No matter what version of the Republican health-care scheme it examines, the Congressional Budget Office reiterates the conclusion of Trumpcare’s critics: These proposals are not about expanding affordable health-care insurance. The GOP is conducting an exercise aimed to deliver tax cuts for the rich funded by brutal Medicaid cuts as it tries to undo the federal government guarantee of health-care coverage that the Affordable Care Act created for able-bodied, non-elderly adults. Unfortunately, Republicans are not honest enough to say what they are after, and for good reason. Giving huge tax cuts to the very rich, slashing Medicaid and renouncing the idea that health-care insurance is a “right” turn out to be really, really unpopular.
Just as it did when the Republicans first proposed a “repeal-only” plan, the CBO finds that the current proposal would increase the number of uninsured by more than 30 million over the next decade. (“The number of people who are uninsured would increase by 17 million in 2018, compared with the number under current law. That number would increase to 27 million in 2020, after the elimination of the ACA’s expansion of eligibility for Medicaid and the elimination of subsidies for insurance purchased through the marketplaces established by the ACA, and then to 32 million in 2026.”)
The GOP bill repeals the subsidies but not the required components of health-care insurance coverage. As a result, coverage would quickly become unaffordable for most every American individual health-care market. “Average premiums in the nongroup market (for individual policies purchased through the marketplaces or directly from insurers) would increase by roughly 25 percent—relative to projections under current law—in 2018. The increase would reach about 50 percent in 2020, and premiums would about double by 2026.” Wow, what’s not to love?
This bill, the hard-right Republicans insist, must pass to preserve their seven-year-old promise to repeal and replace Obamacare. A steep increase in premium costs is the response to complaints about steep increases in premium costs. One can only imagine the ads that will run against lawmakers who would vote for such a bill.
The mystery is not why Republican senators would refuse to vote for this monstrosity but how any Republican can, with a straight face, say he or she is improving health care in the United States by voting for this. As we said when “repeal only” was first introduced, the bill would immediately wreck the exchanges, and the health-care system they would bring about would be far worse than under Obamacare and pre-Obamacare coverage.
Vituperative commentators and activists on the right are spitting mad that Republicans cannot get their act together to make good on their promise. They lambaste their fellow Republicans for lack of nerve and for inconsistency. What they do not do much of, if at all, is defend the particular bill on the merits, by the standards the GOP set for itself. The party became convinced that Obamacare was “unworkable,” citing rising premiums and higher deductibles. If Obamacare is unworkable, what is the party’s own work product?
There is something clarifying about the GOP’s return to a repeal-only bill (although who knows whether Senate Majority Leader Mitch McConnell is so rattled by this debacle as to force a vote that would fail and nevertheless haunt Republicans for years to come). It does confirm that the GOP’s anti-government venom — not the particulars of Obamacare or its replacement — is what motivates the Trumpkin/right-wing alliance. At least we can dispense with the pretense that these Republicans want to help Americans by getting rid of Obamacare.