Movie producers, when they expect poor reviews, often won’t screen a movie for film critics before it’s released, pinning their hopes on advertising and hype to sell tickets.
Something similar must have been behind House Republicans’ release of their plan to repeal and replace the Affordable Care Act.
President Trump is offering up hype via Twitter: “healthcare is coming along great.” And TV advertising is expected as well, but that’s not stopping the rotten tomatoes from landing with a wet smack.
The bill had been locked away — only Republicans were told in which basement room to find the bill so they could read it — until its release on Monday. And rather than wait for the reviews, including a crucial one by its own nonpartisan Congressional Budget Office, House Republicans launched into meetings Wednesday before the House’s Energy and Commerce and Ways and Means committees for mark-up, where amendments are offered up and voted on.
After marathon sessions, one that concluded early Thursday morning, the bill passed both committees on party-line votes. It now goes to the budget committee for reconciliation, then to the House floor.
That’s without giving Democrats and the public a chance to read the bill first. Without committee hearings where testimony from experts and those most affected by the legislation could have been heard. And without information from the CBO, which is expected to provide estimates on what the legislation will cost, compared to the current costs of Obamacare, but also how many millions of Americans could lose health care coverage.
The CBO report — which could be available as early as Monday had House Republicans shown any patience — also should show what effect the legislation will have on the Medicare trust fund, and the changes to Medicaid and how much of that program that states might be expected to fund on their own.
Nevertheless, the critics are pointing out the problems in the American Health Care Act.
Many of the more than 20 million total who gained health care coverage under the ACA are expected to lose coverage under the Republican plan, as could many of 11 million who gained coverage under the ACA’s expansion of Medicaid. Already looking toward re-election in 2018, Republicans have delayed the cuts in their plan. Those who are eligible for Medicaid and sign up before 2020 will not lose their coverage immediately, but those who leave the program, because they find work or get coverage elsewhere, won’t be allowed to rejoin later if their situation changes.
The GOP plan also seeks to limit how much the federal government spends per person on Medicaid, leaving the states to pick up about $370 billion in costs between 2020 and 2027.
Rather than the subsidies provided to low-income Americans under Obamacare, the Republican plan offers a tax credit, based on age. Younger Americans would receive a $2,000 tax credit with which to purchase health insurance, while those 60 and older would receive a $4,000 tax credit. But that won’t pencil out for many older insurance customers, as insurance companies will be allowed to charge them five times what they charge younger customers. Obama-care limits the cost to three times what the youngest customers pay.
Debated during International Women’s Day, the GOP plan seeks to defund Planned Parenthood, beginning with a one-year funding freeze, and would bar the use of tax credits to purchase plans that offer coverage of abortion services. But at the same time, the plan limits the tax credits to $14,000 per family, regardless of how many children a family has.
Oh, and let’s not skip over the $600 billion in tax breaks provided primarily for wealthy individuals and corporations to the disadvantage of low- and moderate-income families.
Republicans have tried to paint the ACA as being near collapse. Yet it has gained in popularity and in enrollment in recent months. As of the end of February, a Kaiser Family Foundation poll found that Obamacare’s favorability had reached an all-time high of 48 percent, compared to 42 percent unfavorability. A Pew Research Center poll, also released late last month, found 54 percent approving of the ACA and 43 percent disapproving.
Other polls have shown a desire for the ACA to be reformed or even expanded. A Fox News poll in January showed only 23 percent wanted Obamacare repealed entirely, while 28 percent wanted it expanded.
No, those aren’t rave reviews from the public, but they show a growing realization of what Obamacare offers in improving health care coverage for millions of Americans and support for reforms that make it work better and improve its affordability and stability.
Democrats aren’t averse to changes to Obamacare.
1st District Rep. Suzan DelBene, D-Washington, who sits on both the Ways and Means and budget committees, said Democrats would work with Republicans to fix the ACA.
“We should always be looking at what’s working and what’s not working and make the investments we need, put that legislation on the table and make those reforms,” DelBene said by phone as she took a break from the committee meeting Wednesday night. “We should be doing that” and not rushing legislation through without the necessary information and proper consideration.
Having now seen the long-awaited Republican sequel to the Affordable Care Act, we have to give it a thumbs down.
Correction: An earlier version of this editorial misstated the committees on which Rep. Suzan DelBene serves. She serves on Ways and Means and the budget committees. Wording also has been clarified to indicate that the more than 20 million who gained coverage through the ACA also includes the 11 million more now served by the expansion of Medicaid.