The ACHA, once thought dead, got revived yesterday. The big change? 8 billion for states that choose to create high risk pools for people with pre-existing conditions. Of course, the fact that this 8 billion boondoggle (which goes to insurance companies) exists only highlights the lie that “no changes are being made with respect to pre-existing conditions”. And 8 billion, by the way, is nowhere near enough.
The heart of the bill is the same one that was polling at under 20 percent and failed two months ago: a near-trillion dollar tax cut for wealthy investors, financed by cuts to insurance subsidies for the poor and middle class. They have added a series of hazily defined changes: waivers for states to allow insurers to charge higher rates to people with preexisting conditions and to avoid covering essential health benefits, and a pitifully small amount of money to finance high-risk pools for sick patients.
The implications of these changes are vast. The Brookings Institution notes that if a single state eliminated the cap on lifetime benefits for a single employee, then employers in every state could actually follow suit, thus bringing back a horrid feature of the pre-Obamacare system, in which people who get hit with expensive treatment suddenly discover that their insurer will no longer pay for their care. This would affect not only those getting insurance through Medicaid or the state exchanges, but also through their job.
The ambiguity of the details is the strategy. Republican leaders have been “assuring centrists that the Senate would make changes to allay their concerns and insisting that few states would actually use the waivers allowing higher premiums for pre-existing conditions,” reports The Wall Street Journal. Sean Spicer says it would be “literally impossible … to do an analysis of any level of factual basis.” Representative Fred Upton told reporters that if the Congressional Budget Office says the bill is underfunded he will push for more money — after it passes his chamber.
They are rushing through a chamber of Congress a bill reorganizing one-fifth of the economy, without even cursory attempts to gauge its impact. Its budgetary impact is as yet unknown. The same is true of its social impact, though the broad strokes are clear enough: Millions of Americans will lose access to medical care, and tens of thousands of them will die, and Congress is eager to hasten these results without knowing them more precisely. Their haste and secrecy are a way of distancing the House Republicans from the immorality of their actions.
There’s simply no way that this can be considered “better”. The White House argument is that it is necessary to keep Obamacare from imploding.
It would be nice to have CBO scoring on this, but that is not going to happen. That is very telling.
Two things not mentioned above:
(1) Congress and its staff are exempt from these changes. Some GOP congresscritters have suggested that the issue of their exemption be taken up in a separate piece of legislation, but I’m not holding my breath. (Why not do it now?)
(2) People like me who get insurance through their employer are not necessarily protected. If your employer is a multi-state employer, it can pick the state which has the crappiest (cheapest) benefits and provide that to ALL employers.
The vote is scheduled for 1:00 pm today. I will update as the day goes on.
23 “No” Republicans will kill the bill in the House. Right now, it doesn’t seem like we are there.
UPDATE 11:40am –
Going the wrong direction (wonder why CNN dropped off the list)
UPDATE 1:14pm –
Voting should start in a half hour or so…
Not sure why WaPo went down…
UPDATE 2:00pm –
They are voting to exempt themselves from Obamacare or whatever else comes up. Democrats AND Republicans.
….and it passes with zero Nays.
UPDATE 2:13pm – Voting started on Health Care passage. Five minutes.
And The House PASSED H.R. 1628 – American Health Care Act 217 to 213
Singing “Na na na na hey hey hey goodbye” — Is it Democrats or Republicans?
I wouldn’t want to be a House Republican in a district Clinton won. Here they are:
Among 23 Clinton-district Rs, 14 yes, 9 no. Full list here along w/ 2016 performance and 2012-2016 prez showing pic.twitter.com/31YSWFt2TE
— Kyle Kondik (@kkondik) May 4, 2017