The problem with health care? Politics matters more

It is difficult to decide which is the worst aspect of the Republicans’ latest try at repealing Obamacare: the irresponsibility, the cruelty or the lies.

There is only one reason the Senate even considered a vote this week: The GOP base, and particularly the party’s donor class, wants repeal. So never mind what happens to Americans with modest incomes who have cancer, diabetes or heart trouble. Politics matters more than giving serious thought to a bill that would upend onesixth of our economy.

That’s why this bill was not subjected to any serious analysis or debate. Republicans scheduled a last-minute hearing this week for show. Because Trump and his party want “a win,” they’re willing to wreak havoc on the insurance markets, state governments and people’s lives to get it.

Any serious deliberative process would have forced the GOP to grapple with a statement from the bipartisan National Association of Medicaid Directors on Cassidy-Graham’s approach of marrying block grants to severe cuts. The association called the bill “the largest intergovernmental transfer of financial risk from the federal government to the states in our country’s history.”

“Any effort of this magnitude,” the Medicaid directors added, “needs thorough discussion, examination and analysis, and should not be rushed through without proper deliberation.” Exactly.

There has always been something deeply wrong about our country’s failure to provide health insurance for all our citizens, which all other wealthy industrialized nations do. It’s not OK for people to face bankruptcy simply because they are doing everything they can to stay alive. Obamacare was a cautious, market-friendly attempt to make the system kinder.

Since the Republicans launched this year’s repeal offensive, many Americans who thought of the Affordable Care Act as a vague sort of failure have heard the compelling stories of those with pre-existing conditions and serious illnesses who are far better off today because of the law. A Washington Post ABC News poll released Friday showed Americans preferred Obamacare to Graham-Cassidy by 56 percent to 33 percent.

Many who believed Trump and other Republicans when they promised to pass something better than Obamacare now know that this pledge was a sham. What the GOP really wants is to spend a whole lot less government money helping people get health care. But they can’t admit it because it sounds heartless.

So instead, they lie outright about what their bill does.

If Obamacare is so bad, why are Republicans reportedly trying to buy the vote of Sen. Lisa Murkowski (R-Alaska) with a special provision that would, in effect, allow Alaska to keep the Affordable Care Act pretty much as is? Why not give every state this option by killing Cassidy-Graham altogether?

One can hope that McCain’s brave decision and the doubts expressed Sunday by other Republican senators have done exactly that. But the

GOP repeal effort never seems to die, so this week remains a testing time. It’s a test of whether the movement that saved the ACA this summer can rally once more. It’s a test for Republicans who claim to take health care policy seriously. And it’s a test for a president who prefers ripping the country apart to governing.