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.
The Republican Plan Is Even Worse Than Obamacare
There is no big political constituency for the GOP’s endgame. Democrats could offer a flawed bill as a first step toward doing more. Republicans don’t really have that option.
I suspect the Republican leadership shares my concerns, given how long they kept the thing in the kind of secret reading room usually used for sensitive intelligence briefings. They were not the first to classify our nation’s health care policy “Top Secret,” of course; that had hilarious echoes of the Obama administration’s decision not to tell states what the exchanges would look like, lest Republicans somehow find out, and make fun of them.
.. they’re resorting to all the same tricks: the secrecy, the opacity, the long implementation delays (the better to get a good score from the Congressional Budget Office, and oh, yes, also, get them past the next election before voters meet their program).
Tom Cotton: an ambitious Republican in the era of Trump — and in the crossfire of health care
On most issues, the lanky Cotton, a rising star in the party, has emerged as one of President Trump’s staunchest supporters, aligning in both tone and substance with the enthusiastic conservative base that helped elect the president. However, on health care, he has not marched in lockstep with the president
.. “There’s kind of a joke among liberals here that he was created in a lab, as we always say, because he’s this conservative everyman,”
.. At the other end of the spectrum are conservative senators such as Rand Paul (R-Ky.) who want to see a more forceful repeal than many of his GOP colleagues. “I’m still open-minded. I do want to vote for a repeal bill,” said Paul
.. Cotton, an Army veteran of the wars in Iraq and Afghanistan who has built a reputation around his hawkish national security views, also backed Trump’s foreign policy approach. He said the president made the “right call” with his decision to strike a Syrian air base last this month.
.. “Lock him up!” some chanted as Cotton defended the president’s foreign policy and ticked through the list of world leaders Trump has met with. They were putting a twist on “Lock her up!” — a popular anti-Hillary Clinton chant at Trump campaign rallies. Others tried to drown them out with “U.S.A.!”
.. “We’d love to get, you know, 52 votes on whatever it is that ultimately emerges from the Senate,” said Sen. John Thune (S.D.), the third-ranking Republican senator. “But we know we have to get 50 plus Vice President Pence.”