Sold on lies, poorly planned, deadly to thousands, and a catastrophe for its authors.
Conservatives believe it is not the government’s responsibility to ensure the poor can afford decent health insurance. They argue that if taxpayers are pitching in for someone’s coverage, that coverage should be lean; a high-deductible plan that protects against catastrophic medical expenses is plenty for charity care.
Under this view, the basic structure of Obamacare — which taxes the rich to purchase reasonably generous coverage for the poor — is ill-conceived and should be reversed.
.. Much as Americans were told the Iraq War was about removing the threat of Saddam Hussein’s weapons of mass destruction, they have been told that the GOP’s health care effort is about replacing Obamacare with “something terrific” — a plan that covers everyone with good health insurance that they can actually afford to use. In both cases, they were lied to.
.. But Republicans have taken everything they said they didn’t like about the process behind Obamacare and supercharged it — it’s as if they’re using their critique of the ACA process as a playbook for retribution. They are moving faster than Democrats did, and they are doing so with less stakeholder support, with a smaller congressional majority, with less bipartisan input, with an unpopular bill backed by an unpopular president, with less information about what their bill would do, and while providing fewer opportunities for members of Congress to amend and improve the underlying ideas.
.. The 2003 “shock and awe” campaign to topple Saddam Hussein reflected a misconception that the hard part of the Iraq War would be fighting through to Baghdad — but once we were there, and once Hussein was gone, it would all work out. It didn’t. The hard part was after Hussein fell, and the United States was responsible for the future of a country it didn’t understand and faced with chaos it hadn’t planned for.
.. President George W. Bush famously called the invasion of Iraq a “catastrophic success” — it was a military victory that left America embroiled in a catastrophe.
.. This is the heath care version of Dick Cheney’s promise that American troops “will, in fact, be greeted as liberators.”
.. A cautious estimate, based off the best available evidence, suggests coverage losses on the scale Republicans envision will lead to more than 24,000 deaths annually.
.. Democrats could, within a matter of weeks, pass a short, clear law restoring and expanding the Medicaid expansion, restoring and expanding Obamacare’s tax credits, allowing Americans to buy into Medicare as an option on the exchanges, and paying for the whole thing by levying hefty taxes on the rich. The bill would be easy to write and easier to explain.
.. If Republicans upend Obamacare, their replacement plan is unlikely to survive the aftermath — it’s simply too different from what voters want, too vulnerable to future change, too loathed by existing interest groups, and too shoddily constructed to build support on its own merits. Rather, their plan will create chaos in insurance markets, anger among voters, and radicalization among their opponents; the policy that eventually fills the vacuum they create will not be one they like.
AHCA is a betrayal of all the GOP’s promises on health care
It does the opposite of what they say.
The American Health Care Act, passed today by the US House of Representatives, is a law that fundamentally does the reverse of what its proponents are promising.
Having run a campaign during which he promised to cover everyone, protect Medicaid from cuts, and replace Affordable Care Act plans with “terrific” coverage, Donald Trump is now behind a bill that cuts Medicaid, covers fewer people, and allows states to replace ACA plans with stingier coverage. Having promised repeatedly to protect patients with preexisting health conditions from insurance market price discrimination, Paul Ryan is pushing a plan that removes existing protections and replaces them with hand-wavy and inadequately funded high-risk pools. Having leveraged public discontent with high deductibles and rising premiums, Republicans are pushing a bill that will leave most patients with higher out-of-pocket costs for equivalent plans and bring back skimpy plans with even higher deductibles.
That’s all happening because the GOP is committed to rolling back the taxes that pay for the Affordable Care Act, delivering a financial windfall to high-income families even though Treasury Secretary Steve Mnuchin swore at his confirmation hearings that the Trump administration would not pursue tax cuts for the rich.
.. When Ryan initially rolled out the American Health Care Act, he accompanied it with a Frequently Asked Questions page that offered a firm statement of moral purpose regarding the treatment of patients with preexisting conditions:
That statement is now gone from the House leadership’s website. In search of additional Freedom Caucus votes, Ryan abandoned that commitment and signed on to the MacArthur Amendment that will, in fact, allow insurers to charge higher premiums to sick people.
.. “I’m not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid,” Trump told the conservative Daily Signal way back in May 2015. “Every other Republican is going to cut, and even if they wouldn’t, they don’t know what to do because they don’t know where the money is. I do.”
.. That fall, his promises got even bigger. “I am going to take care of everybody,” he told 60 Minutes. “I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now.”
.. The bill his party is now pushing will cover fewer people, charge higher premiums, raise copayments, and raise deductibles.
The reason is that the AHCA takes a ton of money out of the health care system in order to provide a $600 billion tax cut,
.. While running for president, for example, Barack Obama promised that his health plan would lead to lower premiums for average families. When pressed, his policy team would gladly clarify that what he meant was premiums would increase at a lower-than-expected rate. That was a reasonable promise, but not nearly so politically appealing as the much grander promise the candidate made in his speeches. And the policy of misleading people worked well enough until he was actually in office, signed a major health care bill, and then people discovered that their premiums were not, in fact, going down.
Trump’s Tax Proposal Is Just a Symptom of the Disease
No wonder this administration can’t get anything done. It specializes in wishful thinking.
This conveys the impression that the administration cares a lot about cutting taxes for very wealthy people and corporations, and considers the other elements of the plan to be filler, to be sketched in brief if at all.
.. Tell hundreds of thousands of government employees that they need to make a more business-friendly environment, and you’ll rapidly discover the terrifyingly myriad ways in which such a directive can be interpreted by individual minds. No, what you actually have to do is create rules to follow, all of them spelled out in mind-numbing minutiae.
Detail makes enemies.
Let’s revisit the personal deduction eliminations, for example. Going to get rid of the deduction for people with high medical expenses? Enjoy the frantic phone calls from patient groups. How about educational savings accounts? Are they going away? Stand by for the firestorm of indignation from middle-class parents. If the Trump administration actually tries to enact its plans, one by one, many of its ideas, so pleasing in vague summation, will become flesh, encounter political resistance, and die an early and gruesome death.
s Health care is now set to be a defining issue in the next election cycles
Governors, gubernatorial candidates and state legislators, meanwhile, will be asked whether they intend to “opt out” of provisions in the Affordable Care Act that are overwhelmingly popular with voters, as is permitted under the Republican plan. Their plans for state Medicaid programs also will be scrutinized if massive GOP cuts to Medicaid funding are realized.
.. I can’t recall a vote this significant in terms of its political potential in 20 years.”
.. Trump’s political advisers calculated that it was less damaging electorally for congressional Republicans to pass a bill that some of their constituents see as deeply flawed than to have passed nothing at all.
.. Polling shows that the public disagrees with Republican health-care plans. Thirty-seven percent of Americans support repealing and replacing the law known as Obamacare, while 61 percent want to keep it and try to improve it
.. slash Medicaid spending by more than $800 billion and cut nearly $600 billion in taxes under the health-care law, most of which will benefit the wealthiest Americans.
.. the Republican bill would lift that prohibition and give states the option to let insurers charge more for them.
.. Wilson added, “Republicans in the House right now should be on their knees praying for the Senate to kill this,” arguing that the line of attack would be less powerful if the bill does not become law.
.. whether it’s the AARP saying it charges people over 50 five times more, or the American Cancer Society saying it guts protections for preexisting conditions. There’s no real way to defend that to voters.”