Access to affordable health insurance for tens of millions of Americans remains in jeopardy. Last week, Senate Majority Leader Mitch McConnell managed to keep "repeal and replace" on life support by the thinnest of margins.
No version of the Senate bill has managed to unite the ultra-conservatives opposed to any taxpayer-financed healthcare for the poor with the few remaining moderates in the GOP. That shrinking faction recognizes that government must step in to offer health insurance when the private market fails to provide this basic human right.
Passing a bill that would repeal the individual and business mandates— the skinny plan—is a cynical ploy to keep the legislative process alive. If enacted on its own, it would destroy the individual market. There's an easy explanation for McConnell's inability to keep his coalition intact. Every iteration of the Senate bill has essentially the same effect. They rip coverage and affordable access to healthcare from 15 million to 33 million people. And they will eventually force drastic cutbacks in Medicaid, the safety net for the nation's most vulnerable citizens.
If McConnell and President Donald Trump get enough moderates to go along with this monstrosity, it will not be because the legislation was made palatable. It will be because the moderates accepted Band-Aids for the grievous wounds inflicted on their neediest constituents.
No healthcare consumer does better under these bills—except perhaps a few healthy people who will get to buy skimpy plans and the insurance companies that want to sell them. These people will only discover how meaningless their coverage is when an unforeseen catastrophic event happens and they submit claims.
The only real beneficiaries are some federal taxpayers. That's the only thing that explains why this vampire legislation refuses to die. The Republican majority cannot give big tax cuts to corporations and the well-to-do-the next item on the GOP agenda-without shrinking the government's current commitments.
That not-so-secret agenda needs to be put front and center. If the GOP majority gets away with cutting benefits for the poor, why would they stop there?
House Speaker Paul Ryan has long sought to limit the federal government's commitment to Medicare by giving seniors vouchers, also known as premium support. To cut back the government's long-term commitment to seniors, all they'd have to do is keep the voucher's growth rate below the cost-of-care growth rate, just as they propose to do with Medicaid.
The government now supports healthcare for more than a third of the population, who in aggregate account for over half of all healthcare spending. Tax dollars support the old, the blind, the disabled, half the nation's children, and, since passage of the Affordable Care Act in 2010, many lower-wage workers-hardworking people whose employers do not provide them with health insurance.
Taxpayers also finance healthcare for veterans, the men and women in the armed services and their families, and millions of federal workers. That includes Sen. John McCain, who, only days after an operation for brain cancer, dragged himself across the country to cast the deciding vote that opened the door to reconsideration of the various Senate bills.
Lobbyists from across the healthcare landscape have been doing a yeoman's job in recent months in fighting the GOP bills. Their arguments remain a powerful indictment of the false claims made by the GOP over the past seven years.
Repealing the Affordable Care Act will lead to unnecessary deaths. It will lead to higher overall healthcare costs by forcing people to postpone care.
Its negative effects on the overall economy will be just as pronounced. It will make it harder for people to escape poverty. It will lead to higher premiums for employers and their workers. And it will force people to cling to their jobs for the health insurance. The GOP has yet to refute any of those arguments. Their bills deserve to die.