SEN. SUSAN COLLINS (R-Maine) was asked Sunday whether the health-care bill the House of Representatives passed last week would, as its GOP boosters insist, improve coverage and preserve patient protections. “I think that’s unlikely,” she responded. “Unlikely” was a kind way of putting it. Ms. Collins’s comments came on the same morning that Trump administration officials and House Speaker Paul D. Ryan (R-Wis.) made several indefensible claims about the bill they championed, despite widespread condemnation from experts, wariness from industry and concern from more sensible members of their own party.
Health and Human Services Secretary Tom Price, for example, was confronted with the fact that the House bill would slash over 10 years more than $800 billion from Medicaid, the health program for the poor and near-poor, even though President Trump campaigned on not cutting that program. Mr. Price claimed that the bill contains “no cuts to the Medicaid program” because Medicaid spending would rise every year. In fact, The Post’s Fact Checker found, spending would not rise every year, but drop significantly in absolute terms in 2020 and take years to recover. Besides, the more pertinent number is how Medicaid spending would change relative to what it would be without the bill: That adds up to a 25 percent cut over a decade. In a related dishonest claim, Mr. Price also insisted that the bill would “absolutely not” cause millions of people to lose Medicaid coverage, even though it would phase out the Obamacare Medicaid expansion, causing people to lose eligibility over time.
Mr. Ryan, meanwhile, argued that the cuts would not hurt anyone because there would be no more “micromanagement of Medicaid by the federal government.” Unsurprisingly, the Congressional Budget Office disagrees with Mr. Price and Mr. Ryan’s prediction of no harm, finding that 14 million fewer people would have Medicaid coverage by 2024, contributing to the massive 24-million-person coverage loss the CBO projected for an earlier version of the bill.
Confronted with the CBO’s damning estimates, Mr. Ryan insisted that the loss of insurance would be by choice, not a matter of necessity. On preexisting conditions, meanwhile, the speaker claimed that, under the House bill, “you cannot be denied coverage if you have a preexisting condition.” Perhaps, but insurers could potentially raise sick people’s premiums so high that it would amount to a denial. They would be left to the mercy of whatever system their states would design to catch those who fell through the bill’s wide cracks. Experts, along with Ohio Gov. John Kasich (R), warn that the bill would drastically underfund state high-risk-pool programs for vulnerable people — even if states tried to set them up according to strong standards.
Then, of course, there is the mistruth that undergirds the whole repeal-and-replace crusade: that Obamacare is facing inevitable collapse. Any collapse would be a result of willful Republican negligence. If Mr. Trump and Congress had made clear they would manage the current system responsibly, rather than leaving even basic policy matters in doubt, insurers would have been more likely to stay in the system. If Republicans had promoted bills that addressed the system’s real problem — insufficient incentives to obtain insurance coverage — companies might even have been enthusiastic. They did neither.
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