AFTER VOTING to move forward on repealing and replacing Obamacare — precipitously, and without any sense of where they would end up — Senate Republicans are trying to slap together a major health-care bill on the Senate floor. If their partisan power play works, the result would be the passage of bad legislation hiking deductibles and stripping insurance coverage from millions of people. If, on the other hand, they fail to bridge their disagreements, they may turn to what some are calling a “skinny repeal” and Health and Human Services Secretary Tom Price has termed a “lowest common denominator.” It sounds bad, and it is.
Either result would be an outrageous ending to a process that has been norm-shattering from the start. Republicans’ strategy to end Obamacare unilaterally, through pure force of partisan will, has discredited Congress’s claim to be a deliberative body and utterly failed to produce a workable plan. GOP leaders ought to go back to the drawing board, hold the hearings they never held, reach out to Democrats, wait for expert analysis from the Congressional Budget Office (CBO) and strike a bipartisan compromise fixing the system. But doing so would require Republicans to prioritize substance over delivering their base a long-promised victory on Obamacare.
Their cynicism is visible in the move toward a skinny, lowest-common-denominator bill. The measure would likely end some taxes and the law’s individual mandate requiring all Americans to carry health-care coverage.
On policy grounds, the plan is nonsensical. After Republicans have spent years railing about rising premiums, this proposal would cause premiums to spike by 20 percent, according to a CBO analysis of an earlier version. The existing mandate is aimed at free riders who refuse to pay for health coverage, then demand that society pick up the tab when they go to the emergency room. Without it, some people would decline to buy into the health insurance system, making the pool of customers purchasing coverage in individual markets generally sicker and more expensive. Premiums would have to rise, and the free riders would get a pass.
In reality, Republican leaders view the skinny repeal not as policy but as a way to push the repeal-and-replace effort a little further along. If the Senate passes something — anything — it can begin negotiations with the House on a final bill. Skinny repeal, in other words, would be nothing more than a way for GOP senators to suppress their disagreements by committing to no particular policy at all. This is legislative can-kicking at its most shameless.
In fact, the legislation is likely to only get worse in a House-Senate conference, altered to better resemble the cruel, deservedly unpopular Obamacare replacement bills House and Senate leaders have floated in recent months. But by the time any House-Senate agreement is negotiated and sent back to the Senate for final approval, congressional leaders will be able warn skeptical lawmakers against spoiling things when the party is so close to victory. It is time for Republicans who oppose denying health care to millions of Americans to make their stand. It will only get harder for them to do so later.
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