One can imagine a bizarre contest among Republicans as to who can say the most insulting, unhelpful remarks about health-care reform, sure to reinforce the stereotype that Republicans are the party of the rich.
Rep. Jason Chaffetz (R-Utah) piped up that for those claiming health-care insurance is not affordable “maybe rather than getting that new iPhone . . . maybe they should invest it in their own health care.” (An iPhone 7 retail costs nearly $800; health-care insurance varies by state but in many parts of the country can cost more than $3,000 for a single, young person. As for families, “The costs of providing health care to an average American family surpassed $25,000 for the first time in 2016 — even as the rate of health cost increases slowed to a record low,” according to an analysis CNBC reported on last year. “The $25,826 in health-care costs for a typical family of four covered by an employer-sponsored ‘preferred provider plan’ is $1,155 higher than last year, and triple what it cost to provide health care for the same family in 2001, the first year that Milliman Medical Index analysis was done.”
Then House Speaker Paul Ryan (R-Wis.) blithely declared that coverage didn’t matter. “What matters is that we’re the lowering costs of health care and giving people access to affordable health care plans. The government will always win the war on government-run plans, saying, if we mandate everybody buys what we say they have to buy, then the government will always estimate that they’ll buy it. I just think that’s bogus, that entire premise of that comparison doesn’t work.” Actually coverage matters a lot to those who are losing it, or those whose “access” will cost more for less coverage than it did under the Affordable Care Act. Dismissing the concern that 10 million to 20 million will lose coverage is politically daft.
And when Ryan says only cost matters, he’s asking for trouble. Many people will pay more out of pocket under the GOP plan while the rich (over $200,000 for an individual) get a huge tax cut by rolling back the ACA’s Medicare surcharge on net investment income (3.8 percent) and on wages above the threshold (0.9 percent). Moreover, insurers and actuaries point out that as long as you keep the ACA provision that bans annual or lifetime limits, health-care providers have an incentive to charge more for service.
And to top it off, the Office of Management and Budget director Mick Mulvaney opines that “insurance is not the end goal here, is it?” Unfortunately, for tens of millions it is. He asserts actual care will be more accessible, but for virtually everyone access is only possible with insurance.
It’s hard to tell how the GOP intended to sell this plan to the public. Right now their game plans consist of the following: Declare Obamacare is dead or dying; underplay principled conservative resistance; dismiss concerns about tens of millions losing coverage; and don’t tell people how much it costs, who benefits and who loses coverage. No wonder they are trying to rush this through. Nevertheless, the plan is so obviously flawed, both politically and substantively, that opposition formed almost instantaneously. (Joining AARP, the American Medical Association and the American Hospital Association have come out against the bill. Fortune reports, “Plenty of other, smaller or specialty trade associations have also expressed deep concerns with the bill, including the American Academy of Pediatrics, the American Psychiatric Association, and the Federation of American Hospitals.”)
This firestorm explains why Republicans from Sen. Tom Cotton (Ark.) to Sen. Lindsey Graham (R-S.C.) have urged the House to slow down. That’s fine advice, but what the House really needs is an about face.