Today's NY Times editorial.
House Republicans have revised their proposal to destroy the Affordable Care Act in an effort to win the support of far-right legislators who opposed the first version. In so doing they have made it much worse.
The original Trumpcare bill, whose spectacular failure embarrassed the White House, had a public approval rating of just 17 percent because it would have taken health insurance away from 24 million Americans, many of them poor, sick and elderly. The new version would further tighten the screws on vulnerable Americans by letting insurance companies charge older people and people with pre-existing conditions much higher premiums than they charge younger and healthier people. It would also give insurers the freedom not to cover essential health services like maternity care and cancer treatment.
The lawmaker who proposed these changes is Representative Tom MacArthur of New Jersey, who says he wants to reduce premiums. The nasty new twist in his version is a provision that, in effect, frees states from having to provide many of the protections now guaranteed by the A.C.A, or Obamacare. States will be permitted to ask the federal government to waive these requirements, and there is a real danger that many lawmakers will cave to pressures from insurance companies that see a way to save money by providing fewer protections.
States might also decide that they have to seek waivers to show voters that they're doing all they can to lower premiums, even if that means putting policies out of reach or making the coverage less comprehensive. Like the original, the bill slashes Obamacare subsidies, making insurance much more expensive for many individuals and families. The premium for a 40-year-old earning $30,000 living in Chattanooga, Tenn., would increase by $3,000 under the bill, according to the Kaiser Family Foundation.
Economic considerations aside, right-wing legislators might seek waivers simply because they dislike government intervention in the private market and recoil from spending money on what they consider wasteful welfare programs. That's one big reason 19 states, including Florida, Georgia and Texas, have refused to expand Medicaid under the A.C.A. even though the federal government pays a vast majority of the cost of providing that coverage.
Obamacare has flaws; the law does not do enough to make premiums and deductibles affordable. But affordability is not what Mr. MacArthur cares about. The AARP says that 40 percent of those between the ages of 50 and 64, or about 25 million people, have the kinds of pre-existing medical conditions that would put them at risk of losing affordable health insurance under the House bill. The American Medical Association is even more pessimistic, predicting that the MacArthur amendment "could effectively make coverage completely unaffordable to people with pre-existing conditions."
Republican lawmakers claim that states could help anybody hurt by their bill by creating high-risk pools with the help of federal grants. But this is a disingenuous argument. Many states operated high-risk pools before the A.C.A., but they ran up large losses and benefited few people.
Republicans who thought they could rush this dreadful bill to give President Trump a first-100-day achievement to gloat about seem oblivious to what most Americans want. A recent Pew poll found that 60 percent of people say that the government has a responsibility to make sure everybody has health care.
The hopeful news is that many centrist Republicans, including members of Congress and governors from swing states like Ohio, have expressed grave reservations about the House bill, in particular the attack on people with pre-existing conditions. It will be up to them to stop their party from jumping off the deep end and jeopardizing the health care of millions of Americans.
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April 28, 2017
Addendum. People, get ready. We will soon release new proposed scripts to use to talk with GOP and Dem Members of Congress. PHone numbers of many here
