EDITORIALS

The three pillars of Republican health care reform: sabotage, speed, secrecy

Posted June 14, 2017, at 9:41 a.m.

Secrecy breeds suspicion, so there is good reason to be very suspicious of a health care bill crafted by the Senate’s Republican leaders. They are being extremely secretive about the details of health care legislation that would repeal and replace the Affordable Care Act. We fear Republicans’ efforts to keep the bill hidden mean that, like the House Republican bill, their legislation will leave millions of American without health insurance while driving up costs and weakening protections for others.

Republicans have refused to make the bill’s language public. There are likely to be no hearings before the bill is brought to the floor for a vote, which leadership wants to hold before the July 4 recess, when few are likely paying attention. Debate will be limited.

On Tuesday, reporters were temporarily barred from interviewing senators in Senate hallways without prior permission from the Senate Rules Committee. It is fashionable among some circles to mock and denigrate the media. But reporters aren’t asking about the health care bill because they are busybodies or disrespectful. They are asking so they can tell Americans, the senators’ constituents, what is in a bill that will affect their lives.

Senate Majority Leader Mitch McConnell “could have started over and had the Senate develop its own legislation, perhaps even working with Democrats on a bipartisan alternative that could withstand the test of time. Instead, McConnell put a plan in place to pass something close to the House bill using three simple tools: sabotage, speed and secrecy,” Andy Slavitt, the former acting head of the Centers for Medicare and Medicaid Services, wrote in the Washington Post.

Why use “sabotage, speed and secrecy” instead? “We aren’t stupid,” a senior Senate aide told Axios. In other words, Senate Republican leadership learned a lesson from the rocky rollout of the House Obamacare repeal bill, which was supported only by Republicans, including Rep. Bruce Poliquin.

That bill, which the nonpartisan Congressional Budget Office concluded will leave 23 million more people without health insurance than if Obamacare remained in place, has been rejected by the public. Only 8 percent of Americans believe the Senate should pass the House Republican bill, which is packed with tax breaks for the wealthy that have nothing to do with health care

According to the latest polling, from Quinnipiac University, 44 percent of people expect health insurance costs will go up under the House Republican bill and 57 percent think fewer people with have insurance coverage. So the Republican secrecy isn’t fooling the American people.

Rather than hide their work because they know if it is faulty, Senate Republicans should spend their time improving the Affordable Care Act. First, they should recognize their rhetoric and shenanigans are destabilizing Obamacare. If the law’s individual health insurance marketplaces fail, as is close to happening in some states as insurers leave the market, it is because of the uncertainty caused by threats and attempts to undermine it.

Because of the ACA, 22 million more Americans have health insurance. This is largely because of subsidies that lowered the cost of insurance for millions and the expansion of Medicaid, in states that did so; Maine has not. Because an insurance pool can only function when it includes a mix of people — young and healthy and older and sick — there are also penalties for those who do not buy insurance in order to draw the young and healthy into the market.

Fixes to the ACA should focus on these areas, such as adjusting subsidies and penalties to better balance the mix of people in the individual insurance market.

The House Republican bill moved in the opposite direction by allowing insurers to charge older, sicker people much more and by ending the Medicaid expansion.

If the Senate’s Republican leadership follows along, with a plan written in secret by a hand-picked group of men, the chamber’s moderate Republicans must reject it.

Then, they can direct attention to where it has always belonged — to improving Obamacare rather than repealing it to settle political scores.

 

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