Republican health-care plan struggles in Senate
The Republican effort to repeal and replace the Affordable Care Act faced new obstacles this week as Senate Majority Leader Mitch McConnell struggled to balance the competing demands of GOP moderates and conservatives, and President Trump added complications by calling for more government health-care spending. Senate Republicans are now writing their own version of the House GOP’s American Health Care Act, which narrowly passed the House last month. But Senate efforts suffered a setback last week when the nonpartisan Congressional Budget Office issued its analysis of the AHCA, forecasting that the measure would leave 23 million more Americans without insurance by 2026 and substantially raise premiums for older and sick people. Although Republicans have a 52-48 Senate majority, moderates and conservatives in the chamber are divided over numerous issues, including how much money to spend to provide subsidies, and whether Obamacare’s expansion of Medicaid should be rolled back. “I don’t know how we get to 50 [votes] at the moment,” said McConnell. In a 50-50 tie, Vice President Pence would cast the deciding vote.
Back from his overseas trip, President Trump tweeted that lawmakers should add “more dollars to healthcare and make it the best anywhere.” He appeared to reverse course in a follow-up tweet, urging GOP senators to “add saved $’s.” So far, Republican healthcare proposals are deeply unpopular with voters: 55 percent view the AHCA negatively, and 31 percent favorably, according to a Kaiser Health poll. The poll found 55 percent want the Senate to significantly change or reject the legislation.
What the editorials said
“The senseless cruelty” of the Republican health-care agenda has never been more apparent, said The New York Times. By letting states waive many of the coverage requirements mandated by Obamacare, the AHCA would massively hike premiums for people with pre-existing conditions and leave “millions of others with policies that offer little protection from major medical conditions.” All of this would be done to cut taxes for the wealthy: The top 1 percent would save an average of $37,200 a year. Now only a handful of moderate GOP senators “stand in the way of this retrograde assault on American health care.”
The CBO score merits “a serious grain of salt,” said NationalReview.com. For one thing, many of those 23 million people would happily “choose not to purchase health insurance” because they would no longer be compelled to do so by Obamacare— which fines the uninsured. And the CBO has gotten its figures wrong before: In 2010, it projected that 24 million people would have signed up to Obamacare’s insurance exchanges by 2017. The actual number? “About 11 million.”
What the columnists said
Senate Republicans “are caught in a trap,” said Paul Waldman in The Washington Post. A health-care plan “built on conservative principles of minimal regulation and minimal government-provided insurance” will never offer sufficient coverage for poor, sick, or old people. “Only government can do that.” That means GOP senators have a choice: write a politically toxic plan like the AHCA, or one “that looks a lot like the ACA.” If they’re brainstorming for something true to their beliefs that the public will embrace, “it doesn’t exist.”
“The GOP health-care bill is fixable,” said Avik Roy in The New York Times. The plan’s big problem is its “one-size-fits-all tax credit,” meaning a couple earning $150,000 a year gets the same assistance “as people barely reaching the poverty line.” But if Senate Republicans scrapped that universal tax credit and directed more money to those who need help with premiums—“whether because of old age, ill health, or low income”—their legislation would almost certainly get a better CBO score and more public support.
Liberals would be foolish to assume that Obamacare repeal will die in the Senate, said Perry Bacon Jr. in FiveThirtyEight.com. McConnell is following the same strategy House Speaker Paul Ryan used to squeeze through the AHCA: He’s formed a 13-member group that’s heavy on conservatives and light on moderates to write the legislation. Once conservatives are on board, McConnell, like Ryan, will dare moderates to block the bill and incur Trump’s wrath. Will any senator really risk becoming “the key vote that stops the repeal of Obamacare, the kind of move that could draw a challenger in a GOP primary”?