May 22, 2019
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House Republicans voted to weaken health care, hurt the poor and cut taxes for the wealthy

Jabin Botsford | The Washington Post
Jabin Botsford | The Washington Post
President Donald Trump speaks in the Rose Garden at the White House after the House pushed through a health-care bill on Thursday.

How bad is the health care plan approved Thursday by the U.S. House of Representatives? Doctors, hospitals, the March of Dimes, Gov. Paul LePage and Republican senators are among the long list of groups who criticized the House vote because it will strip millions of Americans of health insurance and make it more expensive, and less comprehensive, for millions more.

While backers of the bill, including Maine’s 2nd District Republican Rep. Bruce Poliquin, focused on repealing the much-maligned Affordable Care Act, called Obamacare, their plan goes far beyond this. It weakens employer-provided insurance. It caps Medicaid spending, which will harm the poor, disabled students and people struggling with substance use disorder. It temporarily bars Planned Parenthood from participating in Medicaid, cutting poor women off from care. It also reduces taxes for the wealthy.

The 217 House Republicans who voted for the bill, without real analysis, have no real idea how it will affect health insurance for millions of Americans. Nor do they know how much the bill, which includes billions of dollars in tax breaks for rich Americans, will cost the U.S. Treasury. No Democrats, including Maine 1st District Rep. Chellie Pingree, voted for the bill.

These House Republicans were more concerned with checking off the box that says “I voted to repeal Obamacare” than with preserving the health insurance, and therefore the health, of their constituents. This debate should not be about ideology, it should be about the wellbeing of all Americans. By that measure, it is a failure.

The House bill was little changed from an earlier version that failed to gain enough support from House Republicans. The nonpartisan Congressional Budget Office concluded that that plan would have left 24 million people without health insurance by 2026.

Analysis of the similar failed legislation by the CBO and others showed that older Americans and those who live in rural areas would be especially hurt by it. These are the people Poliquin is supposed to represent.

In Maine, nearly a third of residents under the age of 65 have pre-existing conditions, which range from obesity, pregnancy and allergies to cancer, heart ailments and arthritis.

On a Thursday conference call, Poliquin told reporters that the bill “ensures that everybody has access to health insurance, including those with pre-existing conditions.”

But, under the House bill, insurance companies can charge more — a lot more — to cover people with pre-existing conditions. This can put insurance out of reach for many of these Americans.

To hide this — and secure more votes for the bill — Republicans added a provision that would set up a separate pool for older, sicker Americans. The bill would set aside a paltry amount of money to support the so-called “high-risk pool.”

According to analysis from Avalere Health, the money included in the Republican bill would cover just 5 percent of the Americans in the individual insurance market who have pre-existing conditions. The funding is so inadequate that all the money in the bill for the high-risk pool would cover less than half of the enrollees with pre-existing conditions in Texas alone.

Backers of the Republican plan pointed to Maine’s brief experiment with a high-risk pool as a success. But it lasted for less than two years, far from enough time to fully assess its effectiveness. During that time, some premiums were reduced, but out-of-pocket expenses increased for many enrollees.

The Republican plan would spread the devastation of an Obamacare repeal to the private insurance market, potentially weakening health insurance for more than 150 million Americans. Provisions in the bill would allow states to define their own “ essential health benefit” standards, a list of care that must be covered by insurers. Employers, which provide half of health insurance coverage in the U.S., could then enroll their employees in health plans in states with less stringent rules and skimpier coverage, even if they don’t have facilities in or do business in those states.

Attention now turns to the Senate, which traditionally is more thoughtful and moderate than the House. Sen. Angus King is a staunch opponent of the House bill; Sen. Susan Collins has a lot of questions and concerns.

The first step in answering those questions is to have the CBO analyze the bill, a critical step skipped by the House. Given the CBO’s analysis of the similar plan, we expect many of the same problems to be highlighted.

This will put the debate back to square one: Should millions of Americans lose affordable and effective health insurance so some Republican lawmakers can brag that they repealed Obamacare?

We believe the answer is a resounding “no.”

 



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