WASHINGTON — House Republicans are apparently ready for yet another attempt to snatch health insurance away from constituents who need it. Someone should remind Speaker Paul Ryan of a saying often attributed to his legendary predecessor, Sam Rayburn: “There’s no education in the second kick of the mule.”
Having failed miserably to win passage of an abomination of a bill — the American Health Care Act — Ryan and his minions are back with something even worse. A draft framework being circulated this week would pretend to keep the parts of Obamacare that people like, but allow the states to take these benefits away. We see what you’re doing, folks.
This is getting silly. What part of “forget it” do Republicans not understand?
I realize there is great pressure to follow through on the GOP promise to “repeal and replace” the Affordable Care Act. And I realize that President Trump, nearing the 100-day mark, sorely needs a legislative victory to tweet about. King Pyrrhus needed a win, too, but that didn’t work out too well for him.
Republicans don’t talk much about the practical reason for moving urgently on health care, which is to set the stage for so-called tax reform: They want to take money now used to subsidize health care for low-income Americans and give it to the wealthy in the form of big tax cuts. Again, we can see you.
I’m sure the crowds at GOP town halls will be understanding. Just be sure to check attendees at the door for tar and feathers.
The new proposal — brokered by Rep. Tom MacArthur, R-N.J., of the moderate Tuesday Group and Rep. Mark Meadows, R-N.C., of the far-right Freedom Caucus — is like a parody, as if life-or-death access to health care were fodder for a “Saturday Night Live” sketch.
Nominally, the “MacArthur Amendment” would retain the Essential Health Benefits standard imposed by the ACA, which requires insurance policies to cover eventualities such as hospitalization, maternity and emergency care — basically, all the things you’d ever need health insurance for.
The amendment would also appear to maintain the ACA’s guarantees that everyone can buy health insurance, including those who have pre-existing conditions, and that parents can keep adult children on their policies until age 26. That all looks fine — but it’s an illusion.
After specifying that these popular provisions will stay, the amendment then gives states the right to snatch them away. States would be able to obtain waivers exempting them from the Essential Health Benefits standards. They would also be able to obtain waivers from the pre-existing conditions requirement by creating a “high-risk pool” to provide coverage for those who are unwell.
There would no longer be a prohibition, however, against charging “high-risk” individuals more — so much more, in fact, that they would potentially be priced out of the market. We would go back to the pre-ACA situation in which serious illness could mean losing a home or filing for bankruptcy.
This may satisfy GOP ideological imperatives — Ayn Rand would be so proud — but it is atrocious policy, even if you put aside considerations such as compassion and community.
We live at a time of enormous economic dislocation. The manufacturing sector has shrunk dramatically, and now retail may be starting down the same path; long-lost jobs in industries such as coal mining are not coming back, no matter what Trump says. Workers need to be able to move to the places where jobs are being created — which means that health insurance should ideally be portable. But Republicans are heading in the other direction by trying to set up a system in which there are radically different health insurance rules in different states. In today’s world, how does that make sense?
Unchanged from last month’s failed bill are provisions that would strip massive amounts of money out of Medicaid, by far the nation’s biggest source of payment for nursing home care. So Republicans might not want to show their faces anywhere near retirement communities.
The Affordable Care Act changed the way most people in this country think about health care. It did not, however, change the thinking of many House Republicans, who continue to believe individuals should be held financially liable for a genetic predisposition toward diabetes or a random cellular mutation that leads to cancer.
Another abject failure to repeal the ACA would be a terrible political outcome for Republicans. But far worse, looking ahead to the 2018 midterms, would be for Trump to sign this latest monstrosity into law.
Eugene Robinson’s email address is email@example.com.(c) 2017, Washington Post Writers Group
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