‘Skinny’ out of fashion

“Skinny repeal” would be bad for Massachusetts. So says Gov. Charlie Baker, who along with nine other governors signed a letter to Senate leaders Wednesday asking to have a say in whatever health care reform bill the Republican-controlled Congress ultimately produces, and we’re inclined to take his word for it.

The skinny repeal approach would retain the Medicaid expansion that came with Obamacare, but eliminate some other provisions of the law — including the individual and employer mandates and the medical device tax. Baker says the approach will destabilize insurance markets and increase premiums for those who are insured (an estimated 15 million more people would be uninsured with this approach).

But frankly it’s hard to get too exercised about this approach because, well, no one seems to know whether a final bill will even remotely resemble “skinny repeal.” Few senators embrace this version of the bill, but it seems to be the least-awful version capable of drawing the requisite 50 votes. And the last pitch to senators from Republican leadership was to support skinny repeal so that the House and Senate can begin meeting in conference to hammer out the real deal.

Forget Nancy Pelosi’s line — “We have to pass the bill so that you can find out what is in it.” The Republicans’ corollary appears to be, “We have to pass the bill, not so it becomes law (silly!), but so we can decide what to really put in it.”

We accept that the business of making laws isn’t always easy or pretty. The Senate is trying desperately to keep reform alive.

But there is a chance that the House will simply accept skinny repeal. Republicans will claim victory in repealing Obamacare, but most Americans will understand it is a half-measure. Meanwhile Baker and other governors — and folks paying higher premiums — will have to deal with the consequences.

Sen. John McCain made an impassioned floor speech in advance of the debate urging a return to regular order, with the hope of fashioning a bipartisan compromise — including with input from states. They might make a muddle of it. It can’t be worse than what we’ve witnessed this week.