Why are Senate Republicans having such a hard time trying to get rid of the Affordable Care Act (ACA)? They can’t even reach agreement within their own ranks. Senate Majority Mitch McConnell has a two-vote majority and cannot afford more than one defection if he expects the GOP health care bill to become law.
Many GOP senators opposed the early versions of the “repeal and replace” legislation but the latest incarnation still has impediments to partisan cooperation as indicated in the latest comments from conservative members of the GOP majority.
Even senators from opposite ends of the GOP ideological spectrum, Susan Collins (R-Maine) and Rand Paul (R-Kentucky), will oppose the bill and intend to vote against a motion to proceed which is the necessary step for any proposal to be brought before the Senate.
Senator Collins believes the measure goes too far in hurting Americans who need healthcare insurance coverage and Senator Paul believes it goes too far in creating more big government with a big budget.
He stated that McConnell’s plan is “not going to fix the death spiral of Obamacare” which he described as allowing people to wait to apply for coverage until treatment is needed which is a flaw that will render the actuarial pool unsustainable. The ACA mandates coverage or payment of a tax because it is needed to sustain the pool.
Republican senators in states where the ACA expanded Medicaid which tremendously helped seniors and people with preexisting conditions like West Virginia, Nevada and Ohio will have a hard time voting for the latest GOP measure even though it has been modified.
Nevada Senator Dean Heller won his seat by a single percentage point in 2012 and his state voted for Hillary Clinton by a narrow margin in November. He is up for reelection in 18 months. It is easy to talk about ideas when you don’t have to consider the implications for individuals.
Democrats wanted to join in any effort to “reform” health care further even though if they stopped speaking out for the poor and for workers, they stood to reap mid-term election successes as a reward. However, it is not possible to let millions of Americans suffer for mere political gain.
The latest version of GOP health care is more about Republicans being able to say we kept our promise to repeal and replace Obamacare than it is about caring for Americans.
There is no getting around the fact that the latest GOP health care measure retains much of the ACA’s structure because it is needed to help moderate and low-income Americans get health care coverage.
It does call for large cuts to Medicaid but without a doubt hundreds of billions of dollars of the responsibility of costs will just be shifted to state governments and the states with the largest populations will experience the greatest pain.
The GOP leadership made changes in the proposed measure to address the concerns of moderate and conservative Republicans but realized they had to retain ACA taxes on the wealthy and coverage for those in need to sell the plan.
They could have worked on changes in a bipartisan manner and a successful reform could have been accomplished with the Democratic leadership. Mitch McConnell wanted this done in spite of them and with little regard to the people who will end up being spited by the plan if it becomes law.
Even with the changes, it will fail to win over enough GOP senators. Senator Paul has called it Obamacare-lite and told “Fox & Friends” he will vote “no” vote on the healthcare bill because it fails to deliver on his promise which was to repeal and replace.
The latest GOP plan provides $45 billion for people with opioid addiction, and includes retention of three ACA taxes — on investments, a Medicare surtax for the wealthy and a tax on insurance executives’ compensation as well as Health Savings Accounts — to pay for health insurance premiums, as well as catastrophic health plans with tax credits to help pay for them and a new marketplace for health plans with narrower coverage but cheaper premiums.
Senate Minority Leader Chuck Schumer likened the changes to camouflage so that Republicans can “tell the American people that this bill is no longer a tax giveaway to the wealthy and … that just isn’t true.”
If the plan falters, President Trump can manufacture a controversy to distract the media and American people from this vitally important issue. We must remain vigilant and communicate our needs and wishes to our representatives in Washington, D.C.