The U.S. Senate still hasn’t figured out its health care bill is supposed to be about health care.
In discussions leading up to Thursday’s unveiling of the Senate’s latest health care plan, we’ve been told the legislation is about upholding a seven-year promise to voters, about avoiding a public relations fiasco for the Republican Party, about cutting taxes, about finding a bill that can get 50 votes.
We hear very little about crafting a plan that provides better health care to more people at lower cost. No wonder the result is setting off alarm bells at health care providers around the nation.
Among the insidious features of the latest bill is that it would allow some insurers to sell relatively cheap, bare-bones policies that don’t cover everything. Major health care groups say healthier Americans would gravitate to those plans, leaving sicker people to share the spiraling cost of comprehensive coverage. Eventually, many of them would simply be priced out of health insurance. Say goodbye to the Affordable Care Act’s protections for people with pre-existing conditions. Even people who paid insurance premiums for years when they were healthy could find themselves denied affordable health care when they need it. People would suffer — and die — unnecessarily.
The bill also would end subsidies after two years for people who buy insurance through exchanges. That would leave many people who can’t afford unsubsidized premiums without coverage.
The bill would phase out the expansion of Medicaid, which has done much to vastly increase the number of Americans with health coverage. The bill also would cut billions from what remains of Medicaid and restructure the program into fixed grants to states, which would be left to find ways to take an ax to benefits.
If senators were interested in a bill that really was about health care, they would hold public hearings, debate various ideas at length and invite extensive comment from those who work in the health care industry and the general public.
Instead, as with previous versions of the Senate health care bill, this one was created quickly and behind the scenes. Sen. Lisa Murkowski, R-Alaska, complained lobbyists got a summary of the bill before she had even seen it.
The revised bill has some tweaks designed primarily to corral Senate votes. It adds $45 billion for opioid treatment. It sets aside $182 billion over 10 years — widely seen as insufficient — to soften the big jump in costs for people who need expensive health care. It allows money in health savings accounts to be used for insurance premiums. But those tweaks don’t disguise the appalling bottom line of this bill.
To justify their actions, President Donald Trump and others have claimed the Affordable Care Act, also called Obamacare, is collapsing. It isn’t. It is basically meeting its goals, and could be better if lawmakers worked to improve it.
Senate Majority Leader Mitch McConnell, R-Ky., plans a vote next week on the Republicans’ proposed ACA replacement. If the vote takes place, senators should remember what’s really at stake — the health of the American people.