Republicans' health bill is a bad 'scrip for Pennsylvania
Is Paul Ryan’s new health care bill destined for the scrap heap? We certainly hope so. It’s an unfinished and poorly-envisioned effort that falls far short of Republican promises to replace Barack Obama’s Affordable Care Act with a better alternative.
The plan was lambasted on Tuesday by Gov. Tom Wolf and hospitals around Pennsylvania — and for good reason. It’s bad policy that would leave more people without health insurance and shift costs to the states, hospitals and the poor. It would harm coverage options for elderly people — of which Pennsylvania has a growing number — and roll back any coverage gains seen by disabled people and those seeking help breaking the cycle of addiction.
Perhaps Congress simply forgot that Pennsylvania and nearly every other state in the union are in the throes of an epidemic of opioid and opiate addictions and overdoses.
The numbers floated by critics of the law are staggering. They claim the GOP plan would jeopardize coverage for 3 million Pennsylvanians, two-thirds of them on the state’s expanded Medicaid rolls.
It’s telling that the bill, which GOP leaders are shilling as a “work in progress” (no kidding, they didn’t even bother attaching cost projections to it) can’t even win full-throated support from conservatives. The legislation has come under fire from think-tanks like Heritage Action for America, lawmakers in the GOP’s Freedom Caucus, Republicans in the Senate, and conservative policy wonks across the board.
The critiques are understandable, given that despite the bill’s promises to repeal and replace, there’s not actually much of that going on within the Republican proposal.
The GOP plan does away with some taxes — paid by the wealthy to support the ACA — as well as Obama’s individual and employer mandate to buy insurance. But that’s where “repeal and replace” stops. Regulated and subsidized individual insurance and an expanded Medicaid program (albeit smaller than under Obama’s law) are still central tenets of the GOP’s formula.
So after eight years of vowing to strike ObamaCare down completely, Republicans have essentially admitted that their idea for improving American health care is no different from Obama’s. This isn’t a free market alternative to government-run health care. It’s just a quibble over what combination of Medicaid expansion and a subsidized and regulated individual insurance marketplace works best.
And as we said above, if the argument is about details then GOP leaders in the House forgot to include some pretty vital ones in their proposal. How much would it cost? How would we pay for it? How many people would lose insurance? How would the markets react?
On Wednesday and Thursday the bill cleared initial hurdles in the House without any of these questions having been answered by the non-partisan Congressional Budget Office.
Our best guess is that this bill isn’t a serious attempt to refine health care law. It’s a sacrifice that Republicans have offered up so they can claim they at least tried to live up to their promises to repeal and replace the Affordable Care Act with a better system.
If this is the best they can do, they have every reason to fear the wrath of their constituents come election season.