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To paraphrase Malcolm X, Americans are being hoodwinked and bamboozled when it comes to President Donald Trump’s promise to repeal and replace Obamacare with something “much, much better.”

Indeed, the Republican House of Representatives on Thursday failed to secure enough votes on its American Health Care Act, dealing a blow not only to Trump, but also to GOP House Speaker Paul Ryan. The failure prompted Trump late-Thursday to threaten to leave “Obamacare” in place and move on to other issues if Friday’s vote fails.

The hubris among Republicans was shaken when their health care megaflop came on the seventh anniversary of Obamacare, which Trump promised to repeal and replace on his first day in office. 

But like so many of the initiatives pushed forward in the new administration, the measure was rushed and thrown together, with no real thought to the impact on the lives of individuals, families and communities. Trump’s promise to tear down Obamacare is far greater than the desire to keep Americans healthy.

So who does this new, shinier “anything but Obamacare” Act benefit? Not middle-income Americans, and definitely not the poorest and most vulnerable citizens who would see cuts to their health care safety net.

Medicaid expansion on the chopping block

Under the proposal, Americans who receive Medicaid, or Medicaid expansion that helped bring care to millions, would be hit hard. The chances are great that the coverage they now have would either be dropped or greatly reduced. Further, if Americans are not covered under an employer’s plan or work as an entrepreneur, who receives coverage through the exchanges, they would receive less care for more money.

Americans 60 and older would really suffer under the Republican plan, which would require them to pay at least $10,000 more annually for health care basics. So again, how is this is better? How is this affordable? And how is this fair and equitable?

The Affordable Care Act is not perfect. And it is true that if Americans fail to carefully select a plan based on both affordable premiums and the care they need, most merely have an insurance card, and cannot afford co-pays or out-of-pocket expenses.

But Obamacare opened the door to care for millions of people, including Black Americans of all ages and stages in their lives, who couldn’t find care because they had often life-threatening pre-existing conditions.

But Obamacare opened the door to care for millions of people, including Black Americans of all ages and stages in their lives, who couldn’t find care because they had life-threatening pre-existing conditions.

It also provides prenatal care for poor, expectant moms, who do not have access to coverage. The ACA provides Black mothers with the care they need to deliver healthy babies, and chips away at high maternal and infant mortality rates.

GOP bill jeopardizes quality care for children

As this new administration promises policies that would strip bare the public education system, this legislation would also jeopardize quality care for over 37 million low-income children and children with disabilities are currently covered by some form of Medicaid.

Children, many of whom are Black, make up the single largest group of people who rely on Medicaid; nearly 36 million children receive Medicaid coverage, including children with special health care needs. A child who is enrolled in Medicaid is more likely to receive Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefits, the standard of pediatric care, covering an array of services like developmental, dental, vision and hearing screenings, and allowing health problems to be diagnosed and treated appropriately and as early as possible.

Don’t get it twisted, Trumpcare would not make coverage more affordable for families of color or anybody else, unless you are already wealthy. There are breaks and provisions buried in the bill that would make costs easier to swallow for some. But in fact, it makes it harder for families to afford premiums on the individual market and phases out the option for states to expand Medicaid to cover more low-income adults, which has led to tremendous cost savings for states and better health outcomes for families across the country. Having healthy parents means children are healthier, too.

The interesting thing is that the biggest opponents of the new bill are ultra-conservative Republicans, known as the House Freedom Caucus, are  the same politicians who wanted the repeal Obamacare in the first place. They have been more vocal in the debate than Democrats, who vowed to fight to protect and repair the Affordable Care Act. Now, not only do Americans need insurance cards, they also need score cards to keep up with all the political jockeying and brinksmanship.

So what can you do? Don’t sit on the sidelines. Do your homework for yourself and your family members. Ask tough questions. If you receive coverage through your employer, call them and ask how a new measure would impact you and your family—and how much more it would cost you. Call your legislators. Tell your stories of how having care impacted your life or that of a family member. The truth is that Black lives depend on it.

Do you think Trump and his surrogates can whip up enough votes to pass the bill Friday evening? Sound off in comments.

Andrea King Collier is a multimedia journalist and author who covers health, health care and health disparities. She is the author of Still With Me.. A Daughter’s Journey of Love and Loss, and The Black Woman’s Guide to Black Men’s Health.​


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