Healthcare Revisited

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Sam Rayburn: “There’s no education in the second kick of the mule” — Trump and Paul Ryan’s learning disability: Eugene Robinson’s Editorial explains. Here are exerts from Robinson’s April 20 Washington Post editorial:

House Republicans are apparently ready for yet another attempt to snatch health insurance away from constituents who need it.

Having failed miserably to win passage of an abomination of a bill — the American Health Care Act — Ryan (R-Wis.) 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 states to take these benefits away. This is getting silly. What part of “forget it” do Republicans not understand?

… Republicans don’t talk much about the practical reason for moving urgently on health care, which is to set the stage for 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.

The new proposal [the MacArthur amendment] — is like a parody, as if life-or-death access to health care were fodder for a “Saturday Night Live” sketch.

Nominally, [the 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 anyone could buy health insurance, including those with preexisting conditions, and that parents could 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. [In addition] There would no longer be a prohibition … 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.

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.