House Republicans and Democrats cast a potentially consequential vote on Thursday to overhaul the U.S. health care system, yet they reacted to the outcome like a pack of inebriated frat boys with no concern for the health of their livers.
Meanwhile, millions of Americans wonder if their household will no longer afford health insurance because a family member suffers from a chronic health condition – or a potentially fatally illness – and they would now be considered an expensive burden on the national health care system. Those with pre-existing conditions are genuinely frightened that, under the American Health Care Act (AHCA) narrowly approved by the House on a partisan line vote, they could no longer pay the price for health insurance.
At the same time, millions of other Americans contemplated whether the high deductibles and premiums they’re paying for faltering Obamacare insurance policies will be alleviated under the AHCA. For families living paycheck to paycheck without employer-provided health benefits, the question is: Will the proposed GOP reforms actually produce lower costs and better care?
Amid this nationwide anxiety, lawmakers living in their respective partisan bubbles within the Washington Beltway treated Thursday’s House vote like a sporting event. The goal was to win the vote, to obtain bragging rights going forward. Us vs. Them. This should surprise no one.
Just prior to the House session, Republican lawmakers gathered for a bizarre final pep talk in the Capitol, with the “Rocky” movie theme song playing at high volume and a ridiculous backdrop portraying World War II Gen. George Patton providing additional inspiration.
After the vote, this juvenile approach to life-and-death issues was followed by a GOP pep rally in the White House Rose Garden with President Trump and Republican lawmakers celebrating their “win” with wild applause and fists thrust into the air.
House Democrats did not come across much better. As the final 217-213 vote in favor of the AHCA ticked down on the House floor, liberal Democrats declared a moral victory. What was on their mind was how the GOP-majority vote could be used to win elections in 2018 and regain Dem control of the House. They began singing “Na-na-na-na, na-na-na-na, hey, hey, hey – goodbye.” And they sounded like a bunch of drunken college students at a home football game taunting their opponent as the clock approaches zero.
But this was not a harmless pigskin game – this was a monumental policy decision that could affect more than 100 million Americans who have true skin in the game.
“After yet another party-line vote in Congress on health care yesterday, we continue to imagine how Washington could be transformed with leaders who represent ‘We, the people’ rather than their own political party,” said Nick Troiano, director of The Centrist Project.
The project’s goal is to elect a small bloc of independent candidates to the House and Senate, giving them enough leverage to force diehard Republicans and Democrats to behave as adults and focus on problem solving.
If Obamacare has not developed as advocates expected, why not search, in a bipartisan, pragmatic manner, for ways to fix the faltering system?
Well, from the standpoint of a typical lawmaker, all issues — even issues that determine whether the seriously disabled or diseased receive proper medical care – presents an opportunity to gain votes in the next election.
How a member of Congress votes depends on their particular political religion, their party loyalty. Rather than engage in an earnest, fix-it process, they depend on faith that their ideology is righteous, and that the opposition’s views are all wrong. Of course, self-preservation, winning re-election, influences every moment of every decision.
As for health care reform, the partisan debate centers on tax subsidies vs. tax credits, health savings accounts, government assistance based on age vs. income, and Medicaid expansion. Objective data on what works and what doesn’t play nearly no role.
Largely missing in the 7-year congressional debate over health care reform is that Obamacare’s Medicaid expansion has unexpectedly produced the biggest impact on helping the uninsured. While Medicaid health care benefits are limited and the access to doctors is constrained, one poll found that nearly 90 percent of new Medicaid enrollees were essentially satisfied with their coverage. That was substantially above the confidence rate of those who gained coverage by shopping on the Obamacare marketplace.
Yet, the AHCA passed on Thursday would halt future expanded coverage of Medicaid and would slash the overall program by more than $800 billion.
As has happened like clockwork in our last several presidential election campaigns, the hot-topic issues that dominate during election season prove to be rather inconsequential once the winner takes (or resumes) the Oval Office.
Unfortunately, the minimal number of Republican moderates who still exist in Congress have been portrayed in the past 24 hours as the group that aggressively finagled the health care bill just enough so that a few extra, essential votes could be secured for passage of the legislation, regardless of the fact that the bill could have dire circumstances for those who face – or will unknowingly face – extraordinarily debilitating medical conditions in the years to come.
At FiveThirtyEight.com, their staff offers a bit of a nuanced look at how the few moderates are affecting this portentous debate as it moves to the Senate:
… Thursday’s vote also reflected the power of a different group: moderate Republicans. Earlier this week, the revised bill looked doomed, mostly because in acceding to the demands of conservatives, GOP leaders had made the bill unacceptable to moderates. (Democrats were almost certain to vote unanimously against any plausible version of the bill, as they did on Thursday.) Winning back enough moderate Republicans to get the bill through the House required another set of concessions (including $8 billion in new funding to support coverage for people with pre-existing conditions). And the House vote was just a preview for the coming battle in the Senate, where moderates wield far more influence.
It would be tough to describe the AHCA as a victory for moderates, or even moderate Republicans. (“Moderate” is a relative term in the GOP, of course. Today’s moderates, especially in the House, are very conservative by historical standards.) Even with that $8 billion, the new bill will significantly erode protections for people with pre-existing conditions, according to most analyses; it will also probably leave millions more Americans without health insurance. But moderates provided the key votes to getting the bill over the finish line, and while the concessions they exacted were modest — the final bill is still significantly more conservative than the previous version — they were a signal that no health care reform will become law without their support. In the Senate (and perhaps also in the eventual conference vote in the House), that could require shaving off some of the legislation’s sharpest edges.
This is the way hyper-partisan politics is played on Capitol Hill. If it requires legitimate negotiations and compromise, a reasonable health care outcome is possible. Still, I find it hard to believe that voters of the independent/centrist/moderate persuasion – the largest electoral bloc in our nation – believe that a “moderate” stand consists of passing a bill that puts the sickest among us out of reach of life-saving health care coverage.
Photo: ABC News screenshot