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Opinion

Opinion: House Republicans are hoping the Senate can save them from their own ruinous healthcare bill

Donald Trump, Tom Price
President Donald Trump, with Health and Human Services Secretary Tom Price, arrives at the Capitol on Tuesday to rally support among House Republicans for their leadership’s healthcare overhaul bill.
(J. Scott Applewhite / Associated Press)

The House GOP leadership has aligned itself so closely with President Trump on healthcare, it’s borrowing his signature sales tactic as it tries to ram through a bill this week to “repeal and replace” Obamacare: the bold but empty promise. Specifically, it’s promising House Republicans a solution to their concerns about drastically increasing insurance premiums for millions of older Americans, but leaving the Senate to figure out how to deliver it.

The leadership released two “manager’s amendments” to its proposed American Health Care Act on Monday evening — one on policy, the other a set of technical changes — that would hasten the repeal of Obamacare’s tax increases while deepening the potential cuts in Medicaid spending. The latter changes were aimed at far-right House members, who’ve complained that the bill wouldn’t do enough to curb federal entitlements.

But numerous other, less ideologically-driven Republicans have balked at the massive number of Americans who would lose insurance coverage as a consequence of the GOP proposal. In particular, by allowing insurers to lower premiums for young people and raise them for older customers, the measure would add thousands of dollars to the cost of coverage for Americans over the age of 50. The bill would also slash premium subsidies for lower-income households and eliminate subsidies for their out-of-pocket costs, rendering insurance and actual healthcare unaffordable for many.

The House leadership simply holds out hope that the Senate will come up with a fix.
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Not to worry! According to a news release by the committee chairmen managing the bill, a provision in one of the amendments — the one that would let taxpayers deduct even more healthcare expenses from their income taxes — would reduce the amount the bill would lower the deficit by $85 billion or so over 10 years. The Senate could use that money instead to “potentially enhance the tax credit for those ages 50 to 64 who may need additional assistance,” the release states.

In other words, rather than proposing a way to help older consumers whose premiums would go up by as much as $8,400 a year, the House leadership simply holds out hope that the Senate will come up with a fix, and that $85 billion will be enough to fund it.

Bear in mind that the bill would reduce subsidies over that same period by almost eight times that amount ($673 billion), by the Congressional Budget Office’s calculation, while also cutting over 10 times as much from Medicaid ($880 billion).

Granted, the point of the bill is to save money for taxpayers and younger, healthier people not covered by large group plans at work. It’s not to extend healthcare coverage, reduce the cost of care or otherwise make the healthcare system work better.

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Nevertheless, the “optics” of this bill, as they say in Washington, aren’t helped in any way by the manager’s amendments. While encouraging states to make deeper cuts in their healthcare programs for the poor (i.e. Medicaid), it would accelerate the tax breaks for high-income Americans, medical device manufacturers, health insurers and other health industry players. More money for the well-to-do, less for the struggling.

Meanwhile, conservative Republicans don’t appear to be mollified by the proposed changes in Medicaid that were designed to win their votes. Despite a blunt warning from Trump, they’re ready to join Democrats in blocking the bill when it comes up for a vote Thursday, the Hill reported.

Trump told House Republicans that voters wouldn’t forgive them if they failed to repeal and replace Obamacare. But even if you believed your political future hung in the balance, with Democrats standing ready to blame you for cost increases that help cause 24 million Americans to go uninsured, would you trust the Senate to solve one of the bill’s most glaring problems? Or would you tell your leaders to come up with a fix before you voted for it?

jon.healey@latimes.com

Twitter: @jcahealey

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