But are they happy now that GOP leaders in the House of Representatives have finally announced their plan to replace the law?
The reaction from Obamacare critics in the Bay Area ranges from hopeful to cautiously optimistic to downright disgusted — no doubt an indication of why the House Republicans’ American Health Care Act is drawing so much controversy in Washington, D.C.
“If this is the best they can come up with after eight years of bitching and complaining, I would have to say we have a bunch of incompetents running the party,” said Phil La Scola, a retired finance manager at Oakland International Airport. “That includes Paul Ryan,’’ the speaker of the House.
The Livermore resident has attacked Obamacare as “a government takeover of one-sixth of our economy,” a sentiment shared by conservative health care policy experts who want to see Obamacare replaced. But some of those experts said this past week that they’re confounded by the GOP plan’s lack of details and its surprising replication, in many respects, of the very law it seeks to upend.
The law replaces Obamacare’s tax credits, aimed at making private health insurance more affordable, with similar credits that allow more affluent Americans to take advantage of government subsidies.
That gives hope to Lori and Bill Nicora, an Albany couple who have fumed for years about the soaring cost of health insurance. Because they are both self-employed, they must turn to the often-volatile individual insurance market.
So the Nicoras’ spirits were lifted after the House Republican’s health plan surfaced with its promise of tax credits for individuals making up to $75,000, and as much as $150,000 for a married couple.
“I think we will benefit,” said Lori Nicora, a court reporter whose husband is a general contractor. “But who knows what adjustments will be made after the bill moves through different committees.”
Unlike the Affordable Care Act — which bases subsidies on someone’s age, income and where he or she lives — the Republican subsidies would be based solely on age. Tax credits would amount to $2,000 for those younger than 30; $2,500 for anyone between 30 and 40; $3,000 for anyone between 40 and 50; $3,500 for those between 50 and 60; and $4,000 for those over 60.
The plan would help higher-income Americans, though Lori Nicora bristles at headlines trumpeting how the “wealthy’’ will benefit under the Republican plan.
“You can hardly call the forgotten Americans in the ACA, like small businesses, entrepreneurs and the self-employed ‘wealthy,’ especially in the Bay Area,’’ she said.
Democrats and health care advocates agree that former President Barack Obama’s signature law needs to be tweaked and expanded to make higher income people eligible for subsidies, but they believe that the GOP’s proposal will so severely slash government subsidies for most lower-income residents that they will be unable to keep their current insurance.
Members of the Tea Party and other conservatives are also upset — for different reasons.
“A number of things contained in this act are sticking points for conservatives, because many of the same things the Republicans are keeping in are all part of Obamacare’’ — and only increase costs, said Sally Pipes, president and CEO of the San Francisco-based Pacific Research Institute, a think tank that promotes limited government.
Those elements include ensuring that anyone with pre-existing conditions won’t be charged more or denied coverage, to allowing children to stay on their parents’ plans until age 26. The plan also would prohibit insurers from setting lifetime limits on health insurance plans. Even an Obamacare provision that expanded Medicaid to adults without dependent children will remain — albeit no longer as generously funded by the federal government beginning in 2020.
“I would have hoped they could have come up with a better program that did not involve government subsidies — or dictate the coverage that an individual should have,” said La Scala, the retired East Bay finance manager. “I’m looking for a way to get government out of health care, but still provide insurance for people who cannot afford it and for people with pre-existing conditions.”
How much the GOP plan will cost and how many Americans it will cover is unknown, at least until the nonpartisan Congressional Budget Office analyzes the figures. Under Obamacare, at least 20 million people have gained insurance coverage, including 5 million in California, slashing the state’s uninsured rate by more than half.
An early analysis from S&P Global Ratings estimates the GOP plan will cause 6 million to 10 million people — most of them low- and moderate-income — to lose their private insurance or Medicaid.
Some Bay Area residents who oppose Obamacare argue that even the GOP plan and its tax credits won’t lower out-of-sight health insurance prices. Santa Clara optometrist Ken Ballentine is among them.
The registered Republican and avid cyclist voted for Trump. But at 63, Ballentine has decided to go without insurance until he turns 65 and qualifies for Medicare.
“The GOP plan will not help me any more than the Obamacare plan,’’ said Ballentine, who blames “the Unaffordable Care Act” for forcing him in 2014 to drop his previous Kaiser Permanente plan that cost him $288 a month for a plan that would have been “even worse” and cost $614 a month.
“Who cares about a tax credit — unless the premium is cheap enough that it more or less pays for it?’’ Ballentine said.
In San Jose, Steve Brown and his wife made the same decision after the couple’s monthly premium for themselves and their two children, ages 10 and 14, almost tripled from $900 in 2013 to just under $2,700 last year.
“It was like a mortgage payment,’’ Brown said.
Now, when the need arises for a doctor, the family pays for its medical costs in cash.
Brown, 41, said he used to own his own security business, but he sold it last fall, in part because of the crushing cost to insure his employees.
He’s looking at the GOP plan to see how it might benefit his family. But even if he and his wife don’t receive any tax credits, Brown said, at least the Republican plan won’t “railroad’’ him by mandating that his family buy insurance.
“It made me feel like I was not in America — or even California — anymore,’’ the staunch Republican said of the current health care law. “It made me feel like I was in a foreign country.’’