"It was sold as giving you more choices," said the speaker of the House of Representatives. "But it didn't do that"by Joseph Evans / April 21, 2017 / Leave a comment
“We want to have a system in America where everyone has affordable access to good health insurance and good health care cover. That is not what the current law does.”
In his role as US Speaker of the House, Paul Ryan is working at the coalface of Donald Trump’s promised healthcare reforms. His relationship with Trump got off to a rocky start in June last year with Ryan describing a statement made by Trump during the election campaign as “the textbook definition of a racist comment” and Trump saying that Ryan was “ineffective and disloyal.” He was slow to endorse Trump during the election, saying that the man who is now president was “not ready” even after he became the Republican nominee.
In Ryan’s words they have “patched up” their relationship, sharing the view that Obamacare is an ailing system with reform as the only fix.
Speaking to Prospect he said: “We won running on an Obamacare repeal and replacement plan. This is a popular thing to do because this law is effectively collapsing under its own weight, it was sold as giving you more choices, but it didn’t do that. A third of all counties in America have only one Obamacare insurer and premiums are going up into double digits every year.”
Despite the hyperbole we have come to expect in the post-Trump era of American politics, Ryan’s criticisms of Obama’s keystone health reform do stand up to scrutiny. The Patient Protection and Affordable Care Act—commonly referred to as Obamacare—was intended to lower insurance premiums for the 45m Americans without any health cover.
Signed into law in 2010, it ushered in a dramatic reduction in the number of people without insurance—in 2016 alone it is estimated that 20-24m people took out cover. But, it was a difficult sell for the Obama administration. It faced opposition from Republican senators such as Mitch McConnell in Congress and has resulted in a collapse in competition that has left nearly 1,000 counties with only one insurance provider.
The American Health Care Act, Trump’s planned replacement for Obamacare has already been shelved once after a lack of support among members of his own party. A vote on the replacement was scheduled in March, but members of the House Freedom Caucus raised objections to elements of the bill, arguing that it did not go far enough in repealing Obama’s legislation.
As concern spread through the Republican leadership that they would not have enough support among House Republicans, it was Ryan who visited the White House to consult with the president before the AHCA was withdrawn from consideration. Ryan later remarked that America is “going to be living with Obamacare for the foreseeable future.” The failure was an early blow to the Trump administration after he had positioned healthcare reform at the forefront of his campaign.
“We have to step in front of this crisis and replace it with something that we believe is a patient-centred system,” Ryan said, “A system where patients have more choices, where we have lower prices, where we have competition. That is at the core of what we are working on doing right now.
“We want to make sure we have lower premiums, that a person who is buying health insurance has a lot of choices and that there is transparency so that they know what the insurance is going to cost before they buy it.”
Ryan has been described as a “policy wonk,” a description used by supporters and critics alike to both elevate and disparage him. His background was in think tanks and he has a degree in economics and political science from Miami University, Ohio. While at university he spent time with libertarian professor Richard Hart discussing the theories of Ayn Rand who, in 2009, Ryan said “did the best job of anybody to build a moral case of capitalism.” It was Hart who suggested that Ryan take on an internship with Senator Bob Kasten, prompting Ryan’s first brush with politics since he was involved in the Model United Nations while at school.
Speaking at an event at the Policy Exchange, Ryan dealt with a wide range of issues including the importance of defence spending in support of Nato, the threat of Russia, and the economic relationship between the US and UK. He also thanked the US’s “friends” in parliament for their backing of Trump’s action against Bashar al-Assad following his use of chemical weapons in April.
He said: “We cannot allow a provocateur in Moscow to threaten our allies or our interests. To truly combat Russian aggression, we need a strong Nato alliance and we need that now more than ever. It remains critical to the safety and security of the United States, of Great Britain and of the world and it must be strengthened.
“Member states should contribute 2 per cent of their GDP to defence spending and we should enhance our lines of communications to ensure that Nato countries receive the most timely and accurate information possible.”
Ryan also used the opportunity to present his view of the future of the “special relationship” between the UK and the US. He outlined his belief that it remains in everybody’s interests for Britain and the European Union to maintain a strong relationship and added that the US would like “to do a bilateral trade agreement as soon as the UK is ready and able.”
He said: “A strong UK, EU relationship is in all of our best interests. In that same vein, the US will work closely with our EU friends and chart a path forward in Trans-Atlantic Trade and Investment Partnership (TTIP) negotiations and my prime job as Chairman of the House Ways and Means Committee we are already working towards this.
“At the same time, we are committed to working with president Trump and your government to achieve a bilateral trade agreement between the US and Great Britain, this is one of the bipartisan measures I bring with me. The US stands ready to forge a new trade agreement with Great Britain as soon as possible.”