By Jacob Prall
The new Senate GOP health-insurance bill, the Better Care Reconciliation Act, is unpopular for a number of reasons. It’s not just that it will take away health care from 22 million people or that it will cause massive premium spikes. It’s not just that it guts consumer protections or that it decimates Medicaid.
Nor is it that it was created in secret by a small, all-male group of hard-core conservatives. It’s not even that the bill includes hundreds of billions of dollars in tax cuts for the wealthiest Americans, paid for by robbing the sickest, poorest, oldest, and most vulnerable Americans of their health care.
It’s all of these things and more.
According to an NPR/PBS NewsHour/Marist poll, the bill enjoys a mere 17 percent approval rating. In many contemporary societies, terrible policy coupled with public disapproval keeps legislative bunk at bay. Unfortunately for the American public, this bill still has a fighting chance.
Fifty is the magic number Senate Majority Leader Mitch McConnell needs to pass the measure in the Senate, but he doesn’t have the votes. Moderate Republicans say the bill goes too far, endangers too many lives. Conservatives say it doesn’t go far enough.
It’s the same problem House Speaker Paul Ryan has, his solution being to ram a piece of unread, untested legislation through the chamber. Compared with the House, the Senate takes its time, giving senators a chance to consider the potential fallout from the passage of the health bill, a measure that undermines one-sixth of the American economy.
After the Congressional Budget Office on June 26 released its abysmal score for the Senate health bill, senators proposed several new amendments, hoping to save the fledgling bill. It’s the GOP’s last attempts to win over enough conservatives or moderates to find 50 votes. Sen. Ted Cruz believes he has the amendment that will save the GOP plan.
Cruz’s strategy to win conservative support involves dismantling Affordable Care Act regulations. Specifically, his amendment would require states to sell just one plan that covers pre-existing conditions. Cruz claims this move will encourage competition and give consumers more choices.
Here’s the problem: The proposal would be catastrophic for the health-care market. The plans offered to people with pre-existing condition would become de facto high-risk pools without any government subsidies. Premiums would spike, barring entry to anyone who both has a pre-existing condition and isn’t fabulously wealthy. The uninsured folks with pre-existing conditions could use the only health care available to them, emergency-room visits, a method that provides no preventative benefits and is extremely costly. When their bills can’t be paid, the costs are shifted to everyone else.
This death spiral would create a meltdown in the insurance markets. As Douglas Holtz-Eakin, a former CBO director, told Politico, “What [the amendment] will do is allow insurers to offer cheap policy to young invincibles. And on the exchange, you’re going to get all the sick people. That’s a recipe for a meltdown.”
Cruz’s amendment would also allow insurance companies to cut costs by ditching “Essential Health Benefits,” such as ambulance rides, mental-health services, maternity care, and a host of others that ObamaCare requires insurance companies to include. Cruz’s proposal will be scored by the CBO, but it is already clear that the amendment would leave us with the same problems that health-care reform seeks to address.
With or without the amendment, the GOP measure is a disaster. Republicans are trying to build conservative ideas into a system that is inherently progressive. The GOP doesn’t believe government has a role in health care, leaving the American public with a Frankenstein’s monster of a bill, full of conservative tax breaks to billionaires and Medicaid cuts stapled and glued to progressive ideas of accessible health care. The result is doomed to be the worst of both worlds, so grab your torches and pitchforks before it’s too late.
