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Senate health care bill shows GOP has learned nothing

Sometimes Trump is his own worst enemy


The new health care bill released by Senate Republicans has exactly the same major flaw that the original proposed “American Health Care Act” did. As such, it does not fix the problems with the Obamacare exchanges. Rather, their decline will continue apace.

From USA Today:

The Senate plan does not include a House provision that would let states get waivers to allow insurance companies to raise premiums on some Americans with pre-existing medical conditions. Both the House and Senate bill would phase out the expansion of Medicaid eligibility, but the Senate bill does it more slowly.

Health insurers will eventually leave the exchanges if Congress does not allow them to either deny coverage to people with preexisting conditions or charge them higher premiums based on their preexisting conditions. The reason is simply that too many otherwise healthy people will simply wait until they get sick to sign up. Under those conditions, insurers can’t make any money and end up leaving the market.

Obamacare’s ban on denying coverage to those with preexisting conditions is why the exchanges are slowly imploding. (See the exchange-implosion map here.) In short, the GOP Senate bill leaves in place what is arguably Obamacare’s worst feature.

It is undoubtedly the Republican moderates in the Senate who are responsible for keeping the preexisting conditions “protection” in place – for two main reasons. First, they are worried that if they eliminate it they’ll be attacked as heartless come election time. Second, as I’ve noted before, it seems they don’t understand how insurance markets work.

Nor, it appears, does President Donald Trump. When Trump stupidly referred to the House bill as “mean,” he was almost certainly referring to the provision in that measure that lets insurers charge higher premiums to those with preexisting conditions in states that have received a waiver from the federal government.

That increased the pressure on Senate Republicans to keep Obamacare’s preexisting condition “protection.”

Today Democrats copied Trump’s language to attack the new legislation. Senate Minority Leader Chuck Schumer (D-N.Y.) said, “The president said the Senate bill needed heart. The way this bill cuts health care is heartless. The president said the House bill was mean. The Senate bill may be meaner.”

Too often Trump is his own worst enemy.

There are ways to help people who have a preexisting condition without destroying health insurance markets. I’ve laid out one here.

Republican moderates and Trump need to ask themselves two questions. First, what is meaner: Letting states waive the preexisting condition protection, or allowing insurance markets to fail so that millions of people have no access to insurance?

Second, how do they think it will play out politically when the blame for the exchanges’ implosion shifts from the Democrats to the Republicans?

Pass this bill the way it is, and that is exactly what will happen.

The Author

David Hogberg

David Hogberg is a writer living in Maryland. He is author of the book, "Medicare’s Victims: How the U.S. Government’s Largest Health Care Program Harms Patients and Impairs Physicians."