Rep. Tom MacArthur (AP)
Earlier this month, Rep. Tom MacArthur presented an amendment to the American Health Care Act to secure broad Republican support. And this week, Rep. Mark Meadows declared the Freedom Caucus’ support. But conservatives in the party should not be fooled: MacArthur’s replacement plan, “Trumpcare 2.0,” is a Trojan Horse. It comes as a gift, filled with options for states to opt out of some Obamacare rules. But it leaves the Affordable Care Act — better known as Obamacare — comfortably in place while Congress gets to grandstand.
While MacArthur’s plan may seem to have some constructive changes at first glance, the proposed measures would keep the worst parts of the ACA. One of the key provisions would shift the responsibility for decisions on healthcare standards to the state level. That means states could choose to opt out of the rules on “essential benefits” and “community ratings” by getting a federal waiver.
But there’s a catch. The default for states will be the same as it is now—keeping the ACA’s federal standards. Nobody wants to be the bad guy and take away popular rules. But Congress made this mess, so they need to clean it up. Representatives like Rep. Amash fought the last version of Trumpcare, and they can do it again.
The proposed provisions include a waiver program that lets states opt out of “essential benefits” — the ACA’s federally-mandated services healthcare providers must offer. That includes a laundry list of items individuals have to pay for, like maternity care and substance abuse care — even if they’ll never use either service.
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