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GOP healthcare mess

Crass politics drove the latest push to overturn the Affordable Care Act


One of the basic principles of the medical profession is, first do no harm.

It’s a principle that seemed all but forgotten by the Republican politicians in Washington as they scrambled desperately this week to reach 50 votes for the so-called Graham-Cassidy bill, the latest iteration of their “repeal and replacement” of the Affordable Care Act, otherwise known as Obamacare. They failed again, but that should provide little comfort to Americans.

We know why this effort rose from the dead, and why now. The Republicans got their marching orders from their big donors during the August recess. They continue to expect repeal of Obamacare, even if Obama’s reform law is based almost entirely on conservative principles hatched in the hallowed halls of the conservative Heritage Foundation and first implemented by then-Massachusetts Gov. Mitt Romney. But then this isn’t about policy, it’s about a name— Obama, and about undoing the legacy of America’s first black president.

That’s the why—the why now was just as crass. The GOP faced a Sept. 30 deadline to pass a repeal bill under the budget reconciliation process. In short, that meant they could get rid of Obamacare with just 50 votes, using Vice President Mike Pence to break the tie. After that, the GOP would need some Democratic votes to pass a health care bill, and Democrats aren’t voting for a bill that would wipe out health insurance coverage to tens of millions of Americans.

But the vast majority of Republicans will, as they’ve proven time and again over the past several months. While the Affordable Care Act has its problems, it at least included a coherent design, and was assembled through more than a year of detailed hearings and deliberations between health care experts and lawmakers. It was complex and it didn’t work for everyone. But for the vast majority of Americans, particularly those in the most need, the new law has made insurance better, more comprehensive, and more affordable. The evidence of that is provided in the simple fact that the number of uninsured Americans has been cut in half since the law took effect.

The latest Republican alternative was no plan at all. After GOP leaders in Washington failed to agree on how to craft a “conservative,” market-oriented healthcare system (which is difficult since Obama beat them to it in 2010), they turned to Graham-Cassidy, which essentially punted the issue to the states, minus a lot of federal funding.

How would that have affected the ability of tens of millions of Americans to obtain quality health insurance that actually protects them in the event of illness or accident? The vast majority of GOP senators didn’t know and didn’t care. They never consulted healthcare experts, doctors, hospital directors, or patients’ groups. Their only guide star was getting to 50 votes. The impact to Americans was entirely irrelevant to the discussion.

Iowa Sen. Chuck Grassley said he could think of at least ten good reasons to oppose Graham-Cassidy, but he said he planned to vote for it anyway, although the bill was ultimately pulled. The Republican money men had said they wanted a bill—any bill— to repeal Obamacare, and the vast majority of GOP senators were happy to oblige, as long as the campaign coffers remain well-endowed.

Never mind that Graham-Cassidy was, effectively, a hand grenade tossed into the midst of one-sixth of the American economy. Never mind that it would have pushed tens of millions of Americans off of insurance and allow insurance companies to sell stripped-down policies at unaffordable prices that offer little more than the illusion of coverage. This is pure, raw politics. Intelligent policy and the well being of Americans had absolutely nothing to do with it.

Which is why it’s no surprise that President Trump loved it, calling it “GREAT” on Twitter last week. “Ends Ocare!” he concluded. That, of course, is the extent of the president’s knowledge or concern about the measure. Much to his surprise, it turned out that healthcare was complicated stuff, and he has more important things to worry about, like distracting Americans with silly and divisive fights over the NFL of all things.

With senators like these, and a demagogue like Trump in the White House, Americans can’t let their guard down when it comes to healthcare.


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