The GOP, not Trump, the real threat to health care
President Trump clearly has no clue what’s happening on health care, taxes or really any other major policy front. He has also made abundantly clear that he has no interest in getting up to speed.
Unfortunately, Trump’s unseriousness has become so grotesque, so all-consuming, that it has distracted us from dozens of other dilettantes and demagogues in Washington — far too many of them other members of Trump’s own political party.
Trump may be a toddler, we keep telling ourselves, but at least some comparative grown-ups on Capitol Hill are thinking things through. Maybe we don’t agree with them all the time; maybe they have a different vision for the role of government than many of us do. Still, at least a few thoughtful, moderate, principled, solutions-oriented people in the legislature are working to offset the White House’s abdication of policy leadership.
The flaming turd that is Cassidy-Graham should disabuse us all of that notion.
What’s been threatening the health-care coverage of tens of millions of Americans isn’t Trump. It’s the entire Republican Party.
This garbage bill, currently looking dead but with a few days left to revive itself, should teach us two things: Republicans don’t care about process, and they don’t care about policy. You could be forgiven for also concluding, as they’ve increasingly suggested this week, that they don’t care about regular Americans, either.
For years we’ve been told that the original sin of the Affordable Care Act was that it was procedurally flawed. It was passed in the dead of night, constructed in smoke-filled backrooms and only passed thanks to partisan budget gimmicks. These critiques were mostly nonsense, of course. Obamacare went through a painfully slow, yearlong process. It was considered at lots and lots of hearings. It received multiple assessments from the nonpartisan Congressional Budget Office and attracted a supermajority of Senate votes.
Contrary to popular misconception, the bill was not even passed using the budget reconciliation process.
All of these attacks may not be true of Obamacare’s passage — but they do apply to Republicans’ attempts to repeal it.
Republican senators gave themselves a few days, and just one cobbled-together finance committee hearing, to pass a bill along party lines with no full CBO budget score. In the absence of any independent assessment of what their proposal does, they made up numbers that ignore big chunks of the bill.
The proposal is opposed by nearly every conceivable stakeholder, from doctors to insurers to pharmaceutical companies to patient advocates. Not only because the process is being rushed, but also because what’s actually in the bill is so terrible.
On major questions of policy, legislators punted to the states, giving them two years to build new health-care systems from scratch — even though state legislators have little expertise in the matter and few of the resources available to Congress.
This alone would be sure to destabilize insurance markets. Now layer on severe funding cuts, ultimately punishing every state; the removal of the individual mandate, which makes sure risk pools aren’t dominated by the most expensive patients; and the unwinding of federal regulations designed to protect those with pre-existing conditions and to make sure the insurance plans that consumers buy actually cover anything.
Chaos, premium spikes for the sick and the poor, and the hemorrhaging of tens of millions of Americans from insurance rolls are all foreseeable consequences. In other words: It’s what happens when an entire party decides to abandon policy experts.
Note that it’s not just the usual tea party crazies pushing for this monstrosity. It’s many supposedly reasonable Republicans, too. These include Republicans such as Sens. Jeff Flake of Arizona and Ben Sasse of Nebraska, upon whom we’ve heaped loads of praise for their principles and backbone.
Even Sen. Lisa Murkowski of Alaska, who helped kill the Senate bill the last go-around, has at this point said merely that she has reservations about the legislation. Given how this bill was constructed and what it contains, anything other than a flat-out rejection gives the lie to her “reasonableness.”
If even late-night TV host Jimmy Kimmel, who has made a career out of playing an average Joe, can figure out how vulnerable this legislation leaves millions of unlucky Americans, surely senators can spot the problems, too.
We knew we can’t trust Trump to craft careful policy that puts regular Americans’ needs above his own. Judging from this debacle, it looks like we can’t trust the rest of his party to do so, either.