A four-vote victory in the House does not bode well for the future of ill-conceived, Republican-crafted legislation designed to kill “Obamacare” when it reaches the Senate. But that doesn’t seem to matter to its proponents, who apparently care more about adding a check mark to President Trump’s skimpy list of accomplishments so far than helping sick people.
Among its flaws is the Republican bill’s proposal to cut Medicaid funding by $880 billion over 10 years, which is about half the increase that President Barack Obama’s Affordable Care Act provides to expand Medicaid coverage. Someone should remind Trump he promised not to cut Medicaid when he ran for president. Cutting Medicaid could lead to up to 24 million fewer Americans having health coverage than if the Affordable Care Act is left in place.
But the pain doesn’t stop there. The so-called Affordable Health Care Act cobbled together by Republicans includes an amendment offered by Rep. Tom McArthur (R., N.J.) that would essentially invalidate the Obamacare guarantee of insurance coverage for people with preexisting conditions. Insurance companies would still have to offer coverage, but could charge much higher rates than they do to other policyholders.
The likelihood of insurance companies collecting excessive premiums is addressed in the GOP bill, but inadequately. The bill would create high-risk insurance pools for people with major medical expenses, but it doesn’t put enough money into the program to cover the expected need.
Just how bad the Republican bill is isn’t known because the rush to get it passed didn’t allow time for the nonpartisan Congressional Budget Office to complete an analysis of the latest version. A CBO analysis of the bill in March concluded that 14 million more people would lack insurance by next year, including up to six million who, without a mandate that includes a tax penalty, would simply choose not to buy health insurance.
The Pennsylvania Budget and Policy Center estimates that under the House-passed bill up to 1.3 million Pennsylvanians will lose their coverage, more than 3,200 people will die because they lack coverage, and the health of five million people with preexisting conditions will be placed in jeopardy. “This legislation was never about improving health care. It was about giving $500 billion in tax breaks to the very wealthy and to big insurance companies and drug companies,” said Policy Center director Marc Stier.
Passing a bill that does more harm than good proves that the ongoing effort to scuttle the Affordable Care Act isn’t really about improving the health of Americans. It’s about fulfilling a seven-year pledge by Republicans in Congress to deprive Obama of what — despite their efforts — is likely to be his most enduring legacy.
Even if Republicans erode the progress made so far, they won’t be able to erase the fact that, were it not for Obama’s perseverance, millions of Americans wouldn’t have health coverage today.
Trump said after Thursday’s close 217-213 vote that he was confident the Republican-controlled Senate would follow the House’s lead. He shouldn’t be so sure of that. The public’s reaction to Congress’ continued and blatant politicization of how Americans afford health coverage may have something to do with that.