Divided GOP haggles over health-care bill
What happened
Republican senators scrambled this week to salvage their effort to repeal Obamacare, as at least a dozen GOP lawmakers expressed serious doubts about the latest health-care legislation and Majority Leader Mitch McConnell extended the session for two weeks into August to continue negotiations. GOP leaders have crafted a revised bill, now known as the Better Care Reconciliation Act, hoping to quickly receive a new Congressional Budget Office score; the previous version was projected to leave an additional 22 million Americans uninsured by 2026, largely because of more than $800 billion in Medicaid cuts. The latest tweaks would reportedly preserve for up to seven years two Obamacare taxes on individuals earning more than $200,000 annually: a 3.8 percent investment income tax and a 0.9 percent Medicare payroll tax. Money from those taxes would support a stabilization fund to help offset consumer costs while the new law takes effect. GOP leaders have also promised an additional $45 billion for opioid treatment, a high priority for centrists such as Sen. Rob Portman of Ohio. But at least one top moderate, Sen. Susan Collins of Maine, said she needed “a complete overhaul to get to a yes.”
Sen. Ted Cruz of Texas has pushed an amendment that would allow insurers to offer cheaper, bare-bones plans that don’t meet current Obamacare requirements, such as those for maternity care and mental-health treatment. Critics fear such plans would attract younger, healthier people, making plans for older, sicker consumers prohibitively expensive. “It would trigger the death spiral,” said Karen Pollitz of the nonpartisan Kaiser Family Foundation. “Like, overnight.”
What the editorials said
“Cruz’s compromise could save health-care reform,” said the New York Post. It delivers “a real escape” from Obamacare, by allowing younger, healthier people to buy affordable coverage “without forcing them to subsidize insurance for older folks.” To placate moderates, GOP leaders might be required to boost funds for people with pre-existing conditions, “but that’s a trade conservatives can take in exchange for letting the market start to work again.”
Moderates will make or break this legislation, said The New York Times. McConnell is trying to win them over with sweeteners “that may seem like improvements but do not change the bill’s substance.” The $45 billion over 10 years to combat the opioid epidemic is a substantial increase from the original $2 billion promised, “but experts say it is hardly enough given the scope of the problem.” Meanwhile an NPR/PBS NewsHour/Marist poll shows just 17 percent of Americans support the legislation. “Tinkering around the edges will not make this bill any less dreadful.”
What the columnists said
“After seven years of nearly endless war against Obamacare,” why can’t the GOP deliver a decent conservative option? asked Craig Garthwaite in The Washington Post. As a lifelong Republican, I’ll offer an inconvenient truth: It’s because Obamacare is fundamentally conservative, and “there simply isn’t much room to the political right” for a system that covers so many people so well. The law calls for private firms “to provide health insurance in a free, but appropriately regulated, market.” That might not thrill small-government ideologues, but it’s “an extension of traditional Republican beliefs.”
Republicans need to accept that most Americans now believe providing health insurance “is the responsibility of the federal government,” said Reihan Salam in Slate.com. Even if McConnell threatens and cajoles enough senators into passing an unpopular bill, “voters will revolt,” possibly “paving the way for single-payer.” The GOP “has little choice but to offer universal coverage in some moreattractive package.” I can imagine a world in which robust growth leaves families feeling so flush, they’ll take responsibility for their own health needs. “Alas, that’s not the world we’re living in now.”
With his bill flailing, McConnell has raised the possibility of working with Democrats to repair, rather than repeal, Obamacare, said Jonathan Cohn in HuffingtonPost.com. “He seemed to be wielding it as a threat” against wobbly Republicans, but it makes more political sense than kicking millions off health insurance. Democrats might accept some easing of insurer rules in exchange for “more federal money flowing into the system.” Republicans could have Cruz-style skimpier plans but leave Medicaid alone. It might enrage the base, but bipartisanship could be the GOP’s “least-bad option.”