Ep 318 ｜ Trump vs. Biden 2020： Health Care
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Summary
Health care is the second most important issue to voters, after the economy, and according to Pew Research, it's the second-most important issue in American politics. Today we're going to talk about the Affordable Care Act aka Obamacare, and why it's a step towards single-payer health care.
Transcript
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hey guys welcome to relatable happy monday we are this is my this is my last subject to talk about
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before the election we'll continue to talk about it over the next couple weeks um but this is my
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last big subject and we're going to be talking about health care last week we talked about
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climate change and the environment today we're talking about health care which is a really big
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deal to a lot of people according to pew research it's the second most important issue to voters
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right after the economy has a direct effect on your life of course it's important and it should
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be important um we're going to talk about the affordable care act aka obamacare the reason why
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that's relevant to this campaign to this election is because joe biden has promised to expand obamacare
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but as i'll explain his plan actually actually obliterates obamacare and it's a it's a step
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towards single-payer health care and that shouldn't be surprising because the champion
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of single-payer health care in the senate is bernie sanders and bernie sanders as the head
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of the unity task force for joe biden he is the farthest left member of the democratic party but
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as the head of the unity task force for joe biden he has helped him craft his health care policy
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proposal and it very much looks like medicare for all um but let's talk about let's talk about
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obamacare because there also are some similarities and it kind of gives us some context for the
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difference in perspectives on health care policy between republicans and democrats um so republicans
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have always been against obamacare aka the affordable uh care act because not because republicans
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don't want people to have health care but because they believe it to be ineffective and
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unconstitutional the individual mandate in obamacare find people for not having health
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insurance in national federation of independent business versus sebelius scotus ruled that the
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individual mandate is just a tax and so it is constitutional now amy coney barrett you probably
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heard a lot recently like in the hearings she disagreed with that argument which is why people are
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saying that your health care is on the line if acb is confirmed which is not actually
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factual uh disagreeing with the constitutionality of a particular decision does not mean that acb
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necessarily has the power desire to take away your health care but there is a case coming up after the
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election that acb would be sitting for um and would be helping decide uh that has to do with the
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affordable care act and the constitutionality of it and so that is why people are afraid but of course
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like obama if they wanted something to be solid they should have done something constitutionally
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that's what republicans have been saying all along in 2017 trump's tax cuts and jobs act eliminated the
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penalty of the individual mandate biden says he wants to bring back the individual mandate and the
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penalty associated with it after the penalty from the mandate was repealed republican attorneys general
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argued that it was unenforceable that is what the case going before the supreme court is going to
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decide after the election uh the u.s health care system is different just getting into a little
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bit of background it's different than most countries in that it is not a nationally paid health service
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that of course is what a lot of people on the left would like uh it's not a single payer it is not
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uh or a multi-payer health fund the u.s health system can be described as really a hybrid system it's
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complicated network of multiple payers involving both private and government health insurance options
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america is the only developed country without universal health care we do have publicly funded
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aka government-run insurance companies we have medicare we have medicaid we have children's health
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insurance program or uh chip and the va about a third of americans are covered by medicare medicaid or
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chip um the reason why obamacare was enacted the affordable care act was enacted back in 2010
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uh is because there are still people that are uninsured or underinsured maybe they don't get
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coverage through their employer they couldn't qualify for medicare or medicaid especially if
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you are like a young adult who is in a state that didn't expand medicaid uh maybe you didn't apply for
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it at all and so obamacare was meant to cover you and the purpose of the legislation was to make it
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more affordable to purchase health insurance they also wanted to lower the cost of health care
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reduce the growing costs of medicare and medicaid throughout the country promised to do it by
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offering consumers discounts known as tax credits on government-sponsored health insurance plans and
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by expanding the medicaid assistance program to include more people who don't have it in their
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budgets to pay for health care also changed a lot of the rules that insurance companies have to
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follow for example in the past if you had a pre-existing medical condition you could be turned down
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for insurance uh from these companies or the coverage for your cost would be astronomical but
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the affordable care act said you can't be turned down just because you have a pre-existing condition
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that is actually a very popular part of the affordable care act uh you only receive discounts
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according to this law to help offset health insurance costs if your household income is between
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one and four times the federal poverty level which is the number the government uses to determine the
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minimum amount of money needed for food shelter and other basic needs uh americans who meet certain
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income-based criteria must by law have insurance that's where the individual mandate comes in that's where
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that penalty comes in you have to pay a penalty if you don't have some kind of health care coverage
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and that individual mandate was the most controversial part as we already talked about of the affordable
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care act democrats included it because they figured that it would force young healthy individuals
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to report in the house or to enroll in the health care exchanges as something they said would offset the
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higher cost of covering people with chronic diseases they also assumed people would take care of
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themselves which would theoretically reduce future health care expenses but republicans were and still
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are very opposed to this mandate they believed and believed that the penalties would be an unneeded burden
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on families who maybe weren't covered by private insurance didn't want or couldn't afford
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uh obamacare but now had to pay the coverage or else they'd get penalized they saw this as both
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counterproductive and tyrannical it's one thing to expand medicaid so that more people can be covered it's
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another thing to force people who don't have insurance onto a government plan they were afraid that this
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would harm low-income families the most and republicans were right about that according to the irs more than
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half of the total penalty payments uh that people who didn't get obamacare had to pay uh because of the
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individual mandate come from people earning less than fifty thousand dollars so most of the people
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paying the penalty because of the individual mandate in obamacare were making less than fifty thousand
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dollars a year eighty six percent of those people paying that penalty because they didn't have health
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coverage uh came from people making less than a hundred thousand dollars a year that's why uh ted
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cruz and other conservatives put up a fight about this in 2013 it ended in a government shutdown
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and trying to defund obamacare uh now that ended up being unsuccessful ted cruz took a lot of flack
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from both the right and the left for for threatening to push the government into a shutdown but it's also
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what launched him into uh the forefront uh of the political scene so maybe that uh did pay off for him
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um in 2017 republican controlled congress eliminated the mandate that went to into effect uh last year
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uh democrats wanted to use that to say that you are kicking millions of people off of their insurance
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by doing this no you're just making sure that people aren't forced to be on insurance um and so it's not
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the same thing as kicking off but that's just a rhetorical play that democrats have done advocates
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of obamacare will say that it slowed the rise of health care costs and that it did this through
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providing insurance for millions and made preventative care free it's good because it requires insurance
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plans to cover essential health benefits including mental health addiction and chronic diseases
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insurance companies can no longer deny anyone for pre-existing conditions or raise your costs
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due to pre-existing conditions but critics of the ACA will cite the harm that it did 3 million to 5
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million people lost their employment-based health insurance because a lot of businesses found it more
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cost effective to actually pay the penalty and let their employees purchase insurance plans on the
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exchanges rather than provide insurance for their employees other small businesses find they can get
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better plans through state-run exchanges so a lot of people lost plans that they liked and they lost the
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quality coverage that they actually preferred and this is where the big lie was uncovered if you like
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your doctor you can keep your doctor even politifact says that this was a huge lie and it was obama
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repeated that over and over again and then in 2013 said that oh you know that's not really what i said or
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that's not what i meant but he did and it was a promise republicans knew from the beginning when he made
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that promise that he could not keep politifact explains it it says uh the affordable care acts tried to allow
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existing health plans to continue under a complicated process called grandfathering which basically said
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insurance companies could keep selling plans if they followed certain rules the problem for insurers
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with that was that the obama care rules were strict if the plans deviated even a little they would lose
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their grandfathered status in practice that meant insurers canceled plans that didn't meet the new
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standards so a lot of people lost the coverage that they liked because of obama care and
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ultimately i believe that is the goal to get people off of the the private health insurance that they
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like and to get them on to government-run health care health care coverage uh obama care required
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services that many people don't need uh like maternity care that meant if someone had an insurance plan
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that didn't cover maternity care that plan had to be canceled so that was one of the rules which was
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really awful for a lot of people for example if you're a 60 year old man or woman uh with health
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insurance but she didn't purchase an insurance plan that covered maternity or pediatric care because
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why would you your plan got canceled this happened to millions and millions of people and replacing the
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affordable plan that these people liked with another plan cost a lot of money to people uh obama and his
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team lied about that over and over again saying that there's nothing in the plan that pushed people
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off their health care coverage but that just wasn't true that was demonstrably not true obama actually
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did somewhat apologize somewhat somewhat apologize in 2013 for misleading people uh and i just want to
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say that when people say that the obama biden a presidency was scandal free this was actually a huge
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scandal not to mention benghazi not to mention fast and furious in the irs uh but that is uh that that
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that's a different story the fact of the matter is it's just not true that their presidency was
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scandal free uh there were a lot of people that were upset about this about this lie in 2013 a pew
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research poll found that the number of people who saw obama as untrustworthy rose by 15 points
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in 2013 because of all of this here's the thing people don't like their health care coverage messed
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with if they like it and a lot of people do a lot of people really like their health care coverage
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a lot of people are satisfied with the coverage that they get from their employer the center for
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medicaid and medicare services titled think obama care for the rise in the uninsured also talks about
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how obama care didn't actually solve the problems that it set out to do while obama care promised
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affordable health insurance for every american and even penalized those who refused to buy it the law
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did nothing to control underlying costs the very structure of the law which imposed billions of
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dollars in new costly regulations also led to higher and higher insurance premiums as a result when
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president trump took office in 2017 average individual market health insurance premiums in
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states using healthcare.gov had already doubled when compared to 2013 the year before obama care's
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main regulations took effect average premiums went up by another 26 percent in 2018 at the same time
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individual market premiums were spiking out of control centers for a medicare and medicare and
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medicaid services data show a substantial enrollment drop among unsubsidized people on the individual
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market who do not receive federal premium tax credits in just two years for 2016 and 2018 unsubsidized
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enrollment declined by 2.5 million people a 40 percent drop these numbers clearly show obama care has
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created a serious affordability problem on the individual market and this was all put in motion
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before president trump took office let's remember that insurers process for setting rates for 2018 was well
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underway at the beginning of 2017 when president trump took office and based on policies set in place under
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the obama administration simply put there are too many people without subsidies who cannot afford coverage
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under obama care there was also under obama care the very controversial contraceptive mandate which requires
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insurance companies and employers who provide health insurance to cover the cost of birth control the problem is
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there are a lot of religious organizations who are opposed to birth control for religious reasons so
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forcing them to pay for it would be an infringement upon religious liberty the contraceptive mandate wasn't
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actually in obama care legislation uh but it originally or but it came uh later in 2011 it offered only
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narrow exceptions to churches but did not include religious non-profits like little sisters of the poor there was a
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supreme court case also in 2014 involving hobby lobby which is a corporation owned by christians and the
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court ruled that closely held religious for-profit corporations did not have to provide birth control
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for their insurance plans uh little sisters of the poor endured is still enduring years of court battles
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until in may 2016 the supreme court ruled um the well they're still they're still going through this but
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in 2016 we actually thought the battle was over because the supreme court ruled in their favor um and
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instructed the lower courts to provide the government an opportunity to find a way to provide services to
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the women who want them without involving the little sisters so that the little sisters of the poor
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wouldn't be forced to cover birth control because uh birth control it's just true we did an episode on
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birth control and ivf and all of that you can go back and listen to that i think it's in the title so you can
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just type it into your podcast app uh but uh birth control pills have abortifacient uh the components
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to them and so you are not going to get a catholic organization who are unequivocally pro-life to pay
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for birth control that's something that they are against and yet the obamacare uh legislation said
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that they must do so that is cruel obama and his administration was continually cruel towards christians
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and religious liberty you can look up the uh irs scandal to see more proof of that this is from
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beckittlaw.org in may 2017 president trump issued an executive order directing hhs and other federal
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agencies to protect the little sisters of the poor and other religious non-profits from the mandate
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on october 6 2017 the government issued a new rule with a broader religious exemption that is under
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president trump in june 2018 uh the little sisters original case was resolved with an order by the
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u.s court of appeals for the 10th circuit and on november 7th uh 2018 hhs issued a rule finalizing
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the little sisters religious exemption but actually in 2020 they won another supreme court battle and it
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is likely to keep going in front of the supreme court so thanks so much obamacare for your attack
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on religious liberty uh you hear democrats say republicans don't want you to have health care
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coverage well republicans don't want you to be forced to have health care coverage that you don't
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want republicans didn't want you to be fined for that uh they don't think that forcing higher taxes
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to pay for obamacare is a good idea especially since as we've seen obamacare actually didn't fulfill
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a lot of the promises that it uh that it gave in the beginning republicans don't think the federal
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government needs to be so involved in health care republicans don't want the federal government to
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infringe upon religious liberty so it's not so black and white as saying republicans don't want
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poor people to be covered that's just not true um and yet this is what many democrats are saying and
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and what they want is more federal involvement uh in the health care system and more of obamacare
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and what they actually want what a lot of democrats want is something called medicare for all not just
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health care for all which would mean there could be a mix of private insurers and public options
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but medicare for all meaning that we are all on medicare there is no choice you get no private
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health insurance provided by your employer we are all on government funded health care like canada or
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uh other countries that have entirely government funded health care now joe biden has not explicitly
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endorsed medicare for all but his health care plan again was crafted by bernie sanders the champion of
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medicare for all and as i will explain soon has the same goal which is the eventual total government
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control of health care which as we will explain will lower the quality of care that we receive
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so even though joe biden's plan isn't called medicare for all i still think it's important to
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explain medicare for all uh since it's so popular among democrats and to super liberal voters and is
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connected is very similar to medicare for all uh democrats say that medicare for all will lower the
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cost of medicine and basic care this will obviously eliminate premiums and deductibles because it will
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be funded by the government which as you know means it is funded by you and me by taxpayers it is not
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free for anyone unless you are a part of the low tax bracket that essentially pays nothing in taxes then
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you are getting something for absolutely nothing and everyone else is paying for it for you kamala
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harris vp candidate jumped on board with this idea a few months ago saying at a cnn town hall the idea is that
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everyone gets access to medical care and you don't have to go through the process of going through an
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insurance company having them give you approval going through the paperwork all the delay that
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that might require let's eliminate all of that let's move on as if going through bureaucracy eliminates
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paperwork and eliminates hoops to jump through everyone knows that going to the dmv or any government
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controlled institution is super easy and without any headaches because all of the employees are so happy to be
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there um and not only that but she had to go back on that not just for the reason that i just listed
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because that's so insane that's such an insane point to make even if you are going to try to support
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medicare for all that's not a good reason to support it that you won't have to jump through any hoops or do
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any paperwork but also because insurance is 18 of our economy and so if you're trying to get rid of that
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get rid of health insurance you're getting rid of a huge industry and a lot of people like i said
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really like the health care plans that they have so just an unpopular thing to say she is not a good
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politician she's just not she's not good at debates she's not good at town halls she's not good at
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interviews it's just kind of crazy how people idolize her in a way that i just don't think that she has
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earned uh there's also a problem with medicare for all of how hospitals would stay in business the
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reason is because hospitals get paid significantly less by medicare than they do by private insurance
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so this is according to the new york times for a patient's knee replacement medicare will pay a
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hospital seventeen thousand dollars the same hospital can get more than twice as much or about
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thirty seven thousand dollars for the same surgery on a patient with private insurance that's because
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medicare pays hospitals about 87 cents for every dollar of their cost compared with private insurers
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that pay a dollar forty five so smaller rural hospitals and health care centers would probably
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have to shut down because they can't afford to provide the same services or you're going to see
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hospitals laying off droves of employees in order to stay afloat and you know hospitals have already
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done that during the pandemic because the the emergency rooms in most places weren't as busy weren't as
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teeming as they originally thought that they were going to be uh that is the problem one of the
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problems with medicare for all it cuts revenue drastically which means a few things hospitals
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have to close down they have to fire employees or lower their quality of care now proponents of
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medicare for all say no no that's just not true health care can just cut costs and cut profits without
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doing any of those things we'll just take a little bit of sacrifice but those are people who it should
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not surprise us don't understand basic economics socialists don't understand basic economics these are the
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same people who believe that employers of small businesses are just going to raise the minimum wage
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of their employees to fifteen to twenty dollars take a huge cut to their own profits so that they
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can't feed their families without firing employees or automating employee tasks entirely these are
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people again who do not understand the basics of economics so we should not trust them to reconfigure
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our health care system and it might be true in some cases that hospitals are charging too much
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absolutely there are problems with the insurance industry that is for sure but medicare for all is
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not going to solve the problem that the vast majority of hospitals have which is simply that
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they are not going to be able to afford to function in a medicare for all system the new york times also
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says this those in favor of the most far-reaching changes including bernie sanders who unveiled his
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latest medicare for all plan as part of his presidential campaign have remained largely silent on the
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question of how the nation's 5 300 hospitals would be paid for pay and uh would would be paid for
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patient care if they are paid more than medicare rates the final price tag for the program could
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balloon from the already stratospheric estimate of upward of 30 trillion dollars over a decade uh so
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what that last part part means is that if hospitals are paid more than they currently are now under
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that's going to cost us the taxpayer trillions and trillions of dollars more than the 30 trillion
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dollars that we're already going to have to pay for something like medicare for all um and so oh but
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if they don't if they are not paid more than current medicare rates then they're not going to be able to
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afford to function we're going to have fewer hospitals to choose from we're going to have less
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quality care uh just another reminder that nothing is free health care cannot be free
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college cannot be free taxpayers are paying for these so-called free services that many on the
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left offer once again it is not compassionate simply to vote for politicians who promise to take
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money from people richer than you and give it to people poorer than you like that is not compassion
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and it doesn't end well the redistribution of wealth doesn't end well socialism doesn't work as
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margaret thatcher said because eventually you run out of other people's money the profit margins on
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medicare for all for hospitals is too thin it's too thin for these hospitals to function so imagine if
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the entire system was medicare again you cut staffers to stay afloat which creates significant
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limitations on care that you can offer patients there's a reason why in the uk and in canada which
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both have universal health care people have to wait so long for major surgeries in a lot of cases
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there aren't enough physicians to go around because these hospitals can't afford to pay their
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physicians because they're not getting enough money from government-run programs fraser institute found
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that canada has some of the worst wait times for emergency rooms for basic sick care so not just for
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life-saving surgery but for basic sick care and for elective surgeries in fact in 2016 canadians waited an
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average of five months for medically necessary specialist treatments you'll remember my friend and my fellow
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blaze tv host lauren chin and they live in canada her dad has the health care coverage that canada
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provides well he was diagnosed with cancer almost a year ago now and they have continued to defer his
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treatments and to defer seeing him not just because of the pandemic which of course kind of put everything
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on hold that's another reason why the lockdowns were so stupid and counterproductive to public health
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but also because their health care system is bogged down they can't deal with something like a pandemic
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and still be able to run effectively and efficiently because like all government-run things it doesn't
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it doesn't work well and so he has had to come to the states they now have to pay out of pocket
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in order for him to get the cancer treatment that they want this is true for thousands that they need
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this is true for thousands of people living in places like canada and the uk every year they come
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here because america is the best innovation we have the best life-saving care that's not to say
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that our system doesn't have serious problems but i'd prefer this any day over a place like canada
00:25:02.480
and the uk where they have to come here to get the life-saving care that they need 60,000 of 60,000
00:25:08.880
canadians visit the u.s and other countries for medical care each year 60,000 in the uk uh they have
00:25:14.720
had 70 years to figure out how to run a government-controlled health care system and right
00:25:19.120
now over 80 percent of doctors in the uk say their workplaces are understaffed that probably
00:25:25.100
explains why over 50,000 non-urgent surgeries were canceled in 2018 when their system was overwhelmed
00:25:31.240
by flu season just flu season that's not even coronavirus just flu season their system was
00:25:36.200
overwhelmed and 50,000 quote non-urgent surgeries we don't know what all that uh encompasses were
00:25:43.240
canceled in 2018 because of the flu because they can't run the government-run health care doesn't
00:25:48.820
run well according to the heritage foundation by 2030 americans already face a serious and
00:25:54.040
potentially dangerous physician shortage ranging between 50,800 and 49,300 primary primary care
00:26:00.600
doctors and between 30,000 and 70,000 non-primary care doctors accelerated retirements job-based
00:26:07.480
burnout and growing demoralization fuel that shortfall and medicare for all will only
00:26:12.680
make that worse because places will be understaffed and people will be underpaid now the biden plan
00:26:19.720
like i said is not medicare for all it's not called medicare for all but it is admittedly the step
00:26:25.440
before medicare for all and it is meant to be that nbc news report uh says that biden campaign officials
00:26:32.620
have already said that biden's public option especially advantaged government plan to compete
00:26:36.920
against all private health plans could quote pave a path to a single-payer health program in the future
00:26:44.180
his plan offers a public option to quote compete with private options which sounds okay except that
00:26:51.420
public options do not fairly compete with private options they purposely obliterate them this is
00:26:56.700
according to robert moffitt at the heritage foundation their unity task force recommendations call for the
00:27:02.600
creation of a robust public option a new government health plan that would be deployed in competition
00:27:07.640
against private health insurance companies the target of this joint effort would include the
00:27:11.840
employment sponsored health plans covering approximately 156 million americans roughly half the country
00:27:18.280
this is an odd proposal initially a provision of obamacare the public option has been a staple of
00:27:24.100
progressive health policy for almost two decades today six major congressional bills meticulously detail the key
00:27:30.520
components of this approach like the biden sanders proposal these bills would deliberately rig the
00:27:35.620
health insurance markets to guarantee the new government health plan advantages denied to private
00:27:41.560
health plans why because government health programs generally cost more than initially advertised
00:27:47.480
and taxpayers can expect to pick up the tab one way or another to cover any financial losses incurred
00:27:52.960
forget fair competition on a level playing field like the congressional bills the unity task force proposal
00:27:59.200
it's a progressive political engineering project to distort health insurance markets it is designed to
00:28:05.200
erode and eventually eliminate america's private health plans it would create new taxpayer subsidies for
00:28:12.260
enrollment in the government plan it would eliminate deductibles for primary care and impose government
00:28:16.880
payment schedules on doctors the government enforced provider payment reductions would enable the new
00:28:22.700
taxpayer-backed government health health care plan to undercut private plan competition with
00:28:28.360
artificially low premiums so the goal is to eventually obliterate uh obliterate private health insurance
00:28:37.740
plans by making them unaffordable by making it really hard to compete against the government plans
00:28:43.640
because the government plans rig the system that is the goal that is how it leads to medicare for all
00:28:50.140
according to christopher jacobs author of the case against single payer he writes this for the federalist
00:28:56.020
by creating a government-run public option like sanders's the biden plan would also take away health
00:29:00.860
health coverage for millions of americans as i've previously explained a government-run plan would
00:29:06.680
sabotage private insurance using access to treasury dollars and other inbuilt structural advantages
00:29:12.560
in 2009 the lewin group concluded that a government-run health plan available to all individuals and
00:29:19.280
paying doctors and hospitals at medicare rates less than private insurance would lead to 119.1 million
00:29:25.480
individuals losing employer coverage biden staff estimates the plan will cost 750 billion dollars in the
00:29:32.340
coming decade on top of the estimated 1.6 trillion plus dollars the federal government will already spend
00:29:38.720
on obamacare subsidies but if many individuals end up losing their private insurance to go on to this
00:29:44.820
newly expanded program costs will soar exponentially also according to biden's plan illegal immigrants
00:29:51.900
can be covered by taxpayer uh taxpayer funded uh government health care plan so that is you and me
00:30:01.880
paying for the health care coverage of those who have come into the country unlawfully so the question
00:30:07.880
is since we know i believe that biden's health care plan will be an absolute disaster
00:30:13.120
will be a disaster will be unaffordable the regulations and the burdens will be unbearable
00:30:19.380
the cost will be astronomical the quality of care will go down um since we know that the question is
00:30:27.100
what is trump's plan because our health care system does have problems what did the republicans
00:30:30.980
propose well republicans understand a few things americans are concerned about high costs they like the
00:30:37.840
guarantee of pre-existing condition coverage but most americans do like their plans they don't want
00:30:43.060
to be thrown off their plan and forced onto a government plan but they want to be able to afford
00:30:47.680
things like insulin which is cheaper in other countries we also want america to be a place of
00:30:53.440
leading medical innovation as it is now when the private market shrinks competition shrinks innovation
00:30:59.140
shrinks and we are no longer the place where people from places like like canada and the uk can come for
00:31:05.280
their heart surgery or their cancer treatment we become just like them with long lines no guarantee of
00:31:10.260
lower quality care understaffed hospitals the trump administration and republicans want people to
00:31:16.980
be covered but they want people to have more options not fewer options uh much less one option
00:31:23.680
like medicare for all uh he issued an executive order last year to improve health care for u.s seniors
00:31:30.200
the federalist describes it like this the executive order promotes innovative benefit structures for
00:31:35.640
medicare advantage the program in which an estimated 24 million beneficiaries receive medicare subsidies
00:31:40.680
via a network of private insurers it discusses reducing barriers to obtaining medicare medical
00:31:46.320
savings accounts a health savings account like mechanism that gives beneficiaries incentives to
00:31:51.940
serve as smart consumers of health care to accomplish that last objective the order references broader access
00:31:57.440
to cost and quality data improving seniors ability to make decisions about their health care that work
00:32:04.200
best for them so it's looking to add expanded access uh more providers monetary savings entitlement
00:32:12.760
reform um and so this is putting more power in the hands of seniors it's giving them more options
00:32:19.880
biden's plan does the exact opposite of those now executive orders are limited ultimately we need
00:32:26.360
legislation through congress to really accomplish and implement um these things and of course executive
00:32:32.920
orders do have power when uh they are they are implemented by the various agencies that are in charge of
00:32:41.240
whatever the executive order is about but ultimately we want things like this to be passed democratically
00:32:47.560
but it's an executive order that ultimately leftists should like because it is setting out to improve the health
00:32:54.440
care of seniors but they actually don't because instead of giving more power to the federal government
00:33:00.360
you're giving more options and power to people to make their own health care decisions uh there was
00:33:06.040
also the american health care act uh the american health care act looks to uh keep certain provisions
00:33:13.320
of the affordable care act under obama like being able to stay on your parents plan until you're 26
00:33:19.720
um the exchanges run by the federal government and states which listed individual and small business
00:33:25.160
health insurance plans would continue uh the ahca would also continue to provide subsidies for
00:33:31.640
premiums that are based on income although the formula would be completely different and the subsidy
00:33:36.200
would likely be much less for low income young americans it even includes a penalty for
00:33:42.920
individuals who don't get coverage so it's very similar actually to the individual mandate of the
00:33:47.480
the aca which is why a lot of republicans have been against this a hca uh the aca expanded medicaid
00:33:54.200
eligibility in 32 states the aca would reverse the eligibility expansion beginning in 2020 the aca expanded
00:34:02.840
required benefits under medicaid such as mental health and addiction services which would no longer be
00:34:08.600
required under the republicans plan which there's been no movement on the republicans plan this particular uh
00:34:14.440
plan in a few years anyway uh if you're on an individual plan under this the limits the aca set
00:34:22.120
would be adjusted to the younger people might see lower premiums and older people much higher premiums
00:34:27.160
uh the aca's complex cost sharing provisions that lowered costs for some low-income americans would be
00:34:33.160
eliminated the ahca would also prohibit federal funding from going to planned parenthood mostly through medicaid
00:34:40.600
for one year uh if you are covered by your employer fines would be eliminated for large employers that
00:34:46.360
don't provide health plans small business tax credits would end in 2020 uh not necessarily a
00:34:53.000
great plan like i said there hasn't been a lot of movement on it in a few years a lot of republicans
00:34:58.360
are even against that plan but there has been more movement i mean trump has worked to lower drug prices
00:35:04.600
that is something that his administration has uh fought to do they have fought to also try to end
00:35:10.840
the the opium addiction crisis that this country is experiencing there's also the republican fair
00:35:17.480
care act of 2020 um and here's what it tries to do it tries to codify the affordable care act
00:35:23.000
pre-existing condition protections in hipaa and so republicans realized that protecting pre-existing
00:35:28.360
conditions was a very popular provision of obamacare and there are republicans fighting to keep that i would
00:35:34.200
say most republicans realize that they have to fight to keep that offering greater protections for
00:35:38.840
patients with pre-existing conditions through an invisible guaranteed coverage risk pool and
00:35:43.320
guaranteed coverage medigap plans eliminating the employer health insurance mandate and allowing
00:35:48.280
those with employer-sponsored insurance offers to receive premium assistance expanding the use of
00:35:53.800
pre-tax dollars to cover more medical expenses including insurance premiums and direct primary care
00:36:01.240
arrangements requiring medical providers to send timely transparent bills to patients so that is
00:36:06.680
trying to get rid of those surprise bills that unfortunately a lot of people have they're like
00:36:11.000
what the heck i can't afford this right now so this republican health bill is trying to uh eliminate that
00:36:17.960
discouraging hospital consolidation and anti-competitive behavior while protecting rural hospitals from
00:36:23.320
closures that is going directly against what obamacare tried to do they tried to consolidate
00:36:28.360
hospitals and the provisions in a lot of cases did hurt rural hospitals as would medicare for all
00:36:35.000
uh modernizing medicare enrollment through a competitive bidding process which promotes medicare
00:36:39.720
advantage plans promoting fiscal accountability and solvency for medicare and medicaid and so
00:36:45.320
the republican plan you know the left says republicans don't have a plan the republicans believe in
00:36:50.200
competition they believe in working with the free market they believe in giving you
00:36:54.600
more options they don't believe in taking away all of your public options they don't want people to
00:36:59.080
not be covered they just don't want you to be forced onto a plan they don't want the taxpayers to pay
00:37:03.960
for health care coverage that is not actually effective and that is actually going to lower our
00:37:08.440
quality of care and hurt hospitals and so the republican plan it is always going to incorporate elements
00:37:15.000
of the free market and is going to try to get the federal government as out of health care as they
00:37:20.680
possibly can because that is what makes the health care system innovative while also holding
00:37:25.480
insurance uh insurance companies accountable so you can look up the republican fair care act of 2020 of
00:37:33.160
course it's not perfect and there are going to be politicians that try to uh work against that on
00:37:37.880
the right and left certainly but there is a competitive plan on the right as opposed to medicare for
00:37:43.400
all or for biden's plan which i think again is unaffordable and ineffective so oh i hope that at least
00:37:49.400
gave you an overview of the two issues or of the issue and the two sides there's so much more that
00:37:55.560
we could talk about in relation to this but unfortunately we just don't have time um okay
00:38:00.360
that's all i have for today we will be back here on wednesday