacare will be dropped causing poor people presently on Medicaid to be turned away, adding even more people to the roles of the uninsured.  

The CBO analysis goes on to show that by 2026, almost 40% of the people age 30 to 49 with income below $30,300 would not have health care insurance.  Were Obamacare still in place, the number is projected to be only 20% without insurance.  For those between 30 and 49 with income above $30,300, 10% would not have health care coverage under the Republican plan but under Obamacare only 5% would be without coverage.  The conclusion of the CBO analysis is that older and poorer Americans would be hurt the worst by the Republican plan while the young and the wealthy would get a benefit.

            Of course, many Republicans claim that the CBO analysis is bias or incorrect.  However, both sides of Congress regularly depend on CBO analysis to predict the outcome of congressional policies.  And the CBO projections are usually fairly accurate.  For example, the CBO prediction of the total number of uninsured resulting from Obamacare was off by only 20%.  Considering the magnitude of Obamacare and the uncertainties of the program, 20% accuracy is reasonable.  Also, even if the CBO estimate is 50% off, 50% of 52 million people is still a lot of people without health care.  Before Obamacare, the United States was the only industrialized nation that didn’t provide health coverage for all of its citizens.  If the Republican plan goes through, the United States will again claim this notoriety.  This is hardly “Making America Great Again”.

Terry AmRhein is the author of the new book, "Democracy on the Edge, A Discussion of Political Issues in America"

Repeal and Replace with What?

Repeal and Replace with What?

Republicans have promised to repeal and replace Obamacare.  The question is, replace it with what?  Here’s an idea.  Replace it with a national Medicare like program.  Medicare was created in 1965 to provide health care coverage for all Americans over the age of 65.  Members of Medicare love the program.  The approval rating among those participating in Medicare is over 90%.   And you don’t have to worry about your doctor participating in Medicare because almost all doctors accept Medicare patients.  Medicare is already a working and functioning program, so there should be less confusion with setting up the new program, basically all that is needed is to expand the eligible participants to include all Americans rather than only those over 65.  Additionally, with so many new people under age 65 participating in this new Medicare program, many of them who are healthy, the Medicare premiums will be far less than medical insurance premiums now.  It will be a realistic and valuable improvement to Americans medical care systems.

If you like this idea, please share it with a friend.

Terry AmRhein, author of Democracy on the Edge

A Close Look at Why Hillary Clinton Lost the Election

A Close Look at Why Hillary Clinton Lost the Election

by Terry AmRhein

Almost every political fortune-teller in the country predicted that Hillary Clinton would win the

Presidential election.  But yet she suffered a stunning defeat.  Clinton has eminent qualifications to serve in office.  She graduated from Yale Law School.  She co-founded the Arkansas Advocates for Children and Families and helped create State Children’s Health Insurance Program to provide health insurance for poor child.  Between 1993 and 2003, she served as First Lady with Bill Clinton.  In 2001 she was elected the first female Senator from the State of New York and served until 2009.  In 2009, she was appointed to serve as Secretary of State with the Obama administration where she helped negotiate the Iran uranium enrichment treaty that reduced Iran’s stock pile of enriched uranium by 98% and reduced the number of gas centrifuges used for uranium enrichment.  Yet the voters elected someone with no experience and no qualifications at all.  

            The fortune-tellers claim that during their polling, they didn’t pay sufficient attention to the rural non-college educated working class people who were not polled during the surveys.  Apparently there is a vague group of thousands of voters wondering aimlessly around fields of corn, wheat and cattle unnoticed by the pollsters, sort of like a farm version of the land of the walking dead, and they miraculously appeared on election day.  I don’t think that was the reason Hillary lost.

            Look at the voting statistics for presidential elections from 2008 to 2016 below:

2008 Presidential Election
Race	% of population	Democrats	Republican
White	74%	43%	55%
African American	13%	95%	4%
Hispanic	9%	67%	31%
2012 Presidential Election
Race	% of population	Democrats	Republican
White	72%	39%	59%
African American	13%	93%	6%
Hispanic	10%	71%	27%
2016 Presidential Election
Race	% of population	Democrats	Republican
White	63%	37%	58%
African American	13%	88%	8%
Hispanic	17%	65%	29%

The percentage of white voters who voted Republican was 55% in 2008, 59% in 2012 and 58% in 2016.  If a large number of white Republicans mysteriously appeared in 2016 to vote for Trump, the percentage of whites voting Republicans would have increased.  But it did not, whites voting Republican actually decreased by 1% this election!  In fact going back to the 2000 election, Gore v Bush, the statistics show that white voters voted 55% Bush and 42% Gore and in 2004, Kerry v Bush, whites voted 58% Bush and 41% Kerry. So whites have voted consistently, since at least 2000, about 57% vote Republican and 40% vote Democrat with other fringe candidates making up the difference to 100%.  Who the Republican candidate , or who the Democratic candidate is, makes little difference.  By and large the popular vote for white Americans is determined by party loyalty, not the candidate.

Likewise, the minority voters vote consistently Democratic.  95% of African American and 67% of Hispanic voted for Obama in 2008 and 93% and 71% voted for Obama in 2012.  Obama was elected because the number of minority voters was large enough to overcome the white Republican vote.  Even going back to 2000 (Gore v Bush) 90% of African Americans and 62% of Hispanics voted for Gore while only 9% voted for George Bush.  In this most recent election, Clinton only got 88% of African Americans, (a 7% point drop from 2008) and 65% of Hispanics (a 6% drop from 2012).  It was enough for her to win the popular election by 2.6 million votes nationwide, by 2.1%, of the vote, but she didn’t win the Electoral College.  Trump is right, the election is rigged, but in his favor.

The Electoral College was devised by our founding fathers as a compromise between various options for electing the president including choosing by direct popular vote and choosing by votes of congress.  Selecting the president by popular vote was problematic because of the slave issue in the South i.e. how would you count slaves for voting purposes. Selecting the president by a vote of congress could make the president indebted to congress, violating separation of legislative and executive branches.  Also selecting the president by congressional vote worried our founders because the election would be held all at one time and all in one place and this would permit a greater possibility of voter manipulation.  The Electoral College offered a combination of the two methods, electors would congregate in their respective states, they would be electors only once, and each state would have delegates in proportion to their representation in congress i.e. the number of representatives the state was allotted plus two senators.   

The problem with the Electoral College is the apportionment of electoral votes.  The smallest number of electors a state can have is three, allowing for one representative plus two senators.  So for a very small state like Vermont, that has only about 750,000 residents, each of the three electors represents about 250,000 people.  California however has about 39 million people and has 55 electoral votes, so each elector represents about 700,000 people.  California should have more electoral votes in order to have each elector represent an equal number of citizens.  Every ten years, federal representatives are reapportioned based on the national census.  So after the 2020 census, California should receive a higher number of representatives and electors.  Until then though, the state is under represented.   Also in most states, with the exception of Maine and Nebraska, the winner of the state takes all of the electoral votes i.e. winner take all.  So Trump won Michigan (16 electoral votes), Wisconsin (10 electoral votes) and New Hampshire (4 electoral votes) for example by less than 1% of the vote and won Florida (29 electoral) and Pennsylvania (20 electoral votes) by a little over 1% of the votes but Trump received all of the 79 electoral votes these states are allocated.  Clinton got no credit for winning almost half of the votes in these states.  Trump won the election by winning states by small margins but did not win the popular vote because Clinton won large states, California and New York for example, by wide margins.    

This flaw in electing our president by the electoral system is no trivial matter.  George Washington became the president of the U. S. in 1789.  Since then a presidential election has been held 57 times.  In five of those cases (1824, John Quincy Adams v Andrew Jackson, 1876 Rutherford B. Hayes v Sam Tilden, 1888 Benjamin Harrison v Grover Cleveland, 2000 George W. Bush v Al Gore and in 2016) the president lost the popular vote but won in the electoral college.  This represents 8.8% of all the elections.  So in almost 10% of the elections, one out of ten, the president has not received most of the popular vote.  Changing the presidential election process to a popular vote would require a constitutional amendment, a very difficult task indeed.  The problem could be mitigated by the states if all the states agreed to allocate their electoral votes in proportion to the electoral votes that each candidate received.  But all states would have to agree to this at the same time.  Otherwise some states would be splitting their votes between candidates and others would still use the winner take all system.  Another suggestion that would avoid a constitutional amendment and would assure that the candidate with the most national votes won the election, is for individual states to allocate all their votes to the candidate that won the most national votes i.e. a winner take all based on the national election.  This would avoid allocating electors by popular state vote and would assure that the winner of the national election actually became President.     

Clinton lost the election because she didn’t win the smaller states and Michigan, Pennsylvania and Florida.  And she didn’t win these states because she didn’t control the nation’s “dominate narrative” about where the country was going and how our problems can be fixed.  She didn’t convince these states that she knew how to fix their problems.  During the campaign, Donald Trump incessantly talked about “Making America Great Again” and “Lying Hillary”.  Clinton allowed Trump to control the conversation.  Clinton’s strong qualifications for office were barely mentioned.  The fact that unemployment stands at 4.9% (the lowest in years) and workers are gaining employment, a stock market near an all-time high, low inflation and a growing GDP went without mention by Clinton.  The fact that 20 million people now have health insurance that didn’t have it before Obamacare and that insurance companies can no longer disqualify people from coverage because of pre-existing illnesses.  Clinton hardly mentioned the Democrat plan to raise the minimum wage to $15 per hour which would help lower income families, or the plan to require paid family leave for all families or the plan to provide a college education to all Americans that desire to go to college.  In addition, the Clinton emails scandal was continuously harped on by Trump.  Yet Clinton never forcibly and convincingly responded to the accusations.  She let Trump make her look guilty and as a result, many people believed she has gotten away with a crime. 

            In addition, Clinton didn’t pound on the scam job of Trump University (which Trump paid $35 million to settle out of court) and where students received little for their tuition.  Nor did she hammer on Trump’s charities in which he paid none of his own money but used donations to the charity for his own profit and self-aggrandizement.  Using money donated to a charity for self-profit is felony fraud.  She should have pounded on this unmercifully, but she did nothing!  

The table also reveals another interesting point.  The fact that the white voters and the minority voters are polar opposites each other, is an indication of how divided our country is.  Within a true democracy, the ethnicity of citizens should not matter.  But in the real world, prejudice and bigotry exists and play a big part in dividing the country.  As the proportion of white voters within the country slowly decreases while the proportion of Hispanics increases, the divide is going to continue to increase.  But there’s more to it than that.   In each election, over 50% of whites voted Republican.  The minority vote was even more lopsided in the other direction.  In each election well over ten times as many Blacks and twice as many Hispanic voted Democrat as voted Republican.  America is becoming a country of whites and a country of minorities.  Each group has its own identity and its own goals that are in conflict with the other group.  A president like Trump who exacerbates bigotry, will make matters even worst.

Terry Amrhein is the author of the acclaimed book, “Democracy on the Edge, A Discussion of Political Issues in America”, voted best political book of 2016 by the Pacific Book Review.