Xeroxing the House’s Obamacare replacement, the Senate spent the last six weeks cloning the House bill with only minor exceptions, knowing anything less would not pass the House. For all intents and purposes, the Senate’s Obamacare replacement practically guarantees, nuclear option and all, that Obamacare remains the law of the land for the foreseeable future. Enough GOP senators, including Sen. Susan Collins (R-Maine or Sen. Lisa Murkowski (R-Alaska) won’t kick off some 24 million Medicaid subscribers, slated to be phased out of the Senate and House’s bills. Called the American Health Care Act [ACHA], other GOP senators, likes Sen. John McCain (R-Ariz.), also won’t want Arizona’s indigent population losing Medicaid benefits under former President Obama’s 2010 Affordable Care Act [ACA]. Since announced today by Senate Majority Leader Mitch McConnell (R-Ky.), reactions have been muted.
Hardcore House and Senate Republicans don’t want the U.S. government involved in providing health care to working-aged citizens, content to let Medicare cover the elderly and disabled. Expanding Medicaid, single-payer government healthcare to the poor, was not something the GOP wanted when Obama signed the ACA into law March 23, 2010 without one Republican vote. For the last seven years, the GOP has tried to repeal Obamacare over 50 times, all met with Obama’s veto. “From what I understand their [Senate] bill tracks in many ways along the lines of the House bill,” said House Speaker Paul Ryan (R-Wis.). Ryan’s observation reflects the fact that the GOP senators knew that changing the House bill would be a non-starter. Senate’s bill drops waivers, allowing insurers to raise premiums for pre-existing conditions, something that skyrockets insurance premiums.
Extending Medicaid payouts for one year over the House bill, the Senate version does little to assure coverage for the nation’s poorest citizens. Capping federal Medicaid subsidies to the states, the Senate bill ends the Medicaid expansion under Obamacare, saving the government billions but ending coverage for some 24 million Medicaid recipients. Ending the IRS penalty, the Senate’s bill no longer requires Americans to participate in the AHCA, rolling back the tax increase on wealthy taxpayers. While the Senate’s bill uses an economic means test to qualify citizens for coverage, it de-funds Planned Parenthood for a year, creating problems for Mukowski and Collins. Like the House bill, the Senate bill prevents participating health insurers from covering abortions, unless due to rape or incest. “Republicans believe we have a responsibility to act, and we are,” said McConnell on the Senate floor.
Copying the House bill with minor tweaks, McConnell hoped have legislation acceptable to the House and Senate but end up pleasing neither. For all Obamacare’s flaws, it didn’t discriminate against poor people or attempt to water down coverage, no matter what the objections from health insurers. What’s most ironic is that some senators, like Sen. Rand Paul (R-Ky.), Sen. Ted Cruz (R-Tx.), Sen. Mike Lee (R-Ut.) and Sen. Ron Johnson (R-Wis.) won’t support the Senate’s Better Care Reconciliation Act [BCRA] because it doesn’t outright repeal Obamacare. However the bill gets tweaked in committee, it’s doubtful that the Senate can get enough consensus to see the Senate’s bill become law. Apart from what the bill doesn’t cover, it’s far too restrictive to the Medicaid population to cut muster with the independent Congressional Budget Office [CBO], expected to rule next week.
When you drill down into the details, it’s clear the Senate version was more payback to Democrats that imposed Obamacare through a procedure trick back in 2010. “Democrats imposed Obamacare on our country,” said McConnell. “They said it would lower costs; it didn’t. They said would increase choice, but of course, it didn’t,” over-simplifying the issue. When you consider Obamacare offered insurance to citizens with pre-existing conditions, it did lower costs because health insurance was either impossible to get or prohibitively expensive. Pointing to rising Obamacare premiums costs is the fault of Congress not imposing price controls on Obamacare insurers. If some lost their doctors under Obamacare, it wasn’t the intent of the program but related to certain medical groups not participating providers. McConnell wants to blame Obamacare for everything when there were ways to fix it.
Today’s Senate version of health care won’t pass muster even within the GOP. For all Obamacare’s flaws, the system does a far better job of covering uninsured Americans than either the House or Senate version. Simply paying back Democrats for imposing Obamacare isn’t enough to fix the system. As long a McConnell is hell-bent at paying back Democrats, nothing will get done to offer better health coverage to American citizens. “The president said the Senate bill should have heart. But this bill is heartless,” said Sen. Minority Leader Chuck Schumer (D-N.Y.), one of Trump’s biggest critics. There’s no guarantees that either the House or Senate versions of health care will reduce premiums or expand to the vast majority of uninsured Americans. Left as it is, it’s far more likely that Obamacare looks here to stay. Instead of payback, the GOP should genuinely look to fix what’s wrong with Obamacare.
