After too much fast talk and too little cold, hard data, the Republican replacement for Obamacare has at last been officially assessed. On Monday, the nonpartisan Congressional Budget Office cut through the rhetoric with the devastating truth that health care experts had predicted: The American Health Care Act would inflict serious pain on millions of Americans.
About 14 million people will lose health coverage by 2018 if the House Republican leadership’s plan is enacted, the CBO estimated. By 2020, that number would rise to 21 million. In all, the plan would nearly double the number of uninsured within the next decade, to 52 million, while jacking up premiums for single policyholders in the next two years by 15 to 20 percent.
So much for the “thing of beauty” promised by President Donald Trump. So much for House Majority Leader Kevin McCarthy’s vow that “though Republicans didn’t create this problem, we’re going to fix it.”
So much for Health and Human Services Secretary Tom Price’s insistence last weekend that “we don’t believe that individuals will lose coverage at all.”
It can come as no surprise that legislation as complex as the Obama administration’s Affordable Care Act can’t be overhauled overnight, as Republicans in Congress are trying to do. Nor should any American be stunned that the GOP’s wishful thinking can’t withstand scrutiny.
The CBO predicts that millions of healthy people will elect not to buy health insurance if the law doesn’t require it, and that millions more will flee as an increasingly sick risk pool initially sends premiums soaring. It is not a bulletin that many millions of low-income people, many of them with severe mental illness, will fall off the rolls as the expansion of Medicaid is gutted.
The CBO holds out hope that younger people will enroll later on, driving down prices. But the bill’s main selling point — that it will shrink the federal deficit — is paid for with a staggering $880 billion cut in Medicaid payments to states over the next decade. Even its fine print is penny-wise and pound-foolish. Its vaunted defunding of Planned Parenthood would mostly just limit access to contraception, the CBO found, adding about $77 million over the next decade to Medicaid costs as impoverished women give birth to unplanned children.
Obamacare has its problems. Premiums are too high, and there are too few doctors in parts of the state and nation. But Republican efforts in recent days to discredit the CBO have made it clear that they know their plan isn’t a fix.
Republicans need to step back, rethink their approach, and put in the hours and analysis necessary to get a workable consensus. What they do will affect health care for a generation.
If they can come up with a plan to improve coverage and insure more Americans, it will indeed, as the president said, be a thing of beauty. But ramming this bill through on an arbitrary political deadline is cynical, and makes you wonder whether well-insured Republicans running Congress have forgotten that they’re dealing with life and death for many of their constituents.