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Obamacare Collapse Takes New Form: Number of Uninsured Surges

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As the Senate reconvened and news circulated Monday about a further collapse of the Affordable Care Act, many wondered if a proposed amendment from Sen. Ted Cruz (R-Texas) could be the effort’s last hope.

The Senate is on a tight deadline to rope at least 50 senators into some sort of an agreement before the month-long August recess. To heighten the need for a swift response even further, the Gallup-Sharecare Well-Being Index published Monday indicated the number of U.S. adults without health insurance has grown by 2 million, leaving 11.7 percent of U.S. adults uncovered. At the end of 2016, 10.9 percent of U.S. adults were uninsured, an all-time low that now appears to be in reverse.

"What it really suggests, if anything, is that the distortion in health care markets caused by the Affordable Care Act is simply hurting people," said Dr. Ramin Oskoui, a leading cardiologist in the Washington, D.C., area and a senior health care adviser to LifeZette. "The people simply can't afford the high-priced coverage that is the Affordable Care Act. It's insurance coverage that doesn't provide meaningful access to care — not when premiums are so high, not when deductibles are so high, not when co-pays for drugs and procedures are so high."

"So I think it speaks to how the Affordable Care Act basically has destroyed the insurance markets and destroyed people getting access to care," Oskoui said of the Gallup-Sharecare results.

All eyes have turned toward Senate Republicans, while their lengthy deliberations continue to yield no results. With President Donald Trump and his administration pressuring the GOP to come up with a suitable piece of health care reform before the August recess, Senate Majority Leader Mitch McConnell (R-Ky.) has found himself in a tight spot attempting to corral his caucus.

"I cannot imagine that Congress would dare to leave Washington without a beautiful new health care bill fully approved and ready to go!" Trump tweet Monday.

But GOP senators took to the Sunday talk shows to give their gloomy forecasts for the fate of their caucus' partial repeal and replace. Sen. John McCain (R-Ariz.) said on CBS News' "Face the Nation" that he thinks the bill is "probably going to be dead" by the end of this week.

Although McConnell hopes to offer a revised bill by the end of this week, many doubt that moderate Republicans such as Sen. Susan Collins (R-Maine) will ever come to an agreement with more conservative Republicans such as Cruz, Sen. Rand Paul (R-Ky.) and Sen. Mike Lee (R-Utah). Lee co-sponsored Cruz's Consumer Freedom Act, which has continued to gain steam as a kind of "lesser of two evils" option for staunch conservatives. The White House endorsed Cruz's amendment, as did the Tea Party Patriots and other senators and House members.

"While we have serious concerns with the initial draft of the Senate health care bill, we believe the amendment proposed by senators Ted Cruz and Mike Lee offers the possibility of removing several of the most restrictive regulations in Obamacare that rob people of health care choices and drive insurance costs higher and higher," the Tea Party Patriots said in a statement last week, adding that the organization "will be more likely to support the bill for passage as the next step in the process to repeal Obamacare" if the Cruz amendment is included.

But moderate Republicans have balked at Cruz's plan, saying it will increase the cost of coverage for Americans with pre-existing conditions. Cruz, who has characterized his own amendment as a "compromise," noted that it would allow insurers to sell plans that don't comply with all of Obamacare's regulations and mandates if they agree to sell compliant plans as well.

"I think that unfortunately it is all posturing, means nothing. Even if it passed it would mean nothing, and I'm sure Ted Cruz is fundraising off, you know, these superficial attempts to accomplish something, in my opinion. It doesn't fundamentally address the cost of health care," Oskoui said. "So that's why all this is jazz and that's why you're not going to see anything happen."

"It won't make a difference. It's the difference between having bright red lipstick and rouge lipstick. It's still putting lipstick on a pig, and also it won't change anything," he added, calling the Cruz amendment "largely nonsense" because it doesn't constitute a full repeal.

If the Senate wants to bring about meaningful change in health care, it must have the courage to address "the actual cost issues," Oskoui said.

"And I think that any lawmaker — and I don't have any animus toward Senator Paul or Senator Cruz, I've never met either man in person — but anyone who dances around the facts is simply not addressing the fundamental core issue," he said. "And that's not happening. Their bills won't go anywhere for obvious political reasons."

Should the amendment fail, Cruz, Paul and Lee all expressed their support for a full repeal with a replacement coming later, after the Senate has more time to come to an agreement. But moderate Republicans such as Collins "just don't want to address the cost issues" that health care coverage poses, Oskoui said, noting that neither "the Democrats or the Republicans are actually serious about solving the financial crisis that the ACA has exacerbated that's been going on for years."

"All they're about is playing the middle class … slow-rolling Trump's base who are the ones who are really suffering from all this," he said.

"We're addicted to government like so many people are addicted to opioids, and nobody wants to address the real addiction issue," Oskoui added. "That's why we're not going to see any meaningful change, because there are too many powerful constituencies that don't want change." (go to page 2 to continue reading)

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As the fate of the Senate GOP's partial repeal and replace hangs in the balance, some have either floated or threatened the idea of turning to Senate Minority Leader Chuck Schumer (D-N.Y.) and the Democratic caucus to retain Obamacare and fix parts of it.

"Every Republican in the House and the Senate, as well as this president and this administration, promised the American people that we would repeal and replace Obamacare," Vice President Mike Pence said Monday on "The Laura Ingraham Show." "And the Senate now is literally within weeks of being able to deliver on that promise to the American people — the legislation before the Senate, for which there is not yet agreement, but we are close."

"If you want to see Congress repeal and replace Obamacare, now is the time to let your voice be heard, because we're certainly hearing from the advocates of single-payer health care," Pence added. "We need to be hearing from Americans who want to repeal and replace Obamacare because we are very close."

But if McConnell fails to rally his caucus, he very well may be forced to crawl to Schumer and compromise even further than the GOP caucus already is.

"When they're not able to get together on what to do and they're not able to put together enough bribes and subsidies to do it that make the bill look like anything like a replacement and repeal bill and doesn't hurt the middle class … McConnell's going to have to go to Schumer, and he's going to have to say, 'Hey, how do we work this out?'" Oskoui said.

"You know the people who talk about some sort of compromise bill, you know, it's interesting — they never tell you what that looks like. Let me tell you what that bill looks like — it basically looks like Obamacare but with more subsidies shoved at the states," he added.

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