The health care dilemma

You’d think House Republicans would have learned one valuable lesson from the Democrats across the aisle — this is no time to spike the football.

Oh sure, they got to enjoy the nifty Rose Garden celebration President Trump promised them if they managed to pass a bill that repeals some of the more onerous elements of Obamacare. But the going will be far more difficult in the Senate, on which states like our own will depend to “fix” this latest “fix.”

“Many of us are here because we pledged to cast this very vote,” House Speaker Paul Ryan warned his members. “Are we going to keep the promises that we made, or are we going to falter?”

Yes, politically there was a lot riding on this bill. To keep a promise, but also to fix a system that in less fortunate states than our own is truly in danger of collapsing. Iowa’s last major insurer selling plans on that state’s health care exchange threatened to pull out in 2018 (two others announced their exit last month). Aetna said this week it would stop selling policies on the individual market in Virginia next year. Anthem announced it was considering exiting a number of marketplaces.

So when Trump says, “Insurance companies are fleeing . . . it’s been a disaster,” he’s certainly not wrong.

But closer to home neither is Gov. Charlie Baker understating the case when he says, “This bill would significantly reduce critical funds for the commonwealth’s health care system.” Massachusetts, which vastly expanded its Medicaid system under Obamacare, may never be able to put that genie back in the bottle. And diminishing federal allotments will make that more problematic.

However, a plus for a number of local companies is the end of the medical device tax.

There is a way for the GOP to keep its promise to repeal and replace Obamacare and still keep the pain for states like Massachusetts to a minimum. That will be the Senate’s job now.