GOP health plan combines bad policy and bad politics
The Republican health care bill that passed by a 217-213 vote Thursday in the House is likely to be studied for generations as an example of how not to legislate.
This measure was neither subjected to hearings nor debated in committee. The non-partisan Congressional Budget Office, which estimated that a previous version would have resulted in 24 million fewer people having insurance, has not “scored” its impact. Although the plan would have life-and-death consequences and reshape a big chunk of the economy, it was slammed through after a mere three hours of debate. No effort at bipartisan compromise was attempted.
The GOP measure is both bad policy and, despite Thursday’s Rose Garden celebration, bad politics. If adopted by the Senate, it would end health coverage for millions of Americans. It would also force Republicans running in competitive districts to defend a plan that ends Americans’ right to buy insurance regardless of a previous condition.
Republicans passed this dog ’s breakfast of a bill because they thought that they had no choice. After stirring up their base during the Obama years with repeated votes to repeal the former president’s signature health plan, they reasoned they had to follow through if they were actually in a position to act.
Initially, there was too much opposition to this approach because both hard-line fiscal purists and swing-district Republicans blocked a previous version. But then President Trump jumped in to argue he couldn’t afford a loss so early in his term. The pressure on rank-and-file members became overwhelming.
Obamacare, the informal name of the health law in effect since 2010, has its flaws, and the uncertainty about its future is further destabilizing the insurance market for individuals in several states. But the law, which balances an obligation to buy coverage with guarantees that illness won’t bankrupt you, is vastly superior to the GOP alternative.
The bill that passed the House on Thursday, likely to go by the name of Trumpcare, would allow insurers to get state waivers to opt out of covering minimum benefits such as maternity care and emergency services. It would also allow insurers in those states to charge whatever they wanted for people with pre-existing conditions.
Those with serious pre-existing conditions would be put in high-risk pools, where they could apply for financial help. Only 5% of them would get such assistance, according to the consulting firm Avalere Health, because the money allotted is nowhere near enough.
There are other Dickensian provisions as well. Medicaid as we know it would come to an end, replaced by a system of grants to states that would short the program by $880 billion over the next decade. At the same time, the measure would lavish a largely wealthy population of taxpayers with $882 billion in tax breaks.
Many House Republicans now hope the Senate, which will draft its own repeal-and-replace version from scratch, will bail them out with something more palatable. But there is only one thing that can be said for what they did Thursday: For shame!