Bad medicine

Expert salesmen of snake oil remedies, President Trump and House Speaker Paul Ryan tout the American Health Care Act as the fix to ills they diagnose in Obamacare, the federal programs that have in recent years expanded health insurance coverage to historically high levels.

Few states would suffer the consequences of their quackery more than New York, an Obamacare success story by measure after measure.

Nearly 3 million New Yorkers get their insurance coverage through the NY State of Health marketplace backed by Obamacare’s subsidies, adding 700,000 more people in 2016 alone.

The price of insurance premiums in the individual market has dropped almost in half since the passage of President Obama’s Affordable Care Act in 2010, as has the share of uninsured New Yorkers, down now to just 5%.

All this while New York has reined in runaway state spending on Medicaid, the safety net health insurer for the poor.

Despite inefficiencies ripe for repair, the system works, in New York and for states across the nation that took Obamacare as opportunity to expand Medicaid eligibility and establish online exchanges where consumers can choose health insurance plans at tolerable cost.

But not if Trump and Ryan succeed in peddling their crock cure — their desperately cynical attempt to deliver on a pledge to “repeal and replace” Obamacare. Not available in stores! With no better idea, they have delivered a perversely worse one, eliminating the individual mandate to carry health insurance, replacing subsidies with stingier tax credits, and putting the biggest economic burdens on older and poorer patients, who will face premiums so high millions will likely forgo coverage. But wait! There’s more! Buried in the House bill, too, are profound redistributions and cuts in the funds the federal government sends back to states to help pay for health care.

States that went all in on the Obamacare opportunity to expand Medicaid coverage would see funding slashed. New York, which went one step further to create the Essential Plan for those at slightly higher incomes, would lose funding for that program entirely. Money back, guaranteed! New York would lose more than $1 billion in funds that help hospitals treat the uninsured — while states that needlessly denied expanded Medicaid coverage to their working-class citizens are poised to get a cash boost. Act now! Not content to obliterate Obamacare, Trump and Ryan would also bludgeon Medicaid despite a half-century’s success, remaking the entitlement program into limited lump-sum payments to each state to be divvied up — and bound to fall short of the actual cost of delivering care.

Gov. Cuomo estimates the cost to New York at a devastating $4.5 billion over four years. New York City’s financially wrecked public hospitals, already spending money they don’t have to care for immigrants and others uninsured, would see costs balloon as potentially hundreds of thousands of city residents lose their coverage.

Every member of Congress who countenances the Trump-Ryan health care bloodletting will do so fully aware of the harm they will do patients and the states that dare aid them.

Their cruel cure is a con job.