Why GOP shouldn’t want Affordable Care Act to fall

Every big story inevitably involves Florida, often in bad ways. That’s true with last week’s court ruling against the Affordable Care Act.

Since Congress passed the law in March 2010, some of the state’s leading Republicans have worked to defeat or undermine it. The chain begins with former Attorney General Bill McCollum, who quickly joined GOP counterparts in a lawsuit challenging the ACA.

Pam Bondi followed McCollum. Like Gov.-Elect Ron DeSantis, Bondi started her campaign on Fox News and rode the exposure to victory eight years ago. She continued the lawsuit, which failed when the U.S. Supreme Court upheld all of the ACA except Medicaid expansion.

This year, Bondi piled onto the Texas lawsuit alleging that when Republicans ended the individual mandate as part of their tax bill, the action rendered the entire law unconstitutional. She was quicker to act against the ACA – which has improved health care in Florida — than she was to sue drug makers and distributors that contributed to Florida’s opioids crisis.

Then there’s Rick Scott, whose contribution to health care was to run a hospital company that drew a $1.7 billion fine for defrauding the government. Scott proposed amending the state constitution to prohibit the federal government from imposing the individual mandate in Florida. He predicted that the law would be “the biggest job killer in the history of this country,” and then bragged for eight years about job growth in Florida.

As for Sen. Marco Rubio, he tried to kneecap the ACA by blocking a provision designed to protect insurers from dramatic losses in the early years of the individual marketplace. Companies didn’t know how to set rates for millions of new customers, so the law divided the risk between them and the government for three years.

Rubio falsely called those payments “a bailout.” He amended a spending bill to prevent the payments. Running for reelection two years ago, Rubio continued his demagoguery by claiming that 400,000 Floridians were about to lose ACA coverage. In fact, they only had to switch plans.

Meanwhile, Bondi, Scott and Rubio have offered no alternatives for the nearly two million Floridians who had obtained insurance under the law. The Republicanled Florida Senate tried to expand Medicaid in 2015, but Scott and the House refused.

So Florida still ranks very low when it comes to the rate of insured residents. A new report by Georgetown University finds that 325,000 children in the state were uninsured last year, an increase of nearly 40,000 from 2016.

The Florida Agency for Health Care Administration wants the Legislature to appropriate $16.3 million next year so the Healthy Kids program can cover another 22,000 children. House Speaker Jose Oliva, R-Miami, told the News Service of Florida that he wants to spend less on health care. Maybe he could end the subsidized coverage for part-time Florida House members.

Ironically, many Republicans privately are hoping that U.S. District Court Judge Reed O’Connor’s ruling doesn’t hold up on appeal. They would get the blowback.

If the Affordable Care Act disappeared, so would the protection for patients with preexisting conditions. Scott ran an ad late in the campaign promising to protect them, though he never said how. Parents also would lose the ability to keep children on their policies until age 26.

Some of Trump’s lower-income, white voters live in states with high rates of opioid abuse. For them, Medicaid expansion is the only means of getting substance abuse treatment. Without the law, health care experts told Politico, the Trump administration would lose the CMS Innovation Center that it uses to test proposals for lowering health care costs.

Many people may have forgotten that the law also closed the coverage gap – known as the “donut hole” – in the Medicare drug plan. Ending the law would raise costs for Florida’s seniors. Rubio hasn’t mentioned that.

In a functioning political system, Congress would approve bipartisan fixes for the ACA. Example: Help those higherearning Americans in their 60s who don’t quality for subsidies and are paying more in the single market.

Instead, Republicans in Washington have tried repeatedly to repeal the law without proposing a replacement and Republicans in states have tried to kill it. Perhaps they all can blame each other if the problem they created becomes theirs to fix.